SHERIDAN -- As she watched her father's health deteriorate because of Alzheimer's disease, Candra Day was devastated to admit she could not provide the care he needed. Once in a nursing home, his health continued to decline, and Day sought alternative care for him.

"You just don't want to think about it, and you don't want your loved ones in a nursing home," she said.

Though the Jackson woman said she feels fortunate that she was able to find a home nurse for her father, the experience made her passionate about providing a way for the elderly to keep their dignity and privacy when they have to leave their homes.

Now Day is a member of a group of citizens and health professionals exploring the feasibility of building a "cottage-style" long-term elder care facility in Jackson. Based on an innovative concept for residential care, called The Green House, the facility would allow residents to eat home-cooked meals at a dining room table and each have their own rooms and bathrooms. Instead of a large structure that has more than 100 patients, Green House homes are small and personalized.

"It's just an essential choice," Day said.

Jackson is just one of several communities in Wyoming interested in building Green Houses. A pilot project has been launched in Sheridan, and already the community has raised $1.1 million for the care facility that will offer privacy, autonomy, support, enjoyment and a place to call home.

"We want people to remain with their dignity ... and live a life we would all be pleased about," said Sy Thickman, co-chairman for fundraising for Green House Living for Sheridan.

Green House committees have also already been formed in Casper, Lovell and Riverton.

The statewide interest is part of the reason Dr. Bill Thomas, creator of The Green House concept, was in Sheridan this week to lead a series of discussions about the future of long-term care in Wyoming.

Not a nursing home

The Green House model creates a small community that focuses on giving the elderly a better life, and its heart is found in the relationships that flourish there, Thomas said.

A radical departure from traditional skilled nursing homes and assisted-living facilities, the Green House model alters facility size, interior design, staffing patterns, and methods of delivering skilled professional services.

Eight to 12 people live in a home where the centerpiece is a living area and a kitchen, allowing the elderly to maintain and enjoy a normal life. Residents see the same staff members daily and feel more comfortable and less confused in the home-like environment.

"The idea of the Green House is not just a different floor plan or a different architecture," Thomas said. "It's really based on a different philosophy of what it means to live and grow and be cared for."

Each home is staffed by caregivers, called shahbazim. The staff has core training as certified nursing assistants, plus extensive training in the Green House philosophy, culinary skills and household management. Paid more than average for CNAs, shahbazim provide a wide range of assistance to those living in the home, including personal care, laundry and meal preparation.

"The average age of someone who moves in a Green House is 84 years old ... They do have significant needs," Thomas said.

While adhering to all codes required by regulations, Green House homes look and feel like a home, and contain few medical signposts.

The idea for the Green House came to Thomas about seven years ago, as he was eager to develop a place where an elderly person is free from the limitations of an institutional schedule and lives a comfortable daily life -- sleeping, eating, and engaging in activities as they choose.

"I started to see that what we needed in the field of long-term care was not just improvement, but resolution," Thomas said.

The Green House model is intended to deinstitutionalize long-term care by eliminating large nursing facilities and creating social settings. Already 25 facilities are under way across the country, while hundreds are in the planning stages.

"Old age is a time of growth and development," he said. "We as human beings grow and develop during our life span. Let's build a place that focuses on growth."

Looking ahead

As baby boomers enter retirement age, building places where people want to live is vital, officials say. State Department of Health Director Brent Sherard said one-third of Wyoming's population is composed of baby boomers, making it the fifth-largest population of baby boomers in the United States, on a percentage basis.

"Planning is really important," he said.

Though the building costs for each of the state's Green Houses are projected to be near or more than $10 million, the operating costs are similar to existing nursing homes.

"You really aren't having higher operating costs, but a higher initial cost," said state Rep. Jack Landon, R-Sheridan, a member of the Legislature's Labor, Health and Social Services Committee.

Research funded by the Robert Wood Johnson Foundation has found that people cared for in Green House homes require less medication, are in better health and have fewer falls, Thomas said.

"What we have found is that living in this type of environment creates better overall health than living in a nursing home," he said.

As fundraising continues in Sheridan and Green House interest increases across Wyoming, state Rep. Jerry Iekel, R-Sheridan, said reinventing traditional nursing home care to create close-knit communities of patients and caregivers may be just what the state needs.

"We're not doing 1950s surgery anymore, we don't need to be doing 1950s long-term care either," Iekel said.