It's a difficult transition for everyone when an elder reaches the point in life when living on his or her own becomes too difficult to manage. For family of the elder, the decision of whether or not to place their family member in a nursing home is a stressful one. For the elders, the feeling of losing their independence, their home, and their own routine is discomforting. Southwest Ohio, however, is seeing a revolution in elder care through the Otterbein Retirement Living Communities, which is opening an Avalon by Otterbein small-house neighborhood in Warren County.

The Avalon by Otterbein small house neighborhoods combine al l of the amenities of home so that elders can maintain as normal of a life as possible, despite being in nursing care. While traditional nursing homes are designed in a hospital style, the Otterbein neighborhoods look like traditional, suburban neighborhoods located within familiar residential locations. Each Avalon by Otterbein neighborhood is a group of five one-story homes grouped around a cul-de-sac. Jill C. Hreben, senior vice president for strategic management, discusses the benefits of small houses for nursing care, saying, "The hospital mode is not designed for people who want to stay for a long time. Otterbein has been on the forefront to change long-term care "¦ Human beings, by nature, aren't designed to live in institutionalized settings. The hospital model [of nursing homes] will evolve into a smaller home setting."

Each 7,000-square-foot house is home to 10 residents, who each have their own private bedroom and bathroom. Each of the residents has the freedom to pick their own paint colors and to bring their own furniture for their private room. The homes each include an open living-dining room and kitchen, a den, a great room with vaulted ceiling and fireplace, a residential cooking area, and a spa/physical therapy room.

Because the small houses are houses and not large, institutionalized buildings, the distances are short and easy for the residents to walk. "It's restoring rehabilitation. People who weren't walking in a traditional nursing home are walking now," comments Hreben.

There are many benefits to the small houses being home to only 10 residents, the most important being the independence the elders are able to maintain. They have the freedom to make their own choices, which is not the case in traditional model nursing homes, where hundreds of residents live. Hreben uses breakfast as an example of the independence the small houses provide: "We restore choices that are difficult to exist in the traditional model. In the traditional model, they have to prepare a hundred meals for breakfast, so everyone has to get up at the same time. In the small-house model, because there's only 10 people, it makes it easy to serve breakfast. You don't have to make it all at once, and you can serve it as people get up."

In addition to the residents creating the menus, which include their own favorite recipes, they are also given the liberty of being able to choose what activities they want to do. Each house has a bus that takes the residents to group activities, such as sporting events, and a quality of life coordinator finds out what each individual resident likes to do and gives them the opportunity to pick their own activities. "I have a resident who moved from a traditional model into a small house," Hreben adds, "and he said, 'I love this place because I'm my own boss again.' "