Green Houses and Nursing Homes: Changes in Resident Function Over the Course of 1 Year - A Pilot Study

Abstract

Background and purpose: Seniors face difficult decisions if their physical and mental functioning begins to decline. Seniors may require assistance as they become elderly, but they never want to burden family members with that responsibility. Some choose to move to traditional nursing homes (NH), and another option that is growing in demand is green houses (GH).Whether the elderly can safely maintain their movement ability over time in green houses has not been studied. The purpose of this study is to examine the changes in impairments and activity limitations in residents of green houses and nursing homes over the course of one year.Participants: Of the 23 volunteer participants in this study over the age of 65, 17 were residents of area nursing homes and 6 were residents of area green houses. Methods: Participants completed a series of outcome measures including the Mini-Mental State Examination (MMSE), Manual Muscle Testing (MMT), Active Ankle Range of Motion (AROM), Handgrip Strength, Five Time Sit to Stand (5xSTS), Timed Up and Go (TUG), Gait Speed (GS) and Functional Independence Measure (FIM) scores.Result: 15 completed the final data collection (GH=2, NH=13). Before the final data collection, 4 participants from both the NH and the GH passed away equaling 8 total expired. Regarding impairments, the overall lower extremity strength of all surviving participants decreased from initial to final testing, with left knee extension strength and bilateral dorsiflexion strength being the two most distinct declines. Ankle range of motion (ROM) decreased for 14 out 15 surviving participants, with the exception of the D2 GH resident increasing right DF ROM by 1.5 degrees. The activity limitation changes included all participants of both groups performing slower on the TUG from initial to final testing with the 2 GH residents performing 2-10 times slower than the average NH resident. Discussion and conclusion:This study demonstrates that there are impairments and activity limitation measurements that can be used to assess change in function over the course of one year in green house (GH) residents compared to traditional nursing home (NH) residents. Interventions provided by physical therapists for elderly residents at a green house or traditional nursing home facility can potentially slow the development of such impairments and activity limitations that may compromise longevity, independence and quality of life.