The Transformation of Long-term Care

The Origins of the Culture Change Movement

More than twenty years ago, a group of experts from across the U.S. gathered to discuss alternatives to the custodial, deficit-focused and rule-based approach that directed most long-term care. A national movement to transform the experience of aging and long-term care was conceived. The Culture Change movement, as it became known, called for person-directed support that respected the choices, capabilities, uniqueness and dignity of each individual.

Today Culture Change is not only altering the way we care for our elders, it's changing the way we care for individuals with cognitive disabilities. These new attitudes are reshaping long-term care that was traditionally custodial and medically driven into humanistic and holistic supportive living environments. 

 
Birth of the Eden Alternative

"The challenge is to create a Human Habitat where people of all ages come together day after day - eager and able to Thrive, not just Survive."      - Dr. Bill Thomas, founder of Eden Alternative

In the early 1990s, Dr. William Thomas was making his rounds at a nursing home in upstate New York when he had an encounter with a resident that affected him deeply. Pulling him close, this frail blue-eyed Elder shared with him her profound sense of loneliness in a desperate whisper. This experience inspired Dr. Thomas to create a better world for our Elders, one in which the plagues of loneliness, helplessness and boredom were addressed head-on and not simply swept under the rug. He imagined a place where people could grow and thrive rather than simply wait to die. In 1994, the Eden Alternative was born and has gone on to become a worldwide leader in the Culture Change movement. Eden has shown how vibrant "Human Habitats" - environments that offer variety and spontaneity, companionship, and opportunities to give as well as receive support - can succeed where pills and therapies fail.

Evolution of Eden LifeLong Living

In early 2006, David Seaton heard an interview with Dr. Bill Thomas on National Public Radio about transforming long-term care in America. As Dr. Thomas explained the philosophy behind the Eden Alternative, Seaton, who has owned and directed long-term care programs since the 1980’s for individuals with cognitive disabilities in central Texas, became intrigued. What Dr. Thomas had to say about the application of the Eden Alternative philosophy with elders really resonated with him. In fact, Seaton had long held similar beliefs that long-term care should be about supporting continued growth and well-being rather than accepting stasis and decline. 

The Eden Alternative philosophy offered an approach that could not only enhance the lives of elders, but also the lives of individuals with cognitive disabilities - a population of individuals Seaton felt was stuck in an "archaic" medical model. But there were some big differences in his residents and the elder population of Eden's focus. Unlike elders who have lived a long, full life, many individuals with cognitive disabilities have had a life interrupted by injury or illness at a young age. Some may have lived with their disability since birth and have required support all their lives. Nevertheless, Seaton felt that much of the underlying philosophy and approach to transform long-term care were quite similar.

In the Fall of 2007, Seaton took his first major step with Eden Alternative by getting his LifeLong Living Community registered as the first Eden Home for people with cognitive disabilities.

Through the Seaton Foundation, an Austin, Texas-based non-profit, a grant was awarded to the Eden Alternative in 2008 to conduct a Demonstration Project to assess the applicability of the Eden Alternative philosophy and approach in long-term care settings for individuals with cognitive disabilities. After completion of the Demonstration Project, Seaton knew that he'd hit on something. And in 2009, The Seaton Foundation partnered with the Eden Alternative to establish Eden LifeLong Living (ELL) to promote well-being and a better quality of life for individuals with cognitive disabilities and those who support them.