Exemplar

Establishing The Eden Alternative™ in Australia and New Zealand

Sonya Brownie
School of Health and Human Sciences, Southern Cross University, Lismore NSW

Cathy Noakes-Meyer
Eden in Oz and NZ Pty Ltd, Box Hill North VIC

Petrea Neeleman
Dutchcare Pty Ltd, Carrum Downs VIC

PP: 222 - 224

Abstract

The Eden Alternative^TM is a philosophy of personal, organisational and environmental transformation founded by Dr. William Thomas, a Harvard trained geriatrician. He wanted to create a living environment in existing aged care institutions to eliminate loneliness, helplessness and boredom from the lives of residents, which he argued were the plagues of ageing that account for the bulk of their suffering.

The Eden Alternative^TM is a contemporary approach to long-term care, designed to combat these plagues of ageing, by incorporating companionship, a sense of purpose, variety and spontaneity into the day-to-day experience of aged care residents. Creating a warm, loving and caring 'home' that enriches the lives of all who live and work in it, is the overarching goal of The Eden Alternative^TM. The locus of decision-making is with the resident, which ensures the right of each resident to a life worth living.

This exemplar outlines the inception and growth of The Eden Alternative^TM in Australia and New Zealand.

Keywords

The Eden Alternative TM; residential aged care facilities; culture change

Article Text

The Eden Alternative^TM founded in 1991 by US geriatrician Dr. William Thomas, promotes human growth in aged care environments and strives to empower and enable older people in partnership with staff, to construct and pursue meaningful lives (Thomas, 1996). This approach to care is intended to combat the plagues of ageing - loneliness, helplessness, and boredom - by enlivening the environment with children, animals and plants to create a vibrant and vigorous habitat that nourishes the human spirit (Thomas, 1996). The Eden Alternative^TM outlines 10 essential principles for ensuring that older people cared for within aged care facilities are assured of a 'life worth living' (go to www. edeninoznz.com.au for more information about the principles).

Adopting the Eden Alternative principles offers facilities a way to reform their model of care, but the implementation of this approach is not without its difficulties. The successful implementation of this model requires more than just environmental enhancement, sometimes referred to as the 'fur and feathers' component of the model. 'Edenising' is a process; a journey; a paradigm shift; an entire way of thinking (Lee, 2001). Any organisation that wants to embrace the Eden Alternative philosophy, and truly transform the lives of its residents, must commit to changing the culture in which they administer and manage the care needs of their residents and staff. They need to accept resident-directed care as the guiding or defining standard of practice and promote autonomy and choice for residents so that they can achieve optimal physical, psychological, social and spiritual wellbeing (Thomas & Johansson, 2003).

The Eden Alternative^TM challenges traditional models of care and management because it is based on a 'whole of facility' management system. It aims to empower the staff and place decision-making authority as close to the resident as possible. It 'flattens' the nursing organisation hierarchy and promotes a decentralised team method of care delivery that puts residents at the centre of the (Keane, 2004). Self-directed work teams usually evolve from this re-arrangement of work roles and responsibilities. It is important to point out that The Eden Alternative^TM is not just concerned with the welfare of the residents, but the staff as well. If staff feel valued, they are more likely to value the residents (Barba, Tesh, & Courts, 2002).

The Eden Alternative^TM has become well-established in the US, and since its inception more than 15 years ago at least 200 American aged care facilities have adopted the Eden Alternative philosophy. The Eden Alternative philosophy has also spread globally, with Eden Alternative facilities in the United Kingdom and Ireland; European countries, including Germany, Austria and Switzerland; Scandinavian countries, including Sweden, Denmark, Finland, and Norway; Japan; Eastern and Western Canada; and even Alaska.

In 1999 Michael Isaac (former CEO of Aged Care Queensland), Petra Neeleman, and Glenn Bunney from Sundale Gardens Ltd., along with several other senior Australian aged care leaders heard Dr. Thomas speak at the International Homes and Services Aged Conference in Hawaii, and were convinced that The Eden Alternative^TM was the way forward for aged care in Australia. The following year, Dr. Thomas was invited by Aged Care Queensland to be a keynote speaker at the Aged Care Conference in Sydney, and in 2001, DutchCare Ltd. opened Australia's first Eden Alternative facility, in Kilsyth, Victoria. DutchCare Ltd. is credited with being the first aged care service organisation to adopt and implement the full ten principles of the Eden Alternative philosophy in Australia.

Dr. Thomas has entrusted the growth of The Eden Alternative^TM in Australia to a not-for-profit, non-government company originally called Eden in Oz Ltd, now known as Eden in Oz & NZ Ltd (EiON). EiON is affiliated with the US Eden Alternative through licensing arrangements, and indirectly to other similar organisations established throughout the world. EiON is responsible for the education, training and dissemination of information in Australia based on the intellectual property of The Eden Alternative^TM. Aged care staff can be trained by EiON trainers to become qualified Eden Associates, by completing a three-day, nationally accredited training course, which permits them to assist facilities implement The Eden Alternative^TM. The three-day course focuses on culture change strategies and prepares the participants to be change advocates within their organisation. Currently, there are more than 1,000 trained Eden Associates from 300 facilities across Australia and New Zealand.

The first New Zealand Eden Associate training was conducted in 2006. Nicola Turner, current General Manager of Enliven Services (at Presbyterian Support Central), and qualified Eden Associate, has adopted and implemented the Eden Alternative philosophy into 17 aged care homes in the North Island of New Zealand. In May 2009 she accepted a position on the EiON Board of Directors, which was subsequently renamed in July 2009 to Eden in Oz & NZ Ltd, under the stewardship of the current chair, Cathy Noakes-Meyer.

The Eden Alternative^TM is a trademarked name (since 1998), and only facilities listed on the Eden Alternative Registry are permitted to use the name. In order to become a registered Eden Alternative aged care home, a facility needs to be able to demonstrate how the ten principles have been applied in a sustainable way to their living and working environment. About 31 residential aged care facilities in Australia are actively engaged in implementing The Eden Alternative^TM and thereby improving the lives of residents and staff (see also AIHW 2009).

In 2011 the Eden Alternative in Oz & NZ Ltd. will reach an important milestone: the organisation will celebrate ten years since the opening of the first Eden Alternative facility in Australia. Since those days, the organisation has been working tirelessly to transform long-term aged care facilities into warm, loving and caring 'homes' designed to enrich the lives of all who live and work in them.

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