Catherine Yanda asked:
It would be fascinating to the group if you could list the main barriers to implementation of the Eden Alternative. The whole concept of culture change on this group is to educate those who already work in the field of aging and encourage dialogue and new participants to weigh in on the future of care.
Richard Ambrosius answered:
Probably the biggest barriers in my experience are: we’ve never done it that way; that will never work; universal worker is a dumb idea, etc. Early on, some administrators I worked with thought adding a dog and a couple cats would do the trick while actually tightening their command and control policies. I actually had a Director of Nursing say that residents and families would never accept such an idea “because no one would want the same person that wiped their butt preparing their meals.” I simply asked who performed both of those tasks for her. The staff/management-centric medical model of long term care has dominated the industry for decades and changing it will take time. However, once residents experience resident-centered care in an empowering culture, they will never accept anything less.
Maryellen Kernaghan responded:
Richard, I could not help but read your experiences with wide-eyed…..shock. For a Director of Nursing to say “no one will want the same person who wipes your butt to prepare your food” must never have been a PARENT! How do we, or did we, begin our lives but with a single care giving taking care of all our needs, our most basic to our most intimate. Sadly that is why culture change is so important. If an infant were handed off from one person to anoher for all its daily needs, we would be shocked and see it as a factory system. Yet, for the elderly, those who are concluding the circle of life – it’s fine. Well – not with you or the wonderful people who share expereinces on this site – and that is why this work is so important. It IS life changing.