SUMMARY
The medical or institutional model of care has been the standard in most of the 1300 nursing homes in Switzerland. Consequently, staffing problems, increasing costs and poor reputation have become the norm. This case study describes two 60-resident homes in Zollikon, Switzerland, which implemented the Eden Alternative®, beginning in 2000. Based on this model, they are committed to the eradication of resident loneliness, helplessness and boredom. Their tools are companionship, spontaneity and the opportunity to give care to each other, staff, children, animals and plants. The change from a medical model was precipitated by a care and financial crisis. Since then, three steps have been taken. The first, the crisis intervention step, was followed by the implementation of total quality management resulting in significant improvements in clinical outcomes and financial stability. Ultimately, the Eden Alternative was successfully introduced. It was perceived as “the missing link” and appears, at this early stage, to meet the real needs of residents and staff. The change process is described and outcomes are presented and discussed.