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Life Worth Living
How Someone You Love Can Still Enjoy Life in a Nursing Home
The Eden Alternative in Action

by William H. Thomas, M.D.

From Chapter 5: Medication Reduction

The Eden Alternative is a radically nonmedical way of thinking about nursing homes. In practice, it substitutes a holistic understanding of human needs and capacities for a medical model of care driven by diagnosis and therapy. We speculated that such a decisive move away from the medical model would have a significant effect on the use of drugs in the nursing home. Given this hypothesis, we decided to examine the use of medications at Chase Memorial Nursing Home and at a control facility.

At the end of the two-year study period, we examined the cost of medications per resident, the number of prescriptions per resident, and the average cost per prescription per month for the period. The first and easiest thing to do was to calculate the average cost of medications per resident per day during the study period and then compare the facilities. This analysis revealed that Chase spent $1.44 per resident per day, while the amount for the other home was $2.32 per resident per day. This is an impressive 38 percent difference in the cost. . . .

The most important factor in the cost decline for medications at Chase is the decrease in the number of prescriptions per resident. The Eden Alternative allowed us to spend less on drugs because we used fewer medications per resident.
We have been able to make dramatic cuts in the use of medications without harming our patients. Of particular interest is the decline in the use of mind- and mood-altering drugs. We believe that pronounced reductions in the use of these medications can be achieved without negative impact on the well-being of residents. . . .
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