KEY TAKEAWAYS
Small Group Safety Infectious disease is less likely to spread in a small group environment−as found with the Small House Model.
Healthy Environment The small house model of nursing care not only promotes a healthy environment for elders, but it also protects them from the spread of infectious diseases.
Dedicated Staff The consistent staff of a small home is easier to monitor for illness and bring fewer potential pathogens into the home.
The COVID-19 outbreak has been particularly devastating to the elderly population, specifically elders living in a traditional skilled nursing environment. Small house design for skilled nursing care−where a smaller number of residents live in a home−can deter the spread of infectious disease amongst the most vulnerable population.
Small House Design
Small house design breaks down the traditional model from large buildings with many residents, to smaller homes of 10-12. Each home provides elders the dignity of their own bedroom and bathroom, as opposed to the traditional model where there may be two or three residents per room−forced to leave their room to bathe.
Person-directed care is commonly practiced within the small house, with a focus on the emotional needs and well-being of the elder. The Green House Model® is often considered the gold standard of the movement, aimed to deinstitutionalize all facets of traditional skilled nursing−including environment, organizational culture, and care delivery.
The small cohort of residents encourages a sense of community for the elders−difficult to facilitate in a typical skilled nursing home. The small houses promote pride of home, autonomy, and identity−significantly improving the elder’s well-being.
Unlike a traditional model with rotating shifts for the staff, small homes often have a dedicated staff. For the elders, this creates a feeling of safety, community, and home, while offering an opportunity for staff to form meaningful connections and provide a better level of care.
COVID-19
The COVID-19 pandemic is making many people realize the value of The Green House or Small House model which has the potential to mitigate the significant risk of infectious disease spread. A large traditional nursing home of 100 or more residents with rotating staff can be highly vulnerable to the spread of an infectious disease.
The small house model acts as a built-in measure of social distancing. Autonomous small homes act more like a low-density suburban community than a larger traditional institution which may more parallel a denser urban setting. Private bedrooms and bathrooms decrease the opportunities for diseases to spread as each room can behave as an infection control room.
A small, dedicated staff is more manageable to monitor for symptoms and there are simply fewer people entering each home, as compared to the traditional environment. The common single-story construction of Small Homes allows elders access to the outdoors which has numerous health benefits including a strengthened immune response system. Visitation is more manageable as elders have access to outdoor spaces to safely spend time with visitors while maintaining social distancing.
Looking Forward
Small house design is about creating real homes for elders. As architects, we can create meaningful environments for seniors that not only help them stay connected and thrive but protect their physical well-being. The small house model may well prove to be a vital component of senior care as we look past the current pandemic and consider how best to protect health while creating loving and meaningful environments.