Evolution of Eden

SUMMARY The American Nursing Home is in the center of a “perfect storm” as a result of financial, workforce and liability issues. To date, conventional approaches to quality improvement have been ineffective at fundamentally changing our notions of care and treatment for our Elders. Begun in 1992 as an effort to transform life in a single New York State nursing home, The Eden Alternative has, a decade later, more than 5000 Eden Associates and 200 organizations as members. Its impact has been international. Building on the principles of Eden and its direct response to loneliness, boredom and helplessness, the Green House concept has subsequently evolved. This is more than an iteration or improvement on the Eden Alternative. Rather, its premise is that change, however well intentioned and profound, in our current system of long-term care is inadequate.