Guest Blog: The Eden Alternative and The Flood

February 12, 2014
Virgil Thomas,

Thanks to Scott Brenner

Rachel Wynn, MS CCC-SLP is speech-language pathologist specializing in geriatric care. She blogs at Gray Matter Therapy, which strives to provide information about geriatric care including functional treatment ideas, recent research, and ethical care. Find her on FacebookTwitter, or hiking with her dog in Boulder, CO.

For years I have been frustrated by care in the skilled nursing facilities that did not meet my high expectations for patient care, respect, and dignity. (Some buildings are better than others in my experience, and I’m certain there are many wonderful buildings I haven’t experienced.)

I have been fighting for better care for our elders in the SNF setting. I wrote a letter and organized many SLPs to send it to the American Speech-Language Hearing Association (ASHA). I met with ASHA leadership at the national convention. I accepted nominations for the ASHA board of directors. And I have encouraged SLPs to advocate for better working conditions to improve the quality of care they can deliver.

It wasn’t until I worked in a building that followed the Eden Alternative principles, I realized my patients weren’t the only ones suffering. Corporate culture profited on the ill treatment of staff, including lack of autonomy and disrespect resulting in chronic unremitting stress.

Honesty and Empathy

In late July 2013, I started working at Frasier Meadows, a CCRC, in Boulder, Colorado that follows the Eden Alternative principles. During my interview I was very upfront about my concerns about unethical patient care. The response wasn’t just reassurance that this facility practiced patient-centered care. My interviewer responded with empathy and deep concern about the global ethical issue impacting our elders. At first I was a little surprised, but then I was a little more confident I found a building where services were delivered at a level that met my high expectations.

At the end of my interview, I was told about the orientation process. Even though I was hired as an experienced SLP to work PRN, they wanted me to complete extensive orientation. Observing other therapists was a part of the orientation. The goal of observation was to understand the culture at Frasier Meadows. My boss told me that the biggest thing people have to learn when beginning to work at Frasier Meadows was to slow down, because we’re treating people.

Slow Down

I love the slower pace. It’s better for me and my clients. I walk slower. My heart rate is lower. I’m sure the adrenaline and cortisol pumping through my veins has decreased. I’m happier. I feel better about the work I do.

Now it’s okay to take a few minutes with any resident who needs a bit of company or assistance, regardless of whether they are on my caseload or not. I stop to comment on a woman’s gorgeous hat, or stop by to see how a previous client is doing. It is so freeing to be able to help people and not stress about how those precious minutes are impacting my productivity. The minutes spent in these activities are few, but the attitude toward these activities is so much different.

Of course, after years of hearing about productivity on a weekly or even daily basis, it’s become ingrained in me. I still fight that little voice in the back of my head when I spend longer than five minutes talking to a family (without the patient present = non-billable time). But these family conversations are one of the most important parts of my job, regardless of whether it’s billable or not.

I fight that little voice when I consult with colleagues or take a few minutes to be human and share life with other therapy team members or nurses. But this is important too. In my prior career it was nothing to spend time each day chatting and building relationships with coworkers. Those relationships make us a much more collaborative team. Being a better team helps us provide better services to our clients.

A Flood of Gratitude

Less than two months after I started working PRN at Frasier Meadows fairly regularly, everything changed. It started raining in Boulder and didn’t stop for nearly a week. We received a year’s worth of rain in the time span of less than a week. Flood waters hit Frasier Meadows. You can read details about the flood and response from Tim Johnson, Frasier Meadow’s CEO or in this Denver Post article.

I was blessed. My home did not have any flood damage. We lost power for four days, but that was the extent of the flood in my household. Once the roads cleared and I was able to drive, I went to work to help on Friday, the day after flood waters rushed into the first floor of the Health Care Center.

The flood waters had receded, so I spent the day on the first floor trying to pack up belongings for residents that were being transferred to other buildings. I tried to find a few sets of undamaged clothing and beloved possessions like photos, stuffed animals, etc. that would make them feel less lost in their temporary new home. The first floor was home to many residents with advanced cognitive-communication impairment, so creating some familiarity was very important to me as a speech-language pathologist.

In the afternoon we had an all staff meeting to be briefed on that status of the power loss, flood damage, and resident care. But it went beyond those basics. Tim Johnson, the CEO, and our director of human resources spoke to us. What they said made me cry.

First they thanked us for our work, compassion, and presence. Then they acknowledged the chaos this natural disaster created. They even said they knew at times things had not been easy and families may have spoken harshly to us in their own state of stress. ‘We know this can damage your spirit; when you are giving your all and someone speaks negatively toward you.’ They organized support groups and opportunities to speak with EAP professionals about how the flood and conditions at work impacted us. They wanted us to take time to rejuvenate our spirits.

Stress and Tears

The level of stress I felt the weekend of the flood was about on par with the level of stress I experienced in day to day work at other buildings where productivity expectations are so high, I felt I could not succeed with my clients or my employer. It’s a fail fail situation.

So I cried. I was so thankful to be working for a wonderful company. I came home and told my neighbors and husband what I had experienced. To them that level of respect and compassion from their employer was the norm. It was then I really understood the Eden Alternative principles weren’t just about our elders. They are about staff too.

Frasier Meadows has rebounded and made incredible strides since the flood. However, my regular PRN work is now occasional PRN work (sometimes very occasional). So far, I haven’t found work elsewhere. Now that I’ve seen my expectations for patient care were not too high, there is no chance I’m going to lower my expectations now.



4 Comments. Leave new

My productivity numbers are often below the required percentage, a sacrifice I make to visit old patients to say hello, see how things are going with them, and I really think they appreciate it. Today I found an old patient crying in the hallway, completely ignored by the nursing staff. I took her with me to sit in a communal room and work with another patient, and her affect altered after 20 minutes so that she was able to go on with her day in a happier place. I want to work with an organization such as you’ve described – how to you find these? and how do they not have to be on the treadmill of billable time???

Kavan Peterson, Editor,
March 5, 2014 3:14 pm

You can go to the website

And find registered home in your area.


This is the way all SNFs should be. This way everyone would want to live there and the stigma would be gone. I love my patients and donate free time each day to make sure these people who deserve our respect, have their needs met, both emotional and medical.

Lucretia Waldbuesser
February 22, 2014 12:47 am

I just found your site, amazing on Pinterest! I was totally engrossed when i read about the Eden Alternative because after 20+ years of practicing I have been contemplating a career change because of the strain imposed by productivity standards and the inability to related as human beings with our patients. Can’t wait to share this info.


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