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We live in a world of finite resources, a world in which non-profits need to ensure that they are optimizing the impact of their funding.  We measure and evaluate, conduct outcomes analysis, gauge opportunity costs and calculate social return on investment.  These exercises are important to be sure, but they only capture a part of the story.  Not everything that counts can be counted, and not everything that matters fits neatly into a report.  That is why I was so excited that some of AARP Foundation’s staff and board of directors recently conducted a site visit of a “Green House” model for long-term care, in which AARP Foundation has an impact investment.

The first thing that struck me was how well-lit the Green House was.  Sunlight flowed into the bedrooms through windows that took up nearly entire walls.  A gentleman in his nineties, whom we visited, sat in a rocking chair in the corner of his room.  The curtains decorating his window, along with most of the furniture in the room were brought from his home when he moved to The Green House Residences at Stadium Place in Baltimore, Maryland.

The Green House residents all have private rooms and also a lot of freedom compared to residents of traditional nursing homes.  Every day they each freely decide when to get out of bed, whether to shower, and how to socialize with the other residents.  Just down the hall from the bedrooms is the kitchen, and residents could eat whatever and whenever they want, although group meals are served three times a day.  The residents work with the staff to plan group meals, and if a few residents decide that they want to go shopping at the mall one day, the staff accommodates their request.

The staff seemed happier than those of a traditional nursing home.  Each staff person worked with only 2 to 3 residents, to whom they were permanently assigned.  Rather that every staff person specializing in one aspect of many residents’ lives: bathing, dining, putting to bed; the staff helped a small number of residents with all aspects of their existence.  This allowed the staff to truly bond with the residents, something that those who work in this low-paying, caring profession really do value.

While there are many measureable benefits of the Green House: improved health outcomes, reduced hospital admissions, reduction in costs from staff turnover; there are also many benefits of the model that are harder to convey.   The dignity of self-determination, the joy of building relationships with caregivers, the comfort of a pleasant environment:  all of these things are important to residents.  But it takes a bit more effort to really weigh their value.  Site visits are a great opportunity to learn more about the measurable and immeasurable benefits of a program, and it’s a practice that I hope AARP Foundation’s staff and board will continue to leverage as we seek to improve the lives of vulnerable older adults.

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