The Green House Project: A Practical Guide for Families Planning Senior Care

1. What is the purpose?

For Green House homes, step 1 starts with the older adult’s preferences, daily routine, and present abilities. Ask what the person wants, what feels burdensome, and what has changed recently. A diagnosis, a brochure, or another family’s story cannot answer those questions alone. Use plain language, give the person time to respond, and pay attention to comfort, refusal, and nonverbal cues. Relatives and staff can add context when communication is difficult, but the person’s experience remains central. This is consistent with person-centered care guidance from the National Institute on Aging (National Institute on Aging, n.d.).

In step 1, make the discussion concrete. Identify the daily tasks, cost, safety concerns, and person responsible for follow-up. A dated note after a trial, visit, or conversation is more reliable than memory during a stressful week. Ask an appropriate clinician, pharmacist, veterinarian, facility nurse, or other qualified professional when a question crosses into their expertise. A flexible plan allows the family to adjust when health, capacity, setting, or the older adult’s wishes change. It should never promise that Green House homes will solve every challenge.

2. Who should decide?

For Green House homes, step 2 starts with the older adult’s preferences, daily routine, and present abilities. Ask what the person wants, what feels burdensome, and what has changed recently. A diagnosis, a brochure, or another family’s story cannot answer those questions alone. Use plain language, give the person time to respond, and pay attention to comfort, refusal, and nonverbal cues. Relatives and staff can add context when communication is difficult, but the person’s experience remains central. This is consistent with person-centered care guidance from the National Institute on Aging (National Institute on Aging, n.d.).

In step 2, make the discussion concrete. Identify the daily tasks, cost, safety concerns, and person responsible for follow-up. A dated note after a trial, visit, or conversation is more reliable than memory during a stressful week. Ask an appropriate clinician, pharmacist, veterinarian, facility nurse, or other qualified professional when a question crosses into their expertise. A flexible plan allows the family to adjust when health, capacity, setting, or the older adult’s wishes change. It should never promise that Green House homes will solve every challenge.

3. What needs checking?

For Green House homes, step 3 starts with the older adult’s preferences, daily routine, and present abilities. Ask what the person wants, what feels burdensome, and what has changed recently. A diagnosis, a brochure, or another family’s story cannot answer those questions alone. Use plain language, give the person time to respond, and pay attention to comfort, refusal, and nonverbal cues. Relatives and staff can add context when communication is difficult, but the person’s experience remains central. This is consistent with person-centered care guidance from the National Institute on Aging (National Institute on Aging, n.d.).

In step 3, make the discussion concrete. Identify the daily tasks, cost, safety concerns, and person responsible for follow-up. A dated note after a trial, visit, or conversation is more reliable than memory during a stressful week. Ask an appropriate clinician, pharmacist, veterinarian, facility nurse, or other qualified professional when a question crosses into their expertise. A flexible plan allows the family to adjust when health, capacity, setting, or the older adult’s wishes change. It should never promise that Green House homes will solve every challenge.

4. How is safety supported?

For Green House homes, step 4 starts with the older adult’s preferences, daily routine, and present abilities. Ask what the person wants, what feels burdensome, and what has changed recently. A diagnosis, a brochure, or another family’s story cannot answer those questions alone. Use plain language, give the person time to respond, and pay attention to comfort, refusal, and nonverbal cues. Relatives and staff can add context when communication is difficult, but the person’s experience remains central. This is consistent with person-centered care guidance from the National Institute on Aging (National Institute on Aging, n.d.).

In step 4, make the discussion concrete. Identify the daily tasks, cost, safety concerns, and person responsible for follow-up. A dated note after a trial, visit, or conversation is more reliable than memory during a stressful week. Ask an appropriate clinician, pharmacist, veterinarian, facility nurse, or other qualified professional when a question crosses into their expertise. A flexible plan allows the family to adjust when health, capacity, setting, or the older adult’s wishes change. It should never promise that Green House homes will solve every challenge.

5. What should be recorded?

For Green House homes, step 5 starts with the older adult’s preferences, daily routine, and present abilities. Ask what the person wants, what feels burdensome, and what has changed recently. A diagnosis, a brochure, or another family’s story cannot answer those questions alone. Use plain language, give the person time to respond, and pay attention to comfort, refusal, and nonverbal cues. Relatives and staff can add context when communication is difficult, but the person’s experience remains central. This is consistent with person-centered care guidance from the National Institute on Aging (National Institute on Aging, n.d.).

In step 5, make the discussion concrete. Identify the daily tasks, cost, safety concerns, and person responsible for follow-up. A dated note after a trial, visit, or conversation is more reliable than memory during a stressful week. Ask an appropriate clinician, pharmacist, veterinarian, facility nurse, or other qualified professional when a question crosses into their expertise. A flexible plan allows the family to adjust when health, capacity, setting, or the older adult’s wishes change. It should never promise that Green House homes will solve every challenge.

6. How is it reviewed?

For Green House homes, step 6 starts with the older adult’s preferences, daily routine, and present abilities. Ask what the person wants, what feels burdensome, and what has changed recently. A diagnosis, a brochure, or another family’s story cannot answer those questions alone. Use plain language, give the person time to respond, and pay attention to comfort, refusal, and nonverbal cues. Relatives and staff can add context when communication is difficult, but the person’s experience remains central. This is consistent with person-centered care guidance from the National Institute on Aging (National Institute on Aging, n.d.).

In step 6, make the discussion concrete. Identify the daily tasks, cost, safety concerns, and person responsible for follow-up. A dated note after a trial, visit, or conversation is more reliable than memory during a stressful week. Ask an appropriate clinician, pharmacist, veterinarian, facility nurse, or other qualified professional when a question crosses into their expertise. A flexible plan allows the family to adjust when health, capacity, setting, or the older adult’s wishes change. It should never promise that Green House homes will solve every challenge.

7. When should it change?

For Green House homes, step 7 starts with the older adult’s preferences, daily routine, and present abilities. Ask what the person wants, what feels burdensome, and what has changed recently. A diagnosis, a brochure, or another family’s story cannot answer those questions alone. Use plain language, give the person time to respond, and pay attention to comfort, refusal, and nonverbal cues. Relatives and staff can add context when communication is difficult, but the person’s experience remains central. This is consistent with person-centered care guidance from the National Institute on Aging (National Institute on Aging, n.d.).

In step 7, make the discussion concrete. Identify the daily tasks, cost, safety concerns, and person responsible for follow-up. A dated note after a trial, visit, or conversation is more reliable than memory during a stressful week. Ask an appropriate clinician, pharmacist, veterinarian, facility nurse, or other qualified professional when a question crosses into their expertise. A flexible plan allows the family to adjust when health, capacity, setting, or the older adult’s wishes change. It should never promise that Green House homes will solve every challenge.

The Green House Project benefits from a specific plan, respectful review, and documented follow-up.

• National Institute on Aging. (n.d.). Health and aging resources.
• Centers for Medicare & Medicaid Services. (2024). Care Compare.