The "dementia village" that's redefining elder care | Yvonne van Amerongen

100,255 views ・ 2019-04-08

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00:12
This is the Hogeweyk.
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It's a neighborhood in a small town very near Amsterdam, in the Netherlands.
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There are 27 houses for six, seven people each.
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There's a small mall with a restaurant, a pub, a supermarket, a club room.
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There are streets, alleys, there's a theater.
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It actually is a nursing home.
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A nursing home for people that live with an advanced dementia
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and that need 24-7 care and support.
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Dementia is a terrible disease,
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and we still don't have any cure for it.
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It's getting to be a major problem in the world,
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for the people, for the politicians,
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for the world -- it's getting to be a big problem.
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We see that we have waiting lists in the nursing homes.
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Most people that come to the nursing homes with dementia are women.
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And that's also because women are used to taking care of people,
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so they can manage to take care of their husband with dementia,
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but the other way around is not so easy for the gentlemen.
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Dementia is a disease that affects the brain.
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The brain is confused.
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People don't know anymore what the time is,
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what's going on, who people are.
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They're very confused.
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And because of that confusion,
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they get to be anxious, depressed, aggressive.
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This is a traditional nursing home.
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I worked there in 1992.
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I was a care manager.
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And we often spoke together about the fact
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that what we were doing there was not what we wanted for our parents,
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for our friends, for ourselves.
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And one day, we said,
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"When we keep on saying this, nothing is going to change.
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We are in charge here.
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We should do something about this,
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so that we do want to have our parents here."
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We talked about that, and what we saw every day
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was that the people that lived in our nursing home
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were confused about their environment,
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because what they saw was a hospital-like environment,
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with doctors and nurses and paramedics in uniform,
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and they lived on a ward.
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And they didn't understand why they lived there.
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And they looked for the place to get away.
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They looked and hoped to find the door to go home again.
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And we said what we are doing in this situation
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is offering these people that already have a confused brain
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some more confusion.
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We were adding confusion to confusion.
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And that was not what these people needed.
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These people wanted to have a life,
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and the help, our help, to deal with that dementia.
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These people wanted to live in a normal house,
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not in a ward.
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They wanted to have a normal household,
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where they would smell their dinner on the stove in the kitchen.
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Or be free to go to the kitchen and grab something to eat or drink.
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That's what these people needed.
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And that's what we should organize for them.
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And we said we should organize this like at home,
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so they wouldn't live with a group of 15 or 20 or 30, like in a ward.
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No, a small group of people, six or seven, family-like.
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Like living with friends.
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And we should find a way to select people
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based on their ideas about life
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so that they did have a good chance to become friends,
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when they lived together.
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And we interviewed all the families of the residents
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about "what is important for your father," "what's important for your mother,"
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"what is their life like," "what do they want."
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And we found seven groups, and we call them lifestyle groups.
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And for instance, we found this formal lifestyle.
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In this lifestyle,
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people have a more formal way of interacting with each other,
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a distant way.
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Their daily rhythm starts later in the day,
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ends later in the day.
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Classical music is more heard in this lifestyle group
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than in other lifestyle groups.
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And their menu,
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well, is more French cuisine than traditional Dutch.
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(Laughter)
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In contrary to the craftsman lifestyle.
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That's a very traditional lifestyle,
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and they get up early in the morning, go to bed early,
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because they have worked hard their whole life, mostly with their hands,
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very often had a very small family business, a small farm, a shop,
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or like Mr. B, he was a farmhand.
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And he told me that he would go to his work every morning
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with a paper bag with his lunch
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and one cigar.
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That one cigar was the only luxury he could afford for himself.
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And after lunch, he would have that one cigar.
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And until the day he died in the Hogeweyk,
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he was in this little shed, every day, after lunch, to smoke his cigar.
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This is my mother.
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She's of the cultural lifestyle,
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she's been living in the Hogeweyk six weeks now.
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And that lifestyle is about traveling, meeting other people, other cultures,
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interest in arts and music.
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There are more lifestyles.
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But that's what we talked about, and that's what we did.
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But that's not life in a house with a group of people,
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like-minded people, your own life, your own household.
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There's more in life,
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everybody wants fun in life and a meaningful life.
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We are social animals --
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we need a social life.
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And that's what we started.
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We want to go out of our house and do some shopping,
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and meet other people.
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Or go to the pub, have a beer with friends.
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Or like Mr. W -- he likes to go out every day,
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see if there are nice ladies around.
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(Laughter)
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And he's very courteous to them,
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and he hopes for smiles and he gets them.
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And he dances with them in the pub.
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It's a feast every day.
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There are people that would rather go to the restaurant,
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have a wine with friends,
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or lunch or dinner with friends and celebrate life.
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And my mother, she takes a walk in the park,
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and sits on a bench in the sun,
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hoping that a passerby will come and sit next to her
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and have a conversation about life
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or about the ducks in the pond.
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That social life is important.
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It means that you're part of society, that you belong.
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And that's what we people need.
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Even if you're living with advanced dementia.
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This is what I see from my office window.
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And one day, I saw a lady coming from one side,
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and the other lady from the other side, and they met at the corner.
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And I knew both ladies very well.
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I often saw them walking around outside.
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And now and then, I tried to have a conversation with them,
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but their conversation was ...
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rather hard to understand.
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But I saw them meeting, and I saw them talking,
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and I saw them gesturing.
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And they had fun together.
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And then they said goodbye, and each went their own way.
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And that's what you want in life, meeting other people
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and being part of society.
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And that's what I saw happening.
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The Hogeweyk has become a place
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where people with very advanced dementia can live,
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have freedom and safety,
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because the professionals working there and the volunteers working there
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know how to deal with dementia.
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And the professionals know how to do their professional work
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in a way that it fits in a natural way in the life of our residents.
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And that means that the management has to provide everything
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those people need to do their work.
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It needs a management that dares to do this.
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To do things differently than we always have done
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in a traditional nursing home.
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We see that it works.
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We think this can be done everywhere,
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because this is not for the rich.
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We've been doing this with the same budget
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as any traditional nursing home has in our country.
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We work only with the state budget.
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(Applause)
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Because it has to do with thinking different,
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and looking at the person in front of you
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and looking at what does this person need now.
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And it's about a smile, it's about thinking different,
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it's about how you act, and that costs nothing.
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And there's something else: it's about making choices.
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It's about making choices what you spend your money on.
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I always say,
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"Red curtains are as expensive as gray ones."
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(Laughter)
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It's possible, everywhere.
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Thank you.
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(Applause)
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