Topic: Evidencing Eden

Day: Thursday 22 October 2020

Time:  2:10pm-2:30pm AESDT


Evidencing Eden

Providers of residential aged care services face increasing expectations from residents and families seeking an individual approach to care needs. Wellbeing has emerged as a focus for the broader community and should be no less important when we age. The converging crises of both an aged care Royal Commission and a global pandemic that reached Australia in January 2020, has placed residential aged care front and centre of the media’s attention, creating a climate of poor credibility and low trust.
Organisations amid the chaos, are seeking to reflect on their own culture and priorities. Person-centred care has been the dominant theoretical framework in health care for over 30 years and it is time to consider is it still relevant?
This study investigates the implementation of an experiential philosophy for culture change, previously situated in a person-centred framework. A review of the literature investigating The Eden Alternative™ demonstrates limited published evidence of the model although case studies acknowledge the benefit for residents. There is repeated recommendation within the literature for further research of the model to inform culture change in aged care.
Furthermore, very few studies were published that sought the views of all three key participant groups, residents, families, and staff. This study undertook semi-structured interviews and focus groups with each and an organisational summit that included a resident Q&A panel to inform the findings.
The study involved two residential aged care communities, a greenfield intervention site and a control site within the same organisation. A mixed method design included pre and post-intervention measurement of resident self-reported wellbeing at both sites and the use of an Appreciative Inquiry to obtain the views and experiences of residents, families and staff who live, visit and work at the intervention site.
The objectives were to develop a relationship-centred model informed by Appreciative Inquiry; to understand the influence this model may have on resident wellbeing; and to add to the knowledge of relationship-centred care in the older population.
The study findings confirmed the hypothesis that the model has evolved to become a relationship-centred approach that improves resident wellbeing with six primary themes emerging from the data. A conceptual model has been designed and resources are being created to assist organisations to articulate and implement the model. This research has the potential to ease the tension between policy and practice for providers in a highly challenging environment.


Fran is a Registered Nurse with more than 20 years’ experience as both a clinician and manager of residential aged care services across a variety of settings. In her current role Fran supports the managers and staff of the 13 residential aged care communities within Wesley Mission Queensland to meet increasing client expectation in a volatile and rapidly changing landscape.
Fran was awarded a Churchill Fellowship to study Dementia services in the UK, Canada and the USA and holds a Bachelor of Health Science (Nursing) a Master’s in Health Science (Gerontology) and is currently completing a PhD investigating the impact of culture change on resident wellbeing.