I'm a student and I've been doing a practicum in a really wonderful LTC facility that bases its philosophy in part on the Eden Alternative. A few things that really stood out for me:
- as has been mentioned previously, residents are allowed to wake and eat on their own time. For most people this is between 0800 and 0900, so it's not as demanding in terms of shifts in the dining room as one might expect. For the few that like to wake early or sleep in, it seems to significantly enhance comfort, and makes the dining room overall less chaotic
- instead of a set menu, residents in the dining room are offered a selection of food choices in steam trays that rotates through the dining room on a cart. There is a fruit and beverage cart that makes rounds as well... I think the moving bev cart is a great idea because I've often found those items on carts in the first place! For many residents, visual choice is easier to comprehend than a list of options, and people are not forced to eat overly large portions or foods they don't enjoy. I have found so far that residents are more likely to choose beverages other than or in addition to coffee/tea if they see the choices. The fruit is display with a cutting board, so that people can choose just a little fruit instead of "the whole thing"... for some tiny ladies this is more appropriate and ensures that they actually have some fruit
- residents have a locked glass display case outside their rooms to display photos, precious objects, medals, etc... i think this is wonderful because one is reminded immediately that there is a complex person behind every door, one who is very unique... I've seen variations of this with a photo display on doors as well. Many people have photos of themselves as young adults which is really fascinating...
- instead of storing small pieces of medical equipment or supplies in obvious places in resident's rooms, things are placed in cupboards or left on the linen carts. For example, briefs/incontinence pads etc. are not stored in one's bathroom in an obvious way, but are left on the linen carts. Night shift will put out pads/briefs for the resident for the day on the bedside table @ their last round of checks for the am shift to use for the resident before breakfast. People who change their own briefs have them in small cupboards usually brought in by family.
- staff are encouraged to contribute to the home-like environment through their unique talents. One person plays the piano for the residents if they have some downtime (and since the staffing ratio is very appropriate given the residents needs, this is certainly possible). Others have contributed artwork, people bring in fruit + flowers from gardens etc. etc...
- there is a "men's club" and a "ladies club" once a week for residents to socialize in common area... the men who are allowed get a small glass of beer!