There's no place like home

The Leonard Florence Center for Living, a Boston-area nursing home, is unique among Green Houses around the country.

The 100-bed community, located in the Boston suburb of Chelsea, is  believed to be the first urban Green House in the United States. Other similar Green House homes are located in suburban settings where buildings are more spread out.

Under the suburban model of care, every resident lives in a house with six to 10 people. Such projects, which have attracted much attention since the first four homes sprouted in Tupelo, MS, in 2004, strive to make nursing homes a place where people come to live, not die.

In the urban, six-floor Chelsea facility, there are two “houses” on each floor.

The 92,000-sqare-foot facility took 18 months to build and cost approximately $33 million, says Berry Berman, CEO of the Chelsea Jewish Foundation. The facility opened in February 2010.

Diane Dooley, principal of the design firm DiMella Schafer, which led the design of LFCL, says the design is the antithesis of any other nursing facility her firm has worked on.

Each house looks like a condo or apartment, with lots of natural lighting and views that overlook the gardens that surround the facility’s campus, Dooley says.

“It’s like entering a house or apartment. You see the living room with a fireplace, furnished just like a home would be,” Dooley says. “Off the living room is a den that’s more private. Each person has a private bedroom and bathroom with easy access to the kitchen. The kitchen is the heart of the house—each one has a hearth and a table set for 10.”

To keep the houses from having an institutional feel, areas such as nurses’ stations, laundry rooms and linen closets are locked and tucked out of sight of bedrooms and common areas.

“Instead of a nurses’ station, there is a built-in desk in the dining area that fits in with the décor,” Dooley says. “It’s very small—five by 30 inches, with cabinetry above and files below. Near that is the required medication, which is locked up.”

Berman is most proud of the facility’s specialized houses for residents with ALS (Lou Gehrig’s disease) and Multiple sclerosis. An assisted-living resident who was an architect before becoming too disabled by ALS to keep up a normal work routine designed the ALS house.

“He designed the architecture and technology himself,” Berman says. “He knew his life depended on it.  He worked hand-in-hand with Diane on the ins and outs.”

Since ALS patients are limited to eye movements to do about everything, the rooms are equipped with that in mind.

“Residents here use their eyes to shut the shade in their room, turn on their television, adjust temperature, send text messages to staff, call to the elevator, go downstairs to the café,” Berman says.

“The main focus of the ALS and MS houses is to combine compassionate caregiving with the best technology.”

Lessons learned

-Green House certification requires a strong connection with the outdoors. Take this seriously

-Communal spaces encourage stronger caregiver-to-patient relationships

-Designing high-tech nursing homes requires constant communication between the design team and the IT department