Question

Review the study from ASC ( Alzheimer's Society of Canada ). Also review the Eden Alternative, Green Houses and the Wellspring Model. Write your findings as a word report on similarities and differences in all of these different approaches to PCC ( Person Centred Care)(20 marks).

Answer 1

The Alzheimer Society is Canada’s leading nationwide health charity for people living with Alzheimer’s disease and other dementias. Active in communities across Canada, the society offers help for today through programs and services for people living with dementia and hope for tomorrow by funding research to find the cause and the cure.

Eden Alternative is based on the core belief that aging should be a continued stage of development and growth, rather than a period of decline. The philosophy was originally applied to nursing homes but has since been adopted with little modification by all forms of residential care, community care and other long term care environments not limited to aged care.

Studies show that implementation of the Eden Alternative philosophy is a powerful tool for improving quality of life and quality of care for those living in long term care. Organizations that have adopted Eden as an organization-wide philosophy has found that there is improved staff satisfaction and retention and significant decreases in the use of medication. Most importantly, Elders, supported by caregivers, can once again direct their own daily lives.

Dr. Bill Thomas, the founder of the Eden Alternative, said that home care is in need of culture change just as much as traditional nursing homes.

The Green House Project models are designed to make long-term-care facilities more “home-like”,

The Eden Alternative’s Ten Principles and core mission to eliminate the three plagues of helplessness, loneliness, and boredom apply to anyone in daily life.

The aim of the Eden Alternative® is to restructure the delivery of to reduce this metaphysical suffering and increase the quality of life. Information for families, residents, and managers is easily accessible online.

The Eden Alternative® is based on the conviction that organizational models of care range in quality from lowest to highest. The lowest quality of care is provided in a traditional care model, which subscribes to hierarchical practices and traditions such as consistent meal times, medication times, assigned bath days, and specific job descriptions, while the highest quality of care is provided in the Eden Household or Greenhouse models

The Wellspring Model, for the Aging, describe one nursing home-based initiative that is striving to improve quality through model clinical practice systems and changes to the prevailing culture in nursing homes.

Wellspring is an early American cultural change model originally designed as a cooperative alliance between 11 independent, not-for-profit, rural and urban nursing homes in Wisconsin (63 to 415 beds). Although there are no specific modes of Wellspring service delivery, have included it here because it is a model of shared services and of interest to organizations. Due to limited human resources and reduced budgets, eleven nursing homes began sharing.

Stone et al. also examined staff retention and found that RN and LPN retention rates increased and decreased, respectively, while the care aide retention rate stayed the same. The overall improvement in combined retention rates was statistically significant. No, statistically significant differences in resident outcomes obtained from the federally mandated Minimum Data Set (MDS) and the OSCAR between residents in Wellspring facilities and residents in nonWellspring facilities occurred during the four-year implementation period.

Eden Alternative, Greenhouses are standalone physical structures that house six to twelve residents. Private bedrooms and bathrooms are organized around a central living space known as a “hearth”. Residents are encouraged to incorporate their own furnishings and personal belongings into the home. Fireplaces serve as a symbol of home, warmth, and comfort . Family-style kitchens with a single dining table promote active community participation. Residents participate in food acquisition and meal planning and preparation or eat meals prepared by cross-trained staff members. Access to outdoor space is another essential component, which should decrease agitation, anxiety, and wandering. The absence of handrails in outdoor spaces, direct sun exposure, and concrete pathways can compromise resident safety, making supervision necessary.

Sharkey et al. examined the amount of time that Shahbazim/care aides spent in direct and indirect care activities in 14 Greenhouses and 13 traditional nursing homes. The average total nursing HPRD (excluding administrative hours) was 5.3 in the Greenhouses while the HPRD in the traditional homes was 3.6. Conversely, Greenhouse residents received 2 HPRD less for housekeeping, laundry, dietary, dietician, and staff education. The authors attribute the smaller number of non-nursing support hours in the Greenhouses to the fact that work was shifted from housekeeping, laundry, and food services to the care aides. Greenhouse care aides were, however, able to engage with residents for long periods of time while they did their other work. Some researchers have reported practical challenges for organizations when Greenhouses are retrofit: the amount of waste, its storage, and disposal. Additionally, the Greenhouse design lacks storage spaces for medical equipment

In theory, the hierarchical organization of health care providers within the Greenhouses is flattened.

Despite a great deal of anecdotal support for the Eden Alternative philosophy, the empirical support for consistent assignments is not extensive. Conversely, resident and staff outcomes specific to the Eden AlternativeGreenhouses and the associated self-management are very promising. Residents living in Greenhouses report heightened emotional well-being and significantly more satisfaction with care.