The Eden Philosophy transforms the lives of residents, staff and the bottom line.
This is part two of a two part article by Pam McDonald that describes how the processes of embracing the The Eden Alternative Principles radically changed the lives of elders, staff and family at Elmhurst Extended Care. You can Read Part One Here – Editor
For the next couple of years, Rick said he and his staff continued to question everything – food service, the dining room and TV, buffets on every floor, food available 24 hours a day — they would pilot changes on one floor before they implemented it throughout the community. After seeing the changes, a state inspector from the Department of Health asked Rick to explain The Eden Alternative to him. The next time Elmhurst offered the training, inspectors from the Department of Health participated.
Rick noted that, up until then, inspectors had encouraged communities to rotate staff assignments, so they could avoid burn out and wouldn’t become overly bonded to the elders. But, as part of their Eden Alternative changes, Rick encouraged staff to become care partners with the elders, so they were given permanent assignments of specific people. “The staff really got to know the elders,” Rick said. “They could raise the level of care and customize routines around each person.
“Our turnover rate before permanent assignments was 46 percent,” Rick noted, “which was the 8th lowest in the state of Rhode Island. But after our first year with permanent assignments, turnover dropped to 4 percent” (no that is not a typo).
Another outcome involved elders, families and staff responses to a death in the community. “Our procedure had been,” Rick explained, “that when someone died, the funeral director took the body out the back door past the dumpster, the housekeepers came in, cleaned and sterilized the room, and Admissions was lining up a new person who moved in the next day.”
“Death was really affecting everyone; there was just so much disenfranchised grief, especially among the housekeepers who had a purely social relationship with the elders. So, we decided to develop a ‘dying with dignity’ policy to give the elders, families and staff the time and space to grieve and to honor that grief. We wanted to develop rituals with the elders involved.
“One of the elders told me he didn’t want to go out the back by the dumpster. He wanted to go out the same door he came in. So now, when an elder is dying, a care partner stays with him or her if they have no family. Staff is always present, their favorite music is played, and their hands and arms are massaged with soothing lotions. If the family wants, we arrange meals and for them to stay overnight.
“Now when an elder dies, the funeral director comes in to transport the body, but the staff drapes the body bag with a pall cloth and they accompany the funeral director and family out the front door. Someone usually recites a poem or says some words for and about the elder we’ve lost or the group will sing or pray together.”
“Recently, during a procession, one of the staff started singing ‘You Are My Sunshine,’ which was that elder’s favorite song, and everyone else joined in.
Later, the daughter of that elder said, ‘During her last days on earth, my mother was treated like a queen.’”
Rick recalled that this was a far cry from what happened with his mother some years ago. Even though he had helped her pick the home where she lived her last days, when she died he was handed her personal belonging in a plastic garbage bag. “What were they saying about how they valued her?” he asked.
Fulfilling The Promise
Elders at Elmhurst Extended Care Center are experiencing many of the benefits promised by The Eden Alternative, including reduction in psychotropic drugs and medications in general. Restraints have not been used in over a decade, and there is less depression as well as improvements in the mortality rate.
Now it is rare for a elder to call out, “Help me, help me” or to ask, “Are you my son?” or to wander around a room wondering aloud, “Why won’t God just take me.”
As Rick explained, “We see expressions like these as unmet needs and we work to determine how we can help. As a result of that approach, our elders require significantly fewer medications that typically mask unmet needs.”
“We’re going to continue to educate people on The Eden Alternative,” Rick concluded. “With imagination and a shoestring budget, we’ve been able to empower our elders and staff. We’re able to take Dr. Thomas’ philosophy and make it our own, and that allows us to make a difference in the lives of the elders in our care.”
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You need a like button! Great stuff as usual! Tears to my eyes…
This is a really amazing article! I am elated to hear there are communities doing what’s best for everyone and truly taking care of body, mind and spirit!
In the seniors housing industry, taking good care of people always makes good business sense.
The Eden Alternative methods may not only be good for the residents and staff but also good for the business aspects of the care organizations.
Such as, lower employee turnover means lower labor costs which could mean lower prices to residents which could mean higher occupancy which means a healthier business organization which ultimately can mean a better life for residents!
From LinkedIn Groups
Truly amazing community that is taking care of body, mind and spirit! More communities should take note of how little changes make a large impact on all community members.
By Tiffany Rayback
From LinkedIn Groups
So logical and so respectful. Thank you for sharing what you have learned … simply by listening. There are a few lessons here.
By Ingrid Heinrichs Pauls
From LinkedIn Groups
I am a trained Eden Associate from1997. I LOVE your article. I wish more administrators would take this on the way you have!! Thank you for sharing this!!
By Paula Frakes, M.A.
From LinkedIn Groups
We have just one community in our area that uses the Eden Alternative approach and it is not only something that is seen in the community it is also felt when you walk through the doors and the halls of communities that are trained in the Eden Alternative. Great article Steve, thanks so much for sharing.
By Debra Pape
Pam – Thank you for writing this article!
The image of handing a garbage bag of personal belongings to the family was an especially poignant reminder that our actions often send unintended messages.
Looking at what we are doing “with new eyes” is critically important!
Thank you for this reminder! – Tamara
I have said for Years…that it’s absolutely possible to remain full and be successful by doing the work the RIGHT WAY. The Eden Alternative is a model that the industry should recognize more whole heartedly. It’s much easier to do things RIGHT and with the whole person/family in mind…than it is to have a consistent struggle with staff turnover, unhappy families, negative PR, adverse reactions from residents. Good Golly – the $ spent on re-hiring & re-training alone…is cringe worthy. Save the money – by providing a nurturing environment that honors the residents you serve and give the staff a voice and the tools to do their job. When, will Exec. Leaders realize this is a better biz formula?
Deinstitutionalization of nursing facilities is always a good idea. With resultant reduction in staff turnover and personal investment in the clients served, all involved parties are rewarded on a level not yet appreciated by society.
I have been working as a Consultant with Assisted Living for 20 yrs. now. It is so refreshing to know that there are other people that feel the way I do.. I put your article on my sites because I believe in what you are doing. I think it is wonderful to address the whole person instead of only worrying about their physical well being. We are so much more than that! We are spiritual beings and when treated with dignity and respect we can not only thrive but also be an inspiration to those who have what it takes to appreciate us and our wisdom. Unconditional love not only feels good but heals all wounds, gives hope for the future, motivates us to be better, improves our relationship with our Supreme Source, whoever that it is to you, and unites us as a race.No matter if we want to admit it or not, we are all connected, we ALL come from the same source and when start acting accordingly we will see heavens gate open and only then we will be able to connect to the love that created us in the first place..one that is unlimited, unselfish and forever unfolding in blessings for those that act from a pure heart. You have my full support, please feel free to contact me anytime! Wishing you many blessings and much wisdom.