The Eden Alternative is a small not-for-profit organization that supports the Culture Change movement in various settings that are homes to elders. It is based on the core belief that aging should be a continued stage of development and growth rather than a period of decline. Since 2009, Tyler Keeter, PT, DPT, a Certified Eden Associate and Area Rehab Director for Infinity Rehab, has worked to integrate Eden’s principles into Infinity’s therapy operations.

The work has led to various principles and trainings for Skilled Nursing Facility therapists, most of which are detailed in Eden’s recently published “Role of Therapy Professional in Person Directed Care” packet, in which Dr. Keeter was an author. “This packet should assist therapy professionals in the journey towards a more person-directed approach. It outlines the basic systems and processes which help support such a culture in the therapy department, and goes on to review specific clinical approaches that may be utilized with clients and residents. I am happy to report that this sort of approach has been found to improve individual clinical outcomes, departmental financial outcomes, resident satisfaction, and therapist happiness in our departments and in the scientific literature, (1)” says Dr. Keeter.

The Eden Principles
  1. The three plagues of loneliness, helplessness and boredom account for the bulk of suffering among our Elders.
  2. An Elder-centered community commits to creating a Human Habitat where life revolves around close and continuing contact with plants, animals and children. It is these relationships that provide the young and old alike with a pathway to a life worth living.
  3. Loving companionship is the antidote to loneliness. Elders deserve easy access to human and animal companionship.
  4. An Elder-centered community creates the opportunity to give as well as receive care. This is the antidote to helplessness.
  5. An Elder-centered community imbues daily life with variety and spontaneity by creating an environment in which unexpected and unpredictable interactions and happenings can take place. This is the antidote to boredom.
  6. Meaningless activity corrodes the human spirit. The opportunity to do things that we find meaningful is essential to human health.
  7. Medical treatment should be the servant of genuine human caring, never its master.
  8. An Elder-centered community honors its Elders by de-emphasizing top-down bureaucratic authority, seeking instead to place the maximum possible decision-making authority into the hands of the Elders or into the hands of those closest to them.
  9. Creating an Elder-centered community is a never-ending process. Human growth must never be separated from human life.
  10. Wise leadership is the lifeblood of any struggle against the three plagues. For it, there can be no substitute.

1. Lenze EJ et al. Enhanced medical rehabilitation increases therapy intensity and engagement and improves functional outcomes in post-acute rehabilitation of older adults: a randomized-controlled trial. Journal American Medical Directors Association. 2012 Oct;13(8):708-12

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