Monkhouse Monday

2nd Eden Europe Networking Conference in Denmark

It is eight years since I had seen Eden at work at Sherbrooke Community Center in Saskatoon, Canada. A few days later in 2000 I sat down with Bill Thomas in Upstate New York and we agreed that I can bring Eden to Europe. Last week Thursday and Friday Bill and I met again, together with 150 Eden-implementers from Austria, Germany, Switzerland, the UK, the Faroe Islands, Sweden, Iceland and last but not least, a big group from Denmark. Aase Porsmose and Karin Dahl hosted the conference where new learning, thinking, celebrating, cross border networking were made possible by people talking to each other, managing three languages: Danish, German and English. We learned Faroe Island Dancing, savoured Danish cuisine and hospitality, met people who are on the same journey. The conference was opened by speeches from Alice Liber, Switzerland (New panther Club) and Anna Madsen, with her dog Monty, residents of a Danish Eden home. Bill Thomas gave us the history, the current and the future of Eden and many speakers shared their learning and insights.

Eden truly does not educate followers, it educates learners.

One of the most important lessons we learned is the one of close relationships. Aase Porsmose and her husband Vaugn started the conference with the new official Eden-hymn, a great song, everybody managed to sing in three languages:

It’s good to see you – so good to see you
Oh, how I’ve missed you, since I’ve been gone
........it’s good to see you, to be in your home

Nun Freunde, lasst es mich einmal sagen,
gut wieder hier zu sein,
gut Euch zu sehn.....

Det’ godt at se jer, sa godt at se jer
Hvor har jeg savnet jer – siden sidtst
.....Det’ godt a se je




Vaugn (Guitar)
Aase, Danish Eden national coordinator (together with Karin Dahl)

Christa Monkhouse

Eden Rocks

This just in...


Westwing Place at Genesis Medical Center, DeWitt is one of the highest-ranked senior care facilities in Iowa, according to rankings of the Centers for Medicare and Medicaid Services.

Westwing Place, a 77-bed facility attached to Genesis Medical Center, DeWitt, scored a maximum of five stars in on-site health inspections, five stars in quality measures, four stars in staffing and five stars in overall quality.

"One of the main reasons for our success is the quality of our staff. If your staff takes pride in the job they do and the care they provide, that is going to make a difference in the other areas of quality,'' said De Schmidt, Director of Nursing, Genesis Medical Center, DeWitt. "Our staff truly considers the residents to be their family and they treat the residents that way.''

Westwing Place is a certified Eden Alternative Facility. Eden recognizes care facilities for preventing loneliness, helplessness and boredom by creating a vibrant habitat for seniors. Eden facilities use an enlivened environment with opportunities for residents to care for companion animals, children and plants.

Illini Restorative Care, a 75-bed facility located adjacent to Genesis Medical Center, Illini Campus in Silvis received four stars in health inspections, four stars in staffing, three stars in quality measures and four stars in overall quality.

Talented people, hard work, a commitment to well-being and the right philosophy, these are the things that make quality long-term care a reality.

Congrats!

Power-Up Friday

Why I love the Eden Alternative:

At our recent Mentor meeting in South Padre, Texas, we met Rachel and Erik, an Oklahoma couple who were planning to get married on the beach that afternoon. They invited the group to stop by at 4:30, as they had no friends or family with them and were marrying alone.

A few of the Eden "ringleaders" went to work immediately, buying a cake and champagne. They used photos of the couple on the beach and the morning sunrise to create a card and a framed picture. Rachel and Erik were incredibly moved by the kindness of strangers, who had given a sacred gift by being witnesses and participants in their special ceremony.

Eden Alternative is more than another philosophy for changing aging - it is one that encourages everyone to internalize and become the change they wish to see.

-- Al Power

Monkhouse Mondays: No more Nursing-Home Placements

Some European regions such as Switzerland have attracted considerable immigration of well-educated, cosmopolitan professionals and their families, often referred to as the "brain-gain“. It is routine for companies to hire relocation-specialists in order to help these individuals and families settle in, find local people to talk to, the right school for the children, a job for the spouse. They get the different culture explained and all in all, everyday life is made as easy and as stress-less as possible.

Relocation to a nursing home should be planned, the culture explained, prepared for and the daily stressors minimized until safely settled in and relationships formed. Following a pilot-project in an Eden-Home in Switzerland, this service has been regarded as essential, because people could choose, plan, were helped and advocated for and the word “placement” was eradicated from use. Shouldn’t this service become mainstream? Elders provide jobs as much as international companies do.

-- Christa Monkhouse

Stress and Memory Loss – an explosive cocktail

I attended the Montréal Ageing and Design conference over the past three days and I would like to share with you some things I have learned with great pleasure.

Montréal is a great city, my friends and I took our time to eat good food and drink wine, nothing seems rushed here. Laid back, friendly, bilingual Canadians. Oh yes, before I forget, from the conference, one of the most impressive lectures:

"Stress and ageing – an explosive cocktail." A lively and charming presentation by stress researcher Sonia Lupien, Ph.D., from Montréal*. As the "middle generation,“ we think we are stressed, but in fact children and our Elders are more stressed. Stress, not ageing, has a devastating effect on our brain.

What causes stress?

Four additive factors lead to stress, such as novelty, unpredictability, threat to one’s ego and the sense of low contol (acronym NUTS).

All four factors are continuously present in the life of Elders in an institution. Due to this environment they suffer from depression and memory loss, both reversible if we encourage social support through friends, family and staff, through supporting active grandparenting, laughing, physical exercise, singing, praying, listening to music, hugging, kissing and just being.

You can measure all this by taking saliva samples, testing for cortisol, a stress hormone. Suddenly the "touchy-feely soft facts“ of companionship, reciprocity and spontaneity as promoted by the Eden Alternative appear to have a "hard“ scientific backing.

-- Christa Monkhouse (out for some more wine again)

*Lupien S.J., Fiocco, A*., Wan, N., Maheu, F*., Lord, C*., Schramek, T*., Tu, M.T*. (2005). Stress Hormones and Human Memory Function across the Lifespan. Psychoneurondocrinology, 30:225-242

http://www.hlhl.qc.ca/crfs/lupien.html
http://www.hlhl.qc.ca/stress

Summer Fun -- On the Move

Here's a great example of changing aging, from right here at St. John's Home in Rochester. This was "On the Move" week, supported by a generous gift from Bob and Mary Hastings. Our Generations Child Care has several special events with the elders at St. John's all week long. Here are some highlights:

Monday: NASCAR Day

The kids put on "pit crew" shirts and decorated the wheelchairs, followed by a series of races. It also made the local news broadcast


Tuesday: Up Up and Away Day

A hot air balloon demonstration, first in the adjacent park:

Then inflated on its side in the Auditorium so kids and elders could go inside the seven story envelope:


Thursday: Water War. This was a hoot and everyone got soaked:



For those who think that life ends when you go through the doors of a nursing home, think again. Many of us are challenging that idea!

The World of Eden

The successful design of Macclesfield's new village for older people has brought a windfall for a town charity.

The money was donated by CLS Care Group, the charity which runs the new Belong village for older people in Kennedy Avenue. CLS Operations Director, Tracy Paine, explained that they had received the money as a result of the village being shortlisted in the national Pinders Healthcare Design Awards.

“It is very exciting as the village now has the opportunity to go to the national final. But we receive cash for getting this far in the competition and we are able to nominate a charity to receive it. Some of the village residents will be cared for in our special dementia household so we are pleased to make this donation to the Alzheimer’s Society in Macclesfield”.

The Design Award ceremony was held at Lord's Cricket Ground this spring where it was announced that Belong Macclesfield, a home that is implementing the Eden Alternative principles, won the award for Best Traditional Design.

For More about Eden in the UK go here.

Green House Revolution

This an op-ed Al Power wrote for the Democrat and Chronicle...

A June 13 letter writer ("Offer our elders family-style care) asked why elders cannot have the same "family-style" care that has been provided to those with developmental disabilities in the community. She cited the need for a home that is warm, open and allows elders to direct their own care.

What she describes is the Green House, a new model of care designed by Dr. William Thomas, founder of the Eden Alternative nursing home movement. About 40 Green House homes are operating in 10 states, and more than 30 more organizations have received grants to develop them.

St. John's Home and the Rochester Presbyterian Home are the only Eden Alternative providers in upstate New York. St. John's has received a grant to develop Green Houses locally, and we plan to open our first Green House by late 2009. We will be the country's first organization to place Green Houses throughout the community, rather than on one separate campus. Our main campus will be transformed into a multi-story Green House community as well.

The Eden Alternative process transforms the traditional nursing home in three ways: interpersonal, organizational and physical. The process begins with changing our attitudes about aging and aged care, and developing close, continuous relationships throughout the home. This is followed by a "leveling" of the organizational hierarchy, bringing more decision-making to the elders and those closest to them. The Green House represents the physical aspect of transformation and further evolution of the care environment.

A Green House is a large ranch-style home for eight to 10 people, each with a private bedroom and bath. A central area contains a kitchen, dining area with a communal table for meals, and a living room/hearth area. There is no nursing station; care is taken to remove institutional trappings.

Direct care is provided by a universal worker, charged with helping to bring forth each elder's abilities. These workers have training in personal care, safe food handling, cooking, activities and light housekeeping. They work collaboratively with a clinical support team of nurses, doctors and social workers who visit the house.

Green Houses also use smart technology, such as paperless record systems, induction cooktops and ceiling-mounted lifts to provide safe and comprehensive care. There is easy access to outdoor space.

Studies of the first Green Houses in Tupelo, Miss., showed that elders who moved there had equal or better outcomes in many health and quality-of-care measurements, with the same reimbursement rate as the comparison nursing homes. They also saw greater family satisfaction, fewer medications and less staff turnover and injuries.

Since that first Green House opened in 2003, similar models of small homes for elders have been developed, both for those in nursing homes and in assisted living communities. Our project team has visited eight Green House communities around the country, as well as other similar models.

It is important to stress, however, that the Green House is more than a building. If such homes are built and operated the way we operate nursing homes, they would simply be small institutions. St. John's Home has adopted the Eden Alternative because we feel it is the most comprehensive model for transformation. We have learned that the most successful of these homes have followed this pathway to create a truly person-directed habitat, where even the frailest elders can experience growth and full engagement with life.

Power is Eden Alternative mentor, St. John's Home.

Christa Monkhouse

I bet Christa is having a great holiday biking in the Alps.

Monkhouse Mondays: First we take Manhattan........

[Editor's Note: Eden Alternative Europe Coordinator Christa Monkhouse guest-posts on a weekly basis from across the Big Pond. Christa helped introduce the Eden Alternative to Europe, first in the UK, then Denmark, Austria, Germany, Switzerland and soon in Sweden, Finland and other European nations. Stay-tuned for regular updates on 'Monkhouse Mondays'.]

“They sentenced me to twenty years of boredom*
For trying to change the system from within
I’m coming now, I’m coming to reward them
First we take Manhattan, then we take Berlin”

Leonard Cohen’s song has long been the unofficial Eden-in-Europe anthem, starting small (with one home in Switzerland = Manhattan) then spreading out over Europe (= Berlin).

This song comes to life in Denmark, where national coordinators Aase Porsmose (aaseporsmose@mail.dk) and Karin Dahl (karindahl@stofanet.dk) are truly taking “Berlin”. Here is their report on bringing the Eden philosophy to “almost the whole country” of Denmark (Note: the charming Danish/English comes to you unedited):

“Our project involves 25 nursing homes from three municipalities across Denmark. The aim is quality-improvement for both residents and staff, due to a culture change to a new focus on every day living, health promotion and relationships. We challenge the present culture in Danish nursing homes. Even though we have worked with a Danish ‘Live and stay’ culture for several years the institutional culture is still dominating. We regard Eden as a necessary superstructure to eliminate the confirmed loneliness, boredom and helplessness.

In the project we have been on a 'preparation tour' to all of the homes making interviews with leaders, staff and users, board members and politicians. We also made 2-hours information meetings about both the project and Eden on the same day.

Right now we are teaching about 30 leaders and 300 chosen staff members their first 3 days course about Eden. In the autumn we make a second 3 days course for the 300 staff members who will have a process-role as 'Eden key-person'. The leaders will have three separate days during the project period, because we wish to be able to support them during the implementation.

We are also going to visit every nursing home 3 times in the education and implementation period, to support the local Eden-group during their Eden-process - the aim with these days is to support the educated Eden-key persons in a way that will make them able to continue the process without having to ask for help from us every now and then.

The project is financed by funds from the Danish Ministry of Social Welfare. More funds have been given to other smaller projects across the country which also involves the Eden principles.

The Eden power-team: Karin Dahl/Aase Porsmose/ nurtured by Jane Verity, Eden Scandinavia Mentor

Christa Monkhouse, Switzerland

*The editorial of the May 2008 Issue of the “International Journal of Older People Nursing” by Jan Reed (p 79 – 79) has the same title (Volume 3, Issue 2)

Power-Up Friday: Eden Care Partner Award

[Editor's Note: Guest-post from Al Power below]

Rochester New York's ABC affiliate, WOKR-TV, featured Eden International Care Partner Award recipient Gregory Payne on their "Bright Spot" to close the evening news on 6/25.

Known to those at St. John's Home as "Greg Grounds", Payne convenes a weekly "Green Thumb Society", helping the elders to start seedlings, and to plant flower and vegetable gardens at the home. The group also pots plants to deliver to visitors, and to those who cannot participate.

Greg read Bill's book, "In the Arms of Elders" several months ago, and became an instant Eden Champion. His work, (which as the news report suggests, comes straight from the heart), has touched the lives of all who live and work at St. John's.

To see the video, click here, and click on the 6/25/08 Bright Spot.

-- Al Power

Next Step

Eden Alternative Executive Director Nancy Fox is moving on up and out and will be leading the culture change journey for Pinon Management starting next month.

This was her last International meeting as ED.

Nancy will remain on as an Eden Mentor and will be based in Denver --- the host city for the 21012 Eden International meeting.

She is a wise, thoughtful and skilled leader.

In the photo I have just finished thanking her from the podium.

Onward!

Changing Aging Bloggers

[Editor's Note: Dr. Bill asked me to post this photo of the Changing Aging blog team from the Eden Alternative International Conference in Columbus, Ohio last week -- From left to right: Christa Monkhouse, Eden Alternative European Coordinator; Dr. Bill Thomas; Jane Verity, who will be blogging about aging issues in Australia and Scandanavia; and longtime Changing Aging contribute Dr. Al Power.]


A few weeks ago I had the privilege to be invited to the re-opening of the Dolder Grand Hotel in Zürich, Switzerland. It had been restored to it’s former glory by it’s visionary proprietor, the renovation taking four years to complete. Everyone knows that the Dolder is "THE place to stay“, a true benchmark in global tourism. On it’s website it rightfully prides itself to meet "exalted standards“.

During the 4th Eden-Alternative international Conference in Columbus, Ohio last week I learned from many organisations and individuals how they strive to make their nursing homes and their surrounding communities into "THE place to live“ for frail Elders and I got the impression that these efforts will lead to Eden being perceived as the "Dolder“, the desirable global standard. The only difference is that while one Dolder Grand Hotel will do, we will need many many more "Edens“. In comparison with today’s prevailing nursing home standards, Eden might indeed sound exalted – but – given what I learned at the conference - not for very much longer.

Power-Up Friday: Changing Aging

The 4th Eden Alternative International Conference will be winding down today. It may take me a while to digest all of the wonderful things I’m experiencing. However, one story from the past came to mind today:

It was six or seven years ago and I was at a Pioneer Network Gathering in Rochester. I found myself sitting in a conference room late at night, conversing with Bill Thomas and renowned elder advocate Carter Williams. Bill was regaling us with tales of his recent Eden bus tour across America.

All of a sudden, Bill paused and said, “You know what’s occurred to me? I’ve realized that it’s not enough to change nursing homes. We have to change society’s view of aging.”

My initial response was mild exasperation, and I thought to myself, “Just as we’re starting to make some noise with the Eden Alternative, leave it to Bill to push things to an impossible level!”

Fast forward to 6/5/08. I sat in the general session yesterday morning and listened to the stories and looked at the faces around me.

And I remembered that night. And I thought, “Damned if we aren’t doing just that! We really are changing aging in our society!”

Sometimes you don’t know where you’re going until you can look back and see where you’ve been.

-- Al Power

Eden International

Hey Everybody, Jude and I are attending the Eden Alternative International conference in Columbus Ohio.

This video was made by Steve Lemoine. Steve is a tremendous leader and he has done an enormous amount of work to make this possible.

Monkhouse Mondays: Social Climate Change

[Editor's Note: Dr. Thomas has invited Eden Alternative's Europe Coordinator Christa Monkhouse to guest-post on a weekly basis from across the Big Pond. Christa is personally responsible for introducing the Eden Alternative to Europe, first in the UK, then Denmark, Austria, Germany, Switzerland and soon in Sweden, Finland and other European nations. Stay-tuned for regular updates on 'Monkhouse Mondays'.]

The social climate change (cooling, not warming)......and it’s solution

I spent the last week in Vienna, Austria, springtime – lilac at it’s peak, roses budding – teaching Eden and attending the Iahsa European conference, listening and learning.

I had the privilege to meet with Prof. Ernst Gehmacher (82). He is member of the Austrian chapter of the Club of Rome for global sustainability and the most prominent person in Europe to measure social capital*. He is convinced that investment into building, nurturing and sustaining human relationships is more profitable (in Dollars and Euros) than "pure“ money investment. As a biologist and sociologist he has accumulated a wide database which clearly indicates that social capital is related to happiness, better health and lower health care costs.

The younger generation, who we confine to grow up in social isolation, their companion pieces of technology such as computers and the internet, is impoverished in terms of social capital, their social climate is getting colder, not warmer. Therefore we should start looking at our elders as providers and deservers of social capital, not just as cost and burden to society and bring the generations back together. And in the end, it will "pay off“ in human warmth and economic growth.

I agreed with him to measure the Eden-Alternative impact with his social capital measurement tools. I keep you posted on this.

*(defined as the sum of social relations at the micro-level such as friends and families, at the meso-level such as membership of clubs, parties and other associations and at the macro-level represented by culture, belief-systems, world- and spiritual views).

-- Christa Monkhouse at info@eden-europe.net

What is the Eden Alternative?

Bill gives a great explanation and overview of the Eden Alternative philosophy in an interview broadcast this morning on ReachMD. Listen Here.

It's worth noting ReachMD is an interesting new media news outlet combining satellite radio and online streaming content to better reach the medical community. From the website:

ReachMD, an innovative communications company, provides thought-provoking medical news and information to healthcare practitioners. Established to help increasingly time-constrained medical providers stay abreast of new research, treatment protocols and continuing education requirements, ReachMD delivers innovative and informative radio programming via XM Satellite Radio Channel 157 and online streaming developed by doctors for doctors.

Monkhouse Mondays: Care Capitals of Europe?

[Editor's Note: Dr. Thomas has invited Eden Alternative's Europe Coordinator Christa Monkhouse to guest-post on a weekly basis from across the Big Pond. Christa is personally responsible for introducing the Eden Alternative to Europe, first in the UK, then Denmark, Austria, Germany, Switzerland and soon in Sweden, Finland and other European nations. Stay-tuned for regular updates on 'Monkhouse Mondays'.]

From the European Culture Capital to the European Care Capital* – What else?

Every year the European Union (EU) selects and celebrates a cultural capital of Europe. They spend considerable amounts of money to polish them up and promote tourism. In fact, several "B-Cities“ have, through this program, become permanently attractive European tourist destinations. One such city is Graz, the capital city of Styria (Arnold Schwarzenegger was raised nearby), and Linz has been chosen for 2009. It's the capital of Upper Austria, on the (blue) Danube close to where I was born and raised. It boasts galleries, musical performances -- such as the impressive "cloud of sounds" -- and the new and well known solar-city, an energy sustainability experiment, with community and neighbourhood-building projects attached to it.


The time is now right to begin selecting the European Care Capital. Cities could apply to show how they have provided an excellent quality of life for their Elders, how they make them welcome, safe and how they promote growth by providing integrated services, imaginative housing, prevention, education for elders and carers, families and integration for people with dementia into society (see my post last Monday). Money would be proudly invested to motivate other communities to strive for the same excellence.

An inspiring example is the "generation-village“ in Burgenland, Austria, near the Hungarian border. The Strem-Village senior center is now being extended into an intergenerational village, bringing back Elders, creating work places mainly for women and thus benefitting the local school, the kindergarden, local businesses and making this rather remote village in wine growing country among rolling hills and open skys an attractive place to raise families. More housing is being built and population is on the increase while neighbouring villages are losing people. Mr. Peter Kalman (peterkalman@aon.at), the CEO of the development, will speak at the Lahsa-Vienna conference in May. He will explain how their approach makes perfect business sense in addition to preserving and enhancing local culture beyond measurement.

So why not copy, copy, copy on a grander scale.

[*Footnote: The European Care Capital is not my idea, but was put forward to me in 2005 by Mr. Rainer Bensch, a politician from Bremen, Germany. He met with me to talk about the Eden Alternative and how it could be the "blanket“ for our society to care for Elders and how European Care Capitals could become it’s gold standard.

--- Christa Monkhouse

Power-Up Friday: International Eden Conference

For anyone who enjoys reading these pages, I hope you will seriously consider joining us at the 4th International Eden Alternative Conference, June 3-6 in Columbus, Ohio. Every two years, leading innovators from around the world gather at a different city to share exciting developments in changing aging in society. Columbus is easy to
get to, and it should be a fabulous time!

Eden Founder Dr. Bill Thomas will be on hand, and will give the opening Keynote address, and Executive Director Nancy Fox and Board member Sara Rowan will convene the conference. There will be dozens of speakers throughout the meeting, including Jane Verity and Hilary Lee (see the "Spark of Life" video on the 5/6 Monkhouse Monday post). There will be a presentation on Green Houses(R), and one about using computer technology to enhance the lives of elders. Bloggers Christa Monkhouse and myself will have presentations as well.

There will be a dinner/dance which will also include a theatrical performance by Howling At The Moon, a company of 8 women over 60 who write and perform sketches about what it means to be older. An International Reception kicks off the event with a convergence of Eden Associates from all corners of the world. The closing Keynote speaker will be Richard Pimentel, a prominent disability rights advocate recently profiled in the documentary film "Music Within".

In between all of this, you can learn about culture change from Europe to Australia, about aromatherapy, intergenerational experiences, changing roles of nurses and others in the elder care workforce, and many, many other topics.

A discounted "early bird" registration deadline has been extended to May 16th. Your fee covers the whole conference, plus breakfasts and lunches, the Tuesday reception, the Wednesday dinner/theater/dance, and a free showing of "Music Within". It's an incredible deal!

To see the whole program and to register, go to www.edenalt.org, and click on the conference link. See you there!
-- Al Power