Beyond the Basics: Effects of the Eden Alternative Model on Quality of Life Issues

Abstract

In Life Worth Living, Thomas (1996) proposed that in long-term care facilities for elderly individuals, loneliness, helplessness, and boredom are out of control and are steadily decaying the residents' spirits, adversely affecting quality of life. While Thomas' contention appeals to common sense, no empirical evidence is offered in its support. The purpose of this quasi-experimental study was to assess the impact of implementation of the Eden Alternative model on levels of loneliness, boredom, and helplessness of older residents of a long-term care facility. The model was introduced into the experimental facility on May 1, 1998. The final sample for the experimental group included 21 cognitively intact older adults from a state veterans home (13 men, 8 women, mean age = 76.1). The final control group was composed of 13 residents in a private long-term care facility (11 women, 2 men, mean age = 85.7). A Background Data Sheet, the Geriatric Depression Scale (includes yes or no questions related to helplessness and boredom), and the UCLA Loneliness Scale (Version 3) were administered by an interviewer at baseline and 1-year post-implementation of the Eden Alternative model. Data analysis from the post-implementation phase revealed significant differences between the groups on levels of boredom (z = -2.6, p = .01) and helplessness (z = -2.2, p = .03). Lower levels of distress were found in the experimental group on both boredom and helplessness, but not loneliness. Findings suggest health care professionals and researchers have an opportunity to take a leading role in impacting services related to quality-of-life issues for this important, but often overlooked, population.

“There's No Place Like Home”: A Scoping Review on the Impact of Homelike Residential Care Models on Resident-, Family-, and Staff-Related Outcomes

“…32,36 Outcomes related to mood were measured in 7 studies with significant benefits in the homelike settings relative to traditional NHs in 2 of the 3 Eden Alternative studies that examined this outcome. 46,48 There was no significant difference in the third Eden Alternative study. 44 Findings were mixed relative to traditional NHs in the one study of nondementia-specific small house settings 45 and in 1 of the 3 dementia-specific settings that examined this outcome.…”

“…42 Outcomes related to social activities/activation were measured in 3 Eden Alternative settings with significant beneficial effects relative to comparison NHs in one study, 44 no difference in one study, 43 and mixed findings in one study. 46 Kane et al 45 reported a positive effect of the Green House in relation to one comparison NH but not the other. In the 2 studies in dementia-specific settings, social activity/ activation outcomes were significantly better than in the comparison NHs.…”

Testing Reliability and Validity of the Person-centered Climate Questionnaire-staff version in Korean for Long-term Care Facilities

“…As for the resident outcomes, studies showed a decrease in boredom, helplessness, and depres-sion by improving residents' social relationships, growing plants or animals, or involving the residents in care decision-making [5]. The small-scale nursing homes (NHs) have also improved residents' quality of life by allowing residents to have more comfortable and individualized care [6].…”

Plotting the Course of Well-Being

“…To help rectify the difficulties associated with institutional living, a movement in long-term care called culture change focuses on a revolution in long-term care settings to create environments where the residents are at home; family members enjoy visiting; employees are respected and appreciated, and their opinions valued; quality of care is excellent; life is worth living; and legal action is unnecessary (Bergman, 2004;Rabig, Williams, Kane, Cutler, & McAlilly, 2006;Zimmerman & Cohen, 2010). Associated with the culture change movement is the need to adequately measure outcomes such as well-being (Kane, 2003).…”