The Green House Project is getting a lot of attention recently on PBS/NPR and the New York Times. The concept isn’t new but compared to traditional nursing homes the concepts are radical. The idea behind the Green House project is to create a small home environment for 10 persons in need of long-term care services. This model of care was originally pioneered by the founders of Anam and refined by them the over the years.

Anam’s emphasis is on serving persons with Alzheimer’s or a related dementia with dignity and meeting each person’s unique situation with comfort and social engagement. Anam’s owners embraced this small home model long before the Green House Project: Back in 1988, Anam’s Stu Gaines introduced a visionary model for serving persons with dementia in ranch homes. The original home developed by Stu was located in Monona, Wisconsin, and served eight dementia residents. This was a far cry from the large 100 bed institutional nursing homes which housed persons with dementia. While Stu’s home was radically different so was the care provided. The emphasis was on meeting resident’s by identify resident remaining abilities and not their deficient while allowing residents to stay involved in their own care and life. The goal was to maintain resident dignity, function and comfort. The daily activities of the home such as meal preparation, cleaning, activities and resident care were handled by “house mothers”. Since 1988, the terms have changed. “House mother” evolved into the term “universal worker” and an emphasis of identifying remaining abilities is reflected in the current term person-centered- care.

Bernie Marinelli, refined many of the concepts Stu originally introduced many years ago. Stu was the consultant to Anam and Illinois became the hotbed of long-term care innovation. Bernie founded Anam Care which serves Northern Illinois. Anam Care embraced the small model but more importantly developed new approaches to maximize the resident’s quality of life through the arts, social engagement, and clear understanding of how a specific dementia types affects the resident and their care. Collectively Stu and Bernie have introduced 75 homes to various communities around the nation.


Their collective leadership, passion, and understanding of dementia and the needs of residents and their families lead to the development of Satori Pathway and The Anam Campus

The Green House Concept:

The Green House Project was developed by Steve McAlilly, CEO of Mississippi Methodist Senior Services and geriatrician William H. Thomas, M.D., in 2003. In the early 1990’s, Thomas founded the Eden Alternative, now a global nonprofit organization that aims to deinstitutionalize long term care facilities by changing the culture of the typical nursing home. Thomas later created The Green House Project with the goal of replacing the institutional nursing home model with small communities where management and staff focused on the resident’s needs, allowing the resident to live a fuller and more vibrant life. A positive outcome resulting from the size and scope of The Green House project was research studies that actually show some measurable benefits of our smaller homes.

In 2004 a report presented to the United States Congress by researchers from the University Of Minnesota School Of Public health, found that the use of a social model of care and maximum staff empowerment to serve residents needing long term care resulted in statistically significant favorable outcomes over traditional facilities. The researchers found that elders in a Green House Project Home were able to perform daily functions longer than those in more traditional assisted living facilities.

A 2009 evaluation of Green House Project care found it provided higher direct care (23-31 minutes more per resident per day) than traditional assisted living models and more than four times as much staff engagement with residents outside of direct care activities.

Residents of Green House Project homes have shown increased reports of mobility and social interaction, and fewer reports of weight loss and depression compared with those living in traditional assisted care facilities.

Here are some of the main areas that the Green House project is similar to the Anam Care approach

  • Each resident has his or her own private room. Homes also include a living room, kitchen and open dining area.
  • Residents are, on the whole, free from scheduling and allowed their own personal freedom regarding waking, sleeping, activities, and meals.
  • The homes are built to blend in with surrounding houses and neighborhoods.
  • Residents do not have strict schedules and are encouraged to interact with staff and other residents and visitors. Staff members and residents develop personal relationships with one another because of the small community and home atmosphere.
  •  A warm living situation consists of a layout that encourages social activity as well as furnishings and décor that provides comfort.


At Anam we provide caring homes promoting meaningful lives for people with dementia s. Residents can move freely through the home, build deep knowing relationships with staff and each other. Our approach is based on a philosophy seeking to reverse the “enforced dependency” of life in a traditional assisted living or nursing home environment. At Anam, the rhythms of the day are largely determined by the needs of the residents and the schedule and attitude is much less staff-focused. Our aim is creating a life for our residents that is as full and vibrant as possible.