Webinar: Small Homes, Big Change!

On December 6th, 2023, Family Councils Ontario and CARP Ottawa welcomed Alex Spanko, Director of Communications and Marketing at the Green House Project to present Green House principles and practical strategies to long-term care advocates, staff, and family councils. This presentation seeks to encourage the development of Green House homes and person-directed living practices in Canada.

Watch the webinar recording here:

First Green House Homes Outside the U.S. Open in Australia

A Green House Dining Room (copied with permission)

ACH Group in Australia recently opened Healthia, the first full implementation of the Green House Care model outside of the United States.

Susan Ryan, CEO of the Centre for Innovation, said “Working with the ACH Group to implement the Green House model has shown the world that small, intentional care communities can work everywhere.”

In its news release, it noted that the Green House Project (GHP) has worked with providers across the United States to build small-home alternatives to traditional nursing homes. With private rooms and bathrooms, ample outdoor space, and a person-directed care philosophy, these homes of no more than 10 to 12 residents have redefined the standard for empowering and high-quality eldercare.  Click here to read more

The GHP is one of several innovative models that transform long-term care homes from ‘institutions to homes’; other models include  but are not limited to: Eden Alternative, the Butterfly Approach, and Hogeweyk.

Transformation is happening and there are Homes in Ontario, Canada, and beyond who have changed their Institutions into Homes! Please join us as Champions for Change in Long-term Care Now by forwarding this post to your contacts, MP, MPP and city councillor.

Quebec is all action in transforming its long-term care homes from institutions to homes


The Hover Green House,  copied with permission

In his presentation on May 17th, Stéphane Bouffard, long-term care consultant at la Ministère de la santé et des services sociaux in Quebec, was passionate when he spoke about the approach being taken to transform all long-term care homes from institutions to homes.  With good reason!

Quebec seems to be ‘all action’ as noted by CBC news in its posting on May 22nd, 2023, “Quebec announces 1st private CHSLDs to get government funding as province moves to fund all”  Click here to read more .    Quebec is taking seriously the need for drastic change to transform its long-term care home system and ensure that residents in any home receive quality care and have quality of life.

Please join us as Champions for Change Long-term Care Now from Institutions to Homes by forwarding this post to your contacts, MPP and city councillor.

Webinar: Overhauling Quebec’s long-term care homes with small more “humane’ homes

A Green House Dining Room

At the May 17th webinar, Stéphane Bouffard, long-term care consultant at  la Ministère de la santé et des services sociaux in Quebec, spoke in no uncertain terms about the progress that is being made to do just that.  His passionate presentation outlined Quebec’s strategic plan to transform long-term care homes from institutions to homes where the focus on new builds has already begun.   The projected size of the units will range from 12 to 15 residents and the care approach has been adapted from existing innovative models including the Green House, and the Hogeweyk Village model.


3. Did you know that………

Did you know that staff turnover is less in the Green House model of care?

For nearly two decades, The Green House Project, an emotion-based model of care, has received praise and positive media coverage for bringing the humanity back to eldercare. But while the model itself is a major departure from the status quo, the math behind it is quite straightforward: Operators that adopt Green House principles find themselves with fuller communities, a more engaged and satisfied workforce, substantially lower risk of COVID outbreaks, and costs that are either in line with or lower than traditional facilities, which typically operate with much greater overhead.

Green House’s unique staffing structure results in greater workplace satisfaction and lower levels of stress for frontline caregivers. Staff turnover is substantially lower than traditional nursing facilities: In 2021, Green House homes had a CNA (Certified Nursing Assistants), much like our PSWs, turnover rate of 33.5%, compared to nearly 130% among traditional nursing facilities prior to the pandemic. Read more here


Emotion-based model of care is one which has smaller environments, 8-16 residents/unit; communal dining room and kitchen; where full-time staff actually know their residents and where residents, staff and families are all valued as a part of the team sharing times of laughter, joy and meaningful activities.

What is most important is that your family member has quality of life in the years remaining. Learn more about emotion-based models of care at www.changeltcnow.ca and contact your MPP now to advocate for emotion-based models of care in all our long-term care homes!

Please help us as champions of emotion-based care for Ontario’s long-term care homes by forwarding this post to your contacts or by sharing on your Facebook, Twitter or Instagram accounts.



Bravo to Quebec: a re-imaging of long-term care homes


A Green House Dining Room (copied with permission)

A recent article in the Globe and Mail (Ontario edition) noted that “Quebec aims to eliminate the indignities of institutional living with the Green House model, a re-imagining of long-term care homes”.  Click here to read more

The Green House model is one of several innovative models of care that feature a safe home-like environment and where relationships matter.  Other innovative models include the Eden Alternative, the Butterfly Home, and the Hogewey Village.

Consistently both before and during the pandemic, long-term care homes where an innovative model was implemented have fared better in so many ways: decrease in staff sick days, decrease in antipsychotic medications, decrease in falls causing injury, fewer Covid cases and fewer deaths caused by Covid, to mention just a few.

While there has been some progress with innovative models in several provinces in Canada, Quebec is the first to show leadership with a provincial strategy that has what it takes to significantly and positively change the face of long-term care homes as we know it.

Ontario missed an excellent opportunity to lead the way when its Independent Long-term care Covid-19 Commission recommended that the Government implement an innovative model in its homes, one of several recommendations in the Commission’s Report.   We encourage you to write to your MPP and demand that the government invest in a provincial strategy to implement emotion-based care within all LTC homes in Ontario.




Leadership Matters: How to make a LTC Home a “home”

On June 8th, Rebecca Priest presented a webinar on the importance of leadership in emotion-based models of care. A leader herself, Rebecca has spent 20+ years working with seniors, serving as a social worker, Green House Guide, and Licensed Nursing Home Administrator and Chief Operating Officer for a large non-for-profit serving elders in upstate New York. 

Rebecca said that a leader is one who:

  • really listens to elders in the home as well as the staff who support them.
  • Wants to hear views from all involved.
  • Values people and partnerships.
  • Fosters relationships between elders, staff and families.
  • Believes all staff are good and want to do a good job.
  • Is not necessarily the person with the title.

“Leadership is not associated with role but with influence.” This person “knows” his/her staff and empowers them in their role. Rebecca’s presentation also compared the Green House model to traditional LTC homes in terms of staff turnover, satisfaction rates, and clinical outcomes. In all cases the Green House model was assessed at better levels. (See ppt here)22 Green House – Leadership and relational models of LTC ppt June 8

“Good relationships lead to good clinical outcomes.” The Green House model is one example of an emotion-based model of care that ensures that all elders live life!

Kudos to the CBC!


Kudos  to CBC for its recent encouraging report on the Green House – a successful initiative in long-term care homes in the United States.

The top two floors of this building just blocks from the Canadian border in Detroit, Michigan, house another Green House Project home. Advocates say the model is adaptable to larger cities as well as rural areas and smaller communities. (CBC News)

In her news article posted on December 12th, Melissa Mancini, a producer with The National, focuses on how smaller long-term care homes can help address big elder-care issues.

As noted in the previous blog post, the Green House model has been implemented extensively in long-term care homes in the United States with proven positive results both in for-profit and non-profit homes, including experiencing fewer number of cases and less deaths than traditional homes during COVID-19.

“It’s a model of nursing home care that allows people to live life in retirement as close as possible to the way they did in their adult lives. It starts with the building — small homes with just 10 or 12 seniors living in them — and extends throughout all aspects of life there”.

“There are 38,000 people waiting for a spot in long-term care homes in Ontario alone and the government is preparing to build hundreds of facilities to meet demand, but some say we should also be reshaping how elder care is offered.”

“I would really challenge those that are investing in this to look at alternatives that are out of the box,” said Tammy Allison, who runs a small long-term care home in Monclova, Ohio. “You can do long-term care differently and you can do it better. And we feel like we’re doing that.”

To read the full article and see related-videos (including interviews of residents with CBC’s David Common), click here

Before we know it Ontario’s provincial election will be here. You have a voice – make bringing an innovative model such as the Green House or the Butterfly Home to long-term care homes a priority and a ballot box issue!



The Green House Model: A Blueprint for Change

Leonard Florence Center for Living outside Boston, Massachusetts

On November 24th, around 200 people registered for the webinar, The Green House Model: A Blueprint for Change. Susan Ryan, Senior Director of The Green House Project gave a dynamic presentation on the model and its positive impact on the lives of elders in the United States. The Green House model is “revolutionizing care and empowering lives’’ Susan said.

Here are just a few key comments that Susan shared about this emotion-based model of care:

  • During COVID-19, every Green House home fared much better in number of cases and less deaths than traditional homes. Smaller is better!
  • A meaningful life is about relationships, autonomy and control, purposeful engagements, honouring natural rhythms, and social connectedness.
  • Transformative culture change is all about deinstitutionalizing long-term care
  • We all want/need to be seen, heard and known as unique individuals
  • Ongoing learning is required by all for sustainability of any culture change.

Please listen and share this inspiring presentation.   Click on the link here.


The Green House: Made for this Moment

Over 290 Green House model long-term care homes exist in the United States and their focus is to deinstitutionalize, destigmatize and humanize care.

The model can be built as stand- alone small homes often 12 to a “home”, or a cottage model having two floors with a Green House model on each floor, or in a vertical building of over 200 residents with elevator access and smaller “homes” inside. There is a separate kitchen, living room, dining room, private or semi-private rooms and bathrooms. Resident rooms have a front door with a door bell and it looks welcoming. Meals are cooked in their “home”, there is consistent staffing who carry out cooking, cleaning and assistance with personal care and each “home” has access to the outdoors. The point is, the environment and life within the home is “homelike”.

When the pandemic hit, it became apparent that the small homelike aspect of this model, fewer staff entering the home, as well as staff having a consistent assignment, all helped to save lives. The advantage of smaller units of elders is that there are fewer infections and there is more ability to control exposure to infections. This is not to say that there were no COVID-19 cases in Green House homes but there were significantly fewer cases and deaths than those housed in institutional settings. Take a look at this short video: Green House: Made for this Moment – YouTube

The pandemic was a terrible tragedy for those living in long-term care homes and we have no way of knowing whether another pandemic will occur. The Green House model provides a safe home for its residents.  There are other innovative models of care such as the Eden Alternative, Hogewey Village and the Butterfly models. All promote safe “homelike “environments. Please do your part to bring transformative culture change to long-term care homes in Ontario. Write to your MPP or to your City Councillor, or write a letter to the editor, or any other action that you think will help to promote a quality, dignified life for our seniors living in long-term care homes.


Another innovative model in long term care homes

Did you know ….

  • 46% of residents have demonstrated some level of aggression with the most common type being “resistance to care.”
  • Normal daily home activities and creative care that is individualized for each resident will maximize functioning and quality of life.

Blog cartoon

Here is another innovative model that was implemented (even though it hadn’t been done before) and it worked – The Green House Model – not the gardening kind…

 “THE GREEN HOUSE® Residences at Bartram Park in Florida offers Assisted Living to individuals living with Alzheimer’s and other dementias.  The Green House Project counts 242 licensed homes in 32 states to date, with 150 more in various stages of development. https://www.bartramlakes.org/memory-care/what-is-the-green-house-model/

We know the Ontario Ministry of Health will be funding 5000 new beds by 2021/22.  This is an excellent opportunity to inspire innovation

If you agree, please ask your MPP to urge the Ministry to dedicate funding for these new beds to organizations that will commit to an innovative environment such as The Green House or other models we have highlighted in previous posts. The same old Ontario model is not good enough.  For a list of all the Ontario MPPs and their contact information click here

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“You never change things by fighting the existing reality.  To change something, build a new model that makes an existing model obsolete.” R. Buckminster Fuller.  

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