You wake up in an institution and are ordered out of bed. Though you would much rather sleep in for a bit, you have no right to dictate your own schedule. You are marched to a sterile, cold room where you will be served food you don't want to eat, seated at a communal table with people who don't want to be there anymore than you do. Nearly all the activities that will make up the rest of your day will proceed in similar fashion, until "lights out" is called and you are commanded to a lonely slumber. With each passing day you are plagued by loneliness, helplessness, and boredom. This is all done in the name of your safety and security, not as punishment. You are not a prisoner, you are a "resident" of a nursing home.
But it doesn't have to be this way, explains Anthony Fisher. The Eden Alternative, a Rochester, New York-based non-profit, has for two decades sought to de-emphasize "top-down, bureaucratic authority," seeking instead to place the maximum possible decision-making authority into the hands of the older adults or into the hands of those closest to them.