Plotting the Course of Well-Being

Abstract

Persons above age 80 comprise the fastest growing segment of the U.S. population, and it is estimated that one in four will need long-term care due to increased disabilities and illness. A major concern for residents, families, and providers is to ensure care that "allows the resident to maintain or attain their highest practicable physical, mental and psychosocial wellbeing." The challenge is measuring a subjective concept such as well-being. The Eden Alternative is a current initiative aimed at improving the quality of life and well-being of long-term care residents. The initiative consists of providing long-term care environments that emphasize person-directed decision making and well-being. The purpose of this study was to explore the psychometric properties of the Eden Alternative Well-Being Assessment Tool (EAWBAT). There are three assessment tools designed to measure the well-being of elders (residents), family members of residents, and employees working in the longterm care environments. The sample consisted of 237 residents, 430 employees, and 134 family members from seven Eden Alternative organizations throughout the United States. Factor analysis was completed to identify the underlying structure in these data for elders, employees, and families. Reliability statistics were computed for each scale. Reliability statistics ranged from .876 (employee assessment tool) to .949 (family assessment tool), indicating the potential of the EAWBAT to measure the well-being of residents residing in long-term care environments, employees supporting them, and their family members.

Assessing Quality for People Living With Dementia in Residential Long-Term Care: Trends and Challenges

“…A relationship-centered approach highlights the need for all parties (residents, relatives, and staff) to fulfill six senses to ensure well-being and good relationship with each other: (a) security—feeling safe, (b) belonging—feeling part of things, (c) continuity—making connections, (d) purpose—having goals, (e) achievement—progressing toward goals, and (f) significance—mattering as a person (Nolan et al, 2004). These relationship-focused outcomes, identified in an ethnographic study conducted in the United Kingdom, align well with other models designed to promote well-being developed for residential LTC in the United States, such as those developed by the Eden Alternative (Wilby, Stryker, Hyde, & Ransom, 2016). Focusing on relationships highlights the importance of engaging with people with dementia and with their proxies, including paid and unpaid caregivers.…”

“…A sixth, and particularly challenging tension is the importance of distinguishing the advantages of collective outcome tools compared with personal outcome tools. As residential LTC attracts additional attention by the research community, a variety of new instruments focused on thriving (Edvardsson et al, 2017) and well-being (Wilby et al, 2016) are increasingly available to measure performance. Although such instruments are a welcome advance in LTC quality assessment, it is not safe to assume that the specific indicators in each of these measures (e.g., “being able to be outdoors as much as I wish”) will apply equally well to all individuals who reside in LTC (White et al, 2012), especially internationally.…”

Effective Relationships Between Younger Caregivers and Older Care Recipients Across a Continuum of Formal Residential Care Settings: A Scoping Review and a Critical Analysis

“…Formal care provided by paid professionals or carers focuses on physical care, nursing, or psycho-medical interventions [10]. To counteract the perceived 'dehumanising' approach to care associated with a medical model, person-centred care (PCC) approaches developed [11][12][13][14], such as: the Eden Alternative, which considers OPs' emotional, social, and psychological needs while promoting their autonomy and self-determination [15,16]; the Values, Individualised, Perspective and Social (VIPS) model, which endorses the individual values and needs of OPs; Green Houses, advocating for the autonomy and dignity of OPs; Dementia Care Mapping, which focuses on the needs of OPs with dementia [17]; the Senses Framework emphasising the interdependence between OP and CG [18]; and, Swanson's middle-range theory of caring explaining the process whereby caring is enacted [19].…”

Situating Eden—Culture change in residential aged care: A scoping review

“…5,6 One such model is the Eden Alternative [Eden] philosophy based on seven domains of well-being. 7 While this approach is often acknowledged by staff, families and care recipients to be successful as a person-centred model for addressing loneliness, helplessness and boredom, there is little empirical evidence of the effectiveness of the approach. The lack of empirical evidence is perhaps not surprising, as the pace of change within aged care services today demands responses faster than the research community can deliver.…”

“…A major indicator of successful culture change in residential aged care is the nature of the relationship between residents, staff and families, with the aim to establish collaborative decision‐making as close to the care recipient as possible and with a philosophy fully supported by senior management 5,6 . One such model is the Eden Alternative [Eden] philosophy based on seven domains of well‐being 7 …”