From Chapter 3: Nature, Hope, and Nursing Homes
 A group of us at Chase Memorial Nursing Home began to toy with a radically unscientific, nonmedical approach to life for our eighty residents. We could see that the people we cared for were suffering needlessly. How, we asked, can we make Chase Memorial a better place to live? After several rounds of lively debate, we hammered out our answer to this question into the form of a grant proposal. Happily, the New York State Department of Health funded it. We call our approach the Eden Alternative, and for us, it has become a new way of envisioning what a nursing home can be.
The Near Side of the River: Neglected Human Needs
Need for Companionship
Companionship is food and drink for the human spirit. All people, in all cultures, in all of recorded history, have sought the pleasures of companionship and have suffered when it was lacking. Current nursing home practice does not provide residents with the companionship they need. There are activities and treatments, not to mention nonstop "caregiving," but none of these offer real companionship. The situation reminds me of a character in the Bernard Malamud novel A New Life: "Levin wanted friendship and got friendliness; he wanted steak and they offered Spam." We need a balm for loneliness.
Need to Care for Others
Human beings find pleasure in caring for others. In fact, this satisfaction has led many of us to work in long-term care. Even though frail people depend on us, they retain the vital human need to give care to others. The sting of requiring constant attention is soothed when a person can give as well as receive care. Cognitive impairment limits the demented resident's ability to take care of others, but it does not erase the need. Helplessness is a dangerous, debilitating condition that can kill as quickly as a cancer or a stroke. We must learn how to prevent its development and to reverse its course.
Need for Variety
Human beings need variety in their surroundings. The practice of leading life completely surrounded by artificial enclosures and routines is a recent and unproven development. Our ancestors, including the frail and elderly, lived close to the rhythms of the natural world. Cycles of change fascinated them and affected their views of daily life.
We can easily find the need for variety and change in ourselves. The thought of being confined to an institution populated solely by the infirm and the staff members who care for them does not fill anyone with pleasure. Nature always mixes growth and decay, youth and age in its habitats. We owe our nursing home residents no less.
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