The Green Revolution – Care Delivery Redesigned

A growing trend in long-term care delivery has sparked the redesign and re-engineering of senior living centers. This trend includes the integration of plants, gardens, and greenhouses within communities. For instance, assisted living homes and skilled nursing facilities nationwide have adopted horticultural programs in order to improve psychological health and serve as a therapeutic comfort for older adults. Mere exposure to living plants and flowers have also shown to increase activity levels in the elderly as well as influence health outcomes for seriously ill patients.


Redesigning homes range from developing community plots or atria that encourage active teamwork and participation through gardening to “meditative labyrinths” or aromatherapy gardens. In fact, the Robert Wood Johnson Foundation-supported “Green House Project” takes advantage of greeneries, natural light, gardens, and therapeutic outdoor spaces that drastically improve the environment and ambience of care settings. The Foundation has called the project a “catalyst for significant social change in how frail older adults are cared for in this country” and the initiative is being adopted at sites nationwide.

Green House Project homes may qualify as assisted living centers or nursing homes and can be funded through Medicaid or Medicare. Medicaid provides free or low-cost health coverage for families and individuals with low income and limited resources in the United States. Medicare is the federal health insurance program for Americans age 65 and older, certain younger people with disabilities, and people with end stage renal disease and amyotrophic lateral sclerosis (ALS). The widespread growth of the Green House Project and other pilot programs represent a movement towards person-centered, comfort-based care. These programs also reflect a broader paradigm shift in the delivery system towards non-medical needs, personal comfort and well-being.

Raca Banerjee works in health care policy and consulting. She has conducted research on a wide variety of policy and legislative issues related to the Affordable Care Act, Medicare, long-term care, health IT, and more. Raca is an active participant of Rotary Club International. In her free time, she enjoys volunteering, performing music, playing tennis, and learning new languages.

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