Innovation: Eden Alternative
USA and international
AAI Domains:
Independent, healthy and secure living (care to older adults, mental well-being)
Participation in society (social connectedness, voluntary activities)
As societies age it is certain that there will be growing numbers of older people who will need long-term care either in their own home or in an institutional setting. This poses challenges for societies, older people and their carers to develop innovative person-centred approaches to care that enable people in need of care and those providing it to find a greater sense of satisfaction and fulfilment than that which is often experienced in ‘standard’ long-term care. The total level of resources dedicated to long-term care is an important consideration in the quality and experience for recipients and providers but there is a risk of an ‘institutional-bureaucratic’ approach developing that does not put people at the centre of the socially important task of providing care.
The Eden Alternative is a non-profit organisation founded by Dr William Thomas in 1991 that has developed a distinctive and innovative approach to the provision of long-term care. It seeks to address three great challenges of long-term care – loneliness, helplessness and boredom – through developing a new paradigm of care based on a collaborative partnership between people receiving care and those providing it.
The Eden Alternative aims to improve the well-being of older people and their carer partners by changing the culture of the communities in which they live and work. The values that inform this approach include innovation, integrity, community, empowerment and passion so that long-term care is a place to enjoy life rather than existing and waiting to die.
There are seven domains for well-being that the approach seeks to influence that include
identity (individuality)
growth (ongoing personal development)
autonomy (freedom of choice)
security (safety, privacy, dignity and respect)
connectedness (sense of belonging through being engaged)
meaning (a sense of purpose and hope for the future) and
joy (sense of contentment and happiness).
There are ten principles for the Eden Alternative that include creating an environment in which older people can enjoy contact with plants, animals and children with daily life being varied and spontaneous so that it does not become boring.
The Eden Alternative provides resources and accreditation, at a cost of approximately $3,300 for a long-term care home, for providers to engage in a structured programme of culture change. This ‘Path to Mastery’ course for cultural change in long-term care setting is based on milestones including leadership, empowerment of the care team and innovative practices. The Eden Alternative is centred on the USA with examples in Canada, Australia, New Zealand and several European countries.
The Senior Centre in Krefeld, a large town of 220,000 near Dusseldorf in North Rhine-Westphalia, became the first long-term care provider in a German speaking country to adopt the Eden Alternative in 2012. This coincided with the building of an extension to the centre that included a roof garden to bring residents and carers closer to nature and provided an opportunity to recruit additional volunteers to address the loneliness, helplessness and boredom that can affect older people even in high quality long-term care.
In relation to active ageing, the Eden Alternative provides a structured programme for changing organisational culture to improve care for older people. It also aims to improve the mental well-being of people involved in caring and encourages voluntary activities through fostering social connectedness.
In the context of ageing societies it is important both for older people in need of long-term care and the people who provide it that the experience is positive and enhances quality of life and well-being. The Eden Alternative provides a person-centred, collaborative and empowering approach to achieving organisational and cultural change that has been adopted in hundreds of long-term care facilities in the USA and around the world.