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  • This is the Hogeweyk.

  • It's a neighborhood in a small town very near Amsterdam, in the Netherlands.

  • There are 27 houses for six, seven people each.

  • There's a small mall with a restaurant, a pub, a supermarket, a club room.

  • There are streets, alleys, there's a theater.

  • It actually is a nursing home.

  • A nursing home for people that live with an advanced dementia

  • and that need 24-7 care and support.

  • Dementia is a terrible disease,

  • and we still don't have any cure for it.

  • It's getting to be a major problem in the world,

  • for the people, for the politicians,

  • for the world -- it's getting to be a big problem.

  • We see that we have waiting lists in the nursing homes.

  • Most people that come to the nursing homes with dementia are women.

  • And that's also because women are used to taking care of people,

  • so they can manage to take care of their husband with dementia,

  • but the other way around is not so easy for the gentlemen.

  • Dementia is a disease that affects the brain.

  • The brain is confused.

  • People don't know anymore what the time is,

  • what's going on, who people are.

  • They're very confused.

  • And because of that confusion,

  • they get to be anxious, depressed, aggressive.

  • This is a traditional nursing home.

  • I worked there in 1992.

  • I was a care manager.

  • And we often spoke together about the fact

  • that what we were doing there was not what we wanted for our parents,

  • for our friends, for ourselves.

  • And one day, we said,

  • \"When we keep on saying this, nothing is going to change.

  • We are in charge here.

  • We should do something about this,

  • so that we do want to have our parents here.\"

  • We talked about that, and what we saw every day

  • was that the people that lived in our nursing home

  • were confused about their environment,

  • because what they saw was a hospital-like environment,

  • with doctors and nurses and paramedics in uniform,

  • and they lived on a ward.

  • And they didn't understand why they lived there.

  • And they looked for the place to get away.

  • They looked and hoped to find the door to go home again.

  • And we said what we are doing in this situation

  • is offering these people that already have a confused brain

  • some more confusion.

  • We were adding confusion to confusion.

  • And that was not what these people needed.

  • These people wanted to have a life,

  • and the help, our help, to deal with that dementia.

  • These people wanted to live in a normal house,

  • not in a ward.

  • They wanted to have a normal household,

  • where they would smell their dinner on the stove in the kitchen.

  • Or be free to go to the kitchen and grab something to eat or drink.

  • That's what these people needed.

  • And that's what we should organize for them.

  • And we said we should organize this like at home,

  • so they wouldn't live with a group of 15 or 20 or 30, like in a ward.

  • No, a small group of people, six or seven, family-like.

  • Like living with friends.

  • And we should find a way to select people

  • based on their ideas about life

  • so that they did have a good chance to become friends,

  • when they lived together.

  • And we interviewed all the families of the residents

  • about \"what is important for your father,\" \"what's important for your mother,\"

  • \"what is their life like,\" \"what do they want.\"

  • And we found seven groups, and we call them lifestyle groups.

  • And for instance, we found this formal lifestyle.

  • In this lifestyle,

  • people have a more formal way of interacting with each other,

  • a distant way.

  • Their daily rhythm starts later in the day,

  • ends later in the day.

  • Classical music is more heard in this lifestyle group

  • than in other lifestyle groups.

  • And their menu,

  • well, is more French cuisine than traditional Dutch.

  • (Laughter)

  • In contrary to the craftsman lifestyle.

  • That's a very traditional lifestyle,

  • and they get up early in the morning, go to bed early,

  • because they have worked hard their whole life, mostly with their hands,

  • very often had a very small family business, a small farm, a shop,

  • or like Mr. B, he was a farmhand.

  • And he told me that he would go to his work every morning

  • with a paper bag with his lunch

  • and one cigar.

  • That one cigar was the only luxury he could afford for himself.

  • And after lunch, he would have that one cigar.

  • And until the day he died in the Hogeweyk,

  • he was in this little shed, every day, after lunch, to smoke his cigar.

  • This is my mother.

  • She's of the cultural lifestyle,

  • she's been living in the Hogeweyk six weeks now.

  • And that lifestyle is about traveling, meeting other people, other cultures,

  • interest in arts and music.

  • There are more lifestyles.

  • But that's what we talked about, and that's what we did.

  • But that's not life in a house with a group of people,

  • like-minded people, your own life, your own household.

  • There's more in life,

  • everybody wants fun in life and a meaningful life.

  • We are social animals --

  • we need a social life.

  • And that's what we started.

  • We want to go out of our house and do some shopping,

  • and meet other people.

  • Or go to the pub, have a beer with friends.

  • Or like Mr. W -- he likes to go out every day,

  • see if there are nice ladies around.

  • (Laughter)

  • And he's very courteous to them,

  • and he hopes for smiles and he gets them.

  • And he dances with them in the pub.

  • It's a feast every day.

  • There are people that would rather go to the restaurant,

  • have a wine with friends,

  • or lunch or dinner with friends and celebrate life.

  • And my mother, she takes a walk in the park,

  • and sits on a bench in the sun,

  • hoping that a passerby will come and sit next to her

  • and have a conversation about life

  • or about the ducks in the pond.

  • That social life is important.

  • It means that you're part of society, that you belong.

  • And that's what we people need.

  • Even if you're living with advanced dementia.

  • This is what I see from my office window.

  • And one day, I saw a lady coming from one side,

  • and the other lady from the other side, and they met at the corner.

  • And I knew both ladies very well.

  • I often saw them walking around outside.

  • And now and then, I tried to have a conversation with them,

  • but their conversation was ...

  • rather hard to understand.

  • But I saw them meeting, and I saw them talking,

  • and I saw them gesturing.

  • And they had fun together.

  • And then they said goodbye, and each went their own way.

  • And that's what you want in life, meeting other people

  • and being part of society.

  • And that's what I saw happening.

  • The Hogeweyk has become a place

  • where people with very advanced dementia can live,

  • have freedom and safety,

  • because the professionals working there and the volunteers working there

  • know how to deal with dementia.

  • And the professionals know how to do their professional work

  • in a way that it fits in a natural way in the life of our residents.

  • And that means that the management has to provide everything

  • those people need to do their work.

  • It needs a management that dares to do this.

  • To do things differently than we always have done

  • in a traditional nursing home.

  • We see that it works.

  • We think this can be done everywhere,

  • because this is not for the rich.

  • We've been doing this with the same budget

  • as any traditional nursing home has in our country.

  • We work only with the state budget.

  • (Applause)

  • Because it has to do with thinking different,

  • and looking at the person in front of you

  • and looking at what does this person need now.

  • And it's about a smile, it's about thinking different,

  • it's about how you act, and that costs nothing.

  • And there's something else: it's about making choices.

  • It's about making choices what you spend your money on.

  • I always say,

  • \"Red curtains are as expensive as gray ones.\"

  • (Laughter)

  • It's possible, everywhere.

  • Thank you.

  • (Applause)

This is the Hogeweyk.

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A2 US TED dementia nursing lifestyle nursing home people

【TED】Yvonne van Amerongen: The "dementia village" that's redefining elder care (The "dementia village" that's redefining elder care | Yvonne van Amerongen)

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    林宜悉 posted on 2019/04/08
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