Increasing numbers of our elders are entering nursing homes and assisted living facilities every day. The Eden Alternative and the new Green House Project, offer a fundamentally different way of looking at elderhood. The premise: caring for our elders in places that are much more like gardens and much less like institutions results in enhanced quality of life as well as improved clinical outcomes.
The article aimed to introduce the Eden Alternative and the new Green House Project, which is an outgrowth of the Eden Alternative, that is operated based on a fundamentally different way of looking at elderhood, grounded in a philosophy of developmental aging.
Human beings were not meant to live in a cold, sterile, controlled environment. They were meant to live in a true human habitat. This would be a start of the creation of nursing homes in the image of Eden. The author called this movement the Eden Alternative, a different way of thinking about elders and long-term care. The 10 principles of the Eden Alternative, found in A Life Worth Living? are used to guide the design and development of caring environments and to change the culture of their organizations. So far, more than 238 organizations have explicitly embraced the Eden Alternative philosophy.
Some of the ideas the author thought to be important:
- Loneliness can be soothed only with the balm of companionship. Elders blossom when they can have close and continuing contact with plants, animals, and children.
- Helplessness is the pain we feel when we always receive care but never have the opportunity to give care. We strive to bring elders into caregiving relationships that can help them balance their emotional and spiritual lives.
- Boredom is not, as commonly assumed, a lack of entertainment. In truth, boredom is a crushing weight that can descend upon us when our lives are lacking in variety and spontaneity. Institutions excel in creating conformity, compliance, and routine; they are not good at conjuring the spark of spontaneity that can make life worth living.
An initial assessment of Eden Alternative implementation between January 1992 and December 1993 demonstrated a dramatic change in medication use. While the traditional nursing home maintained or increased the average monthly number of prescriptions per patient, the Eden Alternative home saw a decrease of at least 10 percent. Furthermore, the average cost of medications per resident per day was 38 percent lower in the Eden home than in the traditional control facility. Of particular interest was the decline of mind- and mood-altering drug use made possible by implementing the Eden Alternative. More recently, a 1999 report was released on a two-year study conducted by the Texas Long Term Care Institute on outcomes in nursing homes adopting the Eden Alternative philosophy and operating principles. Five Texas nursing homes were provided small grants to implement the Eden Alternative. Beds in the participating facilities totaled 734.
A summary of significant cumulative findings include as follows:
- Aa 60% decrease in behavior incidents
- A 57% decrease in Stage I and Stage II pressure sores
- A 25% decrease in bedfast residents
- An 11% decrease in employee injuries
- An 18% decrease in restraints
- A 48% decrease in staff absenteeism
- An 11% census increase
Some money is required to initiate the changes in environment and culture, although it would be probably much less than anyone would think. For instance, the grants for the five Texas nursing homes ranged from only $5,000 to $30,000. On the other hand, it is clear from the outcomes above that creation of Eden Alternative environments can actually save money. This transformation does not hinge on finances but rather on attitudes and commitment.
No limitations were listed in the article.