I’ve been thinking a lot about a comment I received last week. I was speaking at a grant funders’ luncheon about the Green House model. I had mentioned at the outset that long-term care costs were untenable, but so were the costs of aging in place, each to his or her own home.
After presenting the Green House model, one of the funders (astute fellows, they) asked me about the operating costs. I proudly told him that the current experience has shown the costs to be the same as traditional long-term care and some operators feel they may be slightly less, (though that depends on how you do the numbers).
His response, which made me think, was that even though we have a model for aging in community that has positive outcomes, we still haven’t succeeded in addressing the high cost of nursing homes, if operating costs are not significantly better.
So that’s what I am wrestling with. Here’s what I know so far:
– Institutional long-term care is a broken model. The Eden Alternative and other strong models of person-directed care remain the most viable pathways for those who are trying to move away from an institutional approach.
– The Green House has the potential to further harness the Eden philosophy and create superior quality of life with equal or better quality of care. If elders need to be cared for in a congregate setting, this model, with a strong Eden foundation, seems to be the best option out there.
– The community Green House (as we are developing at St. John’s) can further harness the power of social capital by weaving Green Houses into the fabric of multigenerational communities.
– But none of this really addresses the rising cost of elder care. (Today, BBC.com states that in the U.K., that cost may triple by 2050.)
The answer seems to lie in the larger domain of community planning. It’s bigger than just what kind of facility provides care, even bigger than the philosophy of person-directed care. The Eden philosophy is incredibly valuable as a central touchstone, but ultimately we need to address the demographics of having more elders per younger adult, and the resulting financial implications.
I believe we need to harness the experiences of elders in a way that not only helps us provide care and sustenance for them, but also enables the community to receive the gifts of their wisdom and perspective in a material way, one that actually sustains the community and provides resilience and financial stability. We are not there yet.
What is the box we still haven’t broken through? What comes next?