Planning for the Future

In January 2008 the New Hampshire Veterans Home (NHVH) formed a Master Plan Committee to begin planning for the needs of the next generation of veterans. In addition to the "normal" health challenges found in aging populations, many of these men and women will have complex medical conditions such as traumatic brain injury, polytrauma, and post traumatic stress disorder.

Because of family dynamics and increasing economic pressures, aging veterans of the Vietnam War and later conflicts may not have the same adequate family or community support to live at home for as long as the World War II and Korean War veterans did, and thus may need nursing home care for a longer period than the older vets.

In building a foundation for the Master Plan, the existing NHVH facilities and infrastructure, the present layout of the campus, amount of buildable land, and possible future programs were considered, along with information gathered from interviews and surveys conducted over the past two years.

Recognizing that NHVH needed an architectural firm experienced in master planning to help consolidate information and prioritize projects, the Veterans Home asked the State of New Hampshire for financial support. During the summer of 2009, the request was funded, and in the fall of 2009 the NHVH Master Plan Committee began working with the Manchester NH firm, Lavallee Brensinger Architects (LBA).

Since then, LBA had held numerous discussions with NHVH staff, considering earlier research done by the Committee and reviewed by LBA; the importance of integrating the vision of the Veterans Home into the Master Plan; existing buildings and site plans; programmatic questions and issues; long term care topics, trends (such as the "Green House" residence model*), and best practices; ideas generated by staff, residents, and family members; code requirements; possible new uses of existing buildings; designs and locations for new resident buildings; phasing priorities; and probable costs.

The Master Plan booklet

According to Fred Urtz, AIA, President of LBA, "The Eden Alternative and Green House concepts propose enhanced living environments that differ dramatically from the clinical environments of the past. These recent concepts are consistent with a much broader realization that elder years are precious, and each of us desires, and deserves, to enjoy them in a welcoming, engaging, stimulating, and home-like environment."

He adds, "Transitioning the NHVH to the new residential model over the next twenty-five years is both an exciting and daunting proposition. The new residential model and the required changes in supporting infrastructure are the primary components of the transition, but there are many other, equally important dynamics. Programmatic change, such as the possibility of admitting new populations, potentially challenges the size and configuration of the future campus. The needs of Gulf War era veterans require enhanced treatments for PTSD and poly-trauma. Outreach programs, satellite facilities, community-based services, and strategic alliances with other health care providers add further complexity to a future vision of the campus."

Previous NHVH Commandant, Barry Conway said: "A twenty-five year plan for the Veterans Home needs to consider all of these potential changes, and remain flexible and scalable to address a future that is not possible to clearly define. By creating a Master Plan, however, we are being far more proactive than in the past, and we believe that setting priorities in the context of a really big picture will help us be more fiscally credible as we ask the State and the Department of Veterans Affairs for continuing support."

In conclusion, Fred Urtz added, "Working closely with the NHVH Master Plan Committee we have crafted reasonable expectations for programmatic and demographic change, and incorporated appropriate design responses into the plan document. The final report defines a phased implementation plan and estimate probable development costs. The plan offers NHVH a powerful tool to present the transition proposal and to build support for its creation."

*From: NCB Capital Impact - The Greenhouse Project

"THE GREEN HOUSE® model creates a small intentional community for a group of elders and staff. It is a place that focuses on life, and its heart is found in the relationships that flourish there. 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. Its primary purpose is to serve as a place where elders can receive assistance and support with activities of daily living and clinical care, without the assistance and care becoming the focus of their existence. Developed by Dr. William Thomas and rooted in the tradition of the Eden Alternative, a model for cultural change within nursing facilities, The Green House model is intended to de-institutionalize long-term care by eliminating large nursing facilities and creating habilitative, social settings."