A Christmas Gift: The Eden Alternative Spain

The Eden Alternative's person-centred care model comes to Spain to support the change of culture in gerontology in our country.

A few months ago I began to shape a research project with which I intend to study boredom as a risk factor in retirement homes in Spain, with the aim of creating a prevention protocol with which to banish this well-known scourge from our institutions. Inspired by The Eden Alternative's philosophy that I described in a previous post, I contacted the head of The Eden Alternative UK & Ireland, Geoffrey Cox, to propose a stay with his team from which I could draw on to carry out my aims; as my final idea was to import their principles into Spain as an ambassador for this initiative. Cox kindly accepted my proposal, and shortly afterwards gave me the news that two colleagues, David Sprowl and Walter Coffey, were working together to bring The Eden Alternative to our country. Aware of my plans, Cox put the three of us in touch. It was true, The Eden Alternative Spain is now a fact - my prayers were answered!

In many of my articles I have stressed that Spain needed to 'Edenise'. What I could not imagine when I was writing them was that this great step would take place so soon. Personally, this is magnificent news. But it is even more so for our elderly care system. I have had the opportunity to do the first interview with the promoters of The Eden Alternative Spain for this blog, which I have come to share with readers today so that together we can begin to taste the honeys of the coming revolution. But first things first: who are these two 'missionaries' who are going to bring The Eden Alternative to Spain? 

Walter Coffey began his career as a musician and seminarian. At the age of thirty-two he decided to train in Gerontology at Georgia State University (GSU) and obtained a Masters in Public Administration in this field. One of his major influences during this time was Dr. Barbara Payne, founder of the GSU gerontology programme. She was also a Methodist minister and had written on spirituality and aging in the 1980s. Upon completion of his training, he worked on creating policies focused on the elderly and became the director of the day centre for the Alzheimer's Association of Georgia. Later, he developed and ran several homes for the elderly. Finally, he spent eighteen years as CEO of LeadingAge Georgia, an association representing non-profit organizations dedicated to providing quality housing, health care and community services to older people. As part of this project, he directed and expanded the Institute on Aging and the Center for Positive Aging. Coffey is a co-founder of one of the largest networks that aims to promote culture change in gerontology in the United States; a change that requires care to be focused on older people living in various types of housing. His greatest achievement, Coffey explains, "has been getting all the key players in providing services to the elderly committed to this work in Georgia. 

David Sprowl's background is quite similar, although with some differences. Sprowl worked for IBM for sixteen years. But at one point, as if by divine inspiration, he decided to make a radical change in his career. "I wanted to do something more spiritually fulfilling," he explains, "and even though everyone thought I was crazy, I left my job at IBM without really knowing what I was going to do next. After participating in some conferences with Coffey and seeing the joy he felt in working to help others, he embarked on the adventure of returning to university to do a Master's in Public Administration focused on non-profit management. As part of his training, he did an internship in a community of low-income retirees, Lutheran Towers, of which he later became the executive director. Sprowl got the job of his dreams, one where he could be the boss to have the authority to support others personally and professionally and where he felt he was really making a difference to people's lives, and where he could practice his Spanish with the Spanish speaking residents! 

Coffey and Sprowl came into contact during these years with the philosophy of The Eden Alternative and understood that the best way to implement the concept of people-centred care was by adopting its language and following its principles, taking it one step further than the residential home, i.e. any living space for the elderly. In the spirit of The Eden Alternative, together they set out to reformulate the old biomedical concepts under which residences were considered 'hospitals' and people 'patients' to achieve a balance between care of the body and care of the soul. Thus, under Sprowl's leadership, Lutheran Towers was one of the first independent retirement communities to benefit from this great cultural change. Having achieved similar success in many institutions around the world, it is now finally Spain's turn. 

How did the idea of founding The Eden Alternative Spain come about? Sprowl and Coffey have spent a lot of time giving talks and training on people-centred care here and there. Having seen a growing interest in the philosophy of The Eden Alternative in Spain, initiatives such as The Green House Project and the teachings of Dr Bill Thomas, and having all these years of experience in training the ten principles, they simply thought: "Why not become regional coordinators of The Eden Alternative in Spain": "we have the passion, we have the experience, and we live in Spain", exclaims Sprowl. The Eden Alternative Spain will support and bring a new focus to the current progress in people-centred care for older people in Spain. "We will provide tailored resources and training that support the needs and desires of individuals and organisations committed to transforming services for older people," announces Sprowl.

Coffey and Sprowl are currently working on making contacts, meeting people in our country committed to culture change and creating a network between them. They already have four 'ambassadors' helping to carry out this mission, including Stephan Biel (Biel Consulting), Josep de Marti (inforesidencias.com), Anna Cebrian (inforesidencias.com) and myself (hooray!). The plan is to continue expanding the network with people from foundations, residences, associations, etc. and to let the magic work itself out through conversation. They are also creating a website which we will soon be able to visit as a meeting point to access all the information provided by The Eden Alternative Spain and they are translating the materials they have into Spanish so that we can soak up the philosophy more easily.

One of the short-term objectives is for those interested to become certified as Eden Associates. "This is important because it helps to connect all the key points of people-centred care," Coffey said, "Many people have gained a doctorate in gerontology and it is only after they have been certified as Eden Associates that they have achieved a holistic understanding of the phenomenon in question. It's about starting with a small step, rather than trying to implement a big change all at once. The certificate is earned by participating in a series of weekly sessions in which the ten principles that articulate The Eden Alternative are discussed. Each week we work on one of them and explore some concepts related to the well-being of older people (connectivity, autonomy, security, belonging...) to understand what role they play in improving the quality of care and life. 

In the middle of the interview I have a question: is Spain ready for The Eden Alternative? Perhaps one of the difficulties that Coffey and Sprowl will have to face will be the fact that many think that their centres already work from a people-centred care perspective. "But it's not true," Coffey reveals, "People are becoming more and more familiar with this terminology, they think they understand it and are applying it, but they are not," Sprowl warns. For example, the manager of one such centre was once asked if he was implementing the 'consistent-dedicated staff' policy, which consists of a group of professionals always working with the same group of residents to develop a real person-to-person relationship. The response was a resounding no. "So," Coffey responded, "you're not practicing people-centered care. 

This is not only the case in Spain; it is a problem they have encountered everywhere. The classic justification is that staff are not willing to work in this way: "There is a refusal to open the mind to do things differently," says Sprowl. Another of the most repeated excuses in the United States is that the proposed changes conflict with existing regulations. But this is not always the case. "What often happens is that professionals create their own ideas about what the current regulations say and take them as true," continues Sprowl. However, there are many political actors who have known The Eden Alternative, and have even been certified, who confirm that there is nothing in this philosophy that goes against the rules. 

Perhaps the most complicated part will be transferring the essence of the concepts that govern The Eden Alternative to Spanish culture. It is not so much that the language of The Eden Alternative cannot be translated into Spanish, but rather the fear that part of its essence will be lost along the way. "Sometimes even English speakers are not able to grasp these key terms," Sprowl says with a laugh. The language with which Bill Thomas described the purpose of The Eden Alternative in its origins may be confusing (for sometimes being a bit poetic, in my opinion), but Eden has just launched an updated version of the ten principles with a simpler language. 

As it could not be otherwise, thinking about the Portuguese readers of this blog, I have asked the interviewees if we will have a The Eden Alternative Portugal soon. The idea has been raised, but for the moment, the Portuguese will have to wait. Sprowl and Coffey are going to focus on Spain, although they are completely open to the possibility of starting to create links with our neighbouring country. 

The Eden Alternative Spain has come to stay with the sole aim of ensuring that older people in Spain have the best possible quality of life and that unwanted loneliness, boredom and feelings of uselessness will become a thing of the past. The long-awaited change of culture in gerontology is today one step closer to materialising in our country. I myself will soon be starting my journey towards certification as an Eden Associate and I will tell you in detail how my journey through the heart of The Eden Alternative unfolds. For me, this is the best Christmas present I could have received. I am eternally grateful to David and Walter for placing their trust in me as an ambassador for this project; although perhaps the one I should thank most deeply is their grandmothers who, as in my own case, were their greatest inspiration. Now, enjoy the holidays and protect the elderly!