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

99,721 views ・ 2019-04-08

TED


Please double-click on the English subtitles below to play the video.

00:12
This is the Hogeweyk.
0
12659
1951
00:14
It's a neighborhood in a small town very near Amsterdam, in the Netherlands.
1
14984
4381
00:19
There are 27 houses for six, seven people each.
2
19881
3469
00:23
There's a small mall with a restaurant, a pub, a supermarket, a club room.
3
23821
4520
00:28
There are streets, alleys, there's a theater.
4
28900
4325
00:34
It actually is a nursing home.
5
34434
2000
00:37
A nursing home for people that live with an advanced dementia
6
37093
5634
00:42
and that need 24-7 care and support.
7
42751
3459
00:47
Dementia is a terrible disease,
8
47234
3263
00:50
and we still don't have any cure for it.
9
50521
3218
00:54
It's getting to be a major problem in the world,
10
54211
3627
00:57
for the people, for the politicians,
11
57862
1848
00:59
for the world -- it's getting to be a big problem.
12
59734
2971
01:03
We see that we have waiting lists in the nursing homes.
13
63228
3245
01:07
Most people that come to the nursing homes with dementia are women.
14
67093
3800
01:11
And that's also because women are used to taking care of people,
15
71855
4960
01:16
so they can manage to take care of their husband with dementia,
16
76839
3853
01:20
but the other way around is not so easy for the gentlemen.
17
80716
4408
01:26
Dementia is a disease that affects the brain.
18
86629
4333
01:30
The brain is confused.
19
90986
2142
01:33
People don't know anymore what the time is,
20
93923
2761
01:36
what's going on, who people are.
21
96708
2738
01:39
They're very confused.
22
99470
1472
01:40
And because of that confusion,
23
100966
2214
01:43
they get to be anxious, depressed, aggressive.
24
103204
6045
01:50
This is a traditional nursing home.
25
110728
2381
01:53
I worked there in 1992.
26
113133
2055
01:55
I was a care manager.
27
115641
1507
01:57
And we often spoke together about the fact
28
117687
3016
02:00
that what we were doing there was not what we wanted for our parents,
29
120727
5001
02:05
for our friends, for ourselves.
30
125752
3308
02:09
And one day, we said,
31
129815
1785
02:11
"When we keep on saying this, nothing is going to change.
32
131624
2754
02:14
We are in charge here.
33
134402
1373
02:15
We should do something about this,
34
135799
2496
02:18
so that we do want to have our parents here."
35
138319
3364
02:22
We talked about that, and what we saw every day
36
142773
3008
02:25
was that the people that lived in our nursing home
37
145805
3693
02:29
were confused about their environment,
38
149522
2365
02:31
because what they saw was a hospital-like environment,
39
151911
3547
02:35
with doctors and nurses and paramedics in uniform,
40
155482
4111
02:39
and they lived on a ward.
41
159617
1667
02:42
And they didn't understand why they lived there.
42
162069
2834
02:44
And they looked for the place to get away.
43
164927
3309
02:48
They looked and hoped to find the door to go home again.
44
168617
4937
02:54
And we said what we are doing in this situation
45
174022
3825
02:57
is offering these people that already have a confused brain
46
177871
5039
03:02
some more confusion.
47
182934
1286
03:04
We were adding confusion to confusion.
48
184244
3534
03:08
And that was not what these people needed.
49
188180
2451
03:11
These people wanted to have a life,
50
191084
2762
03:13
and the help, our help, to deal with that dementia.
51
193870
3564
03:17
These people wanted to live in a normal house,
52
197957
4732
03:22
not in a ward.
53
202713
1150
03:24
They wanted to have a normal household,
54
204482
2825
03:27
where they would smell their dinner on the stove in the kitchen.
55
207331
4698
03:32
Or be free to go to the kitchen and grab something to eat or drink.
56
212966
4262
03:37
That's what these people needed.
57
217611
2230
03:39
And that's what we should organize for them.
58
219865
2499
03:43
And we said we should organize this like at home,
59
223269
4721
03:48
so they wouldn't live with a group of 15 or 20 or 30, like in a ward.
60
228014
4952
03:53
No, a small group of people, six or seven, family-like.
61
233434
4214
03:59
Like living with friends.
62
239069
1873
04:02
And we should find a way to select people
63
242709
3079
04:05
based on their ideas about life
64
245812
2754
04:08
so that they did have a good chance to become friends,
65
248590
3100
04:11
when they lived together.
66
251714
1568
04:14
And we interviewed all the families of the residents
67
254225
4160
04:18
about "what is important for your father," "what's important for your mother,"
68
258409
3693
04:22
"what is their life like," "what do they want."
69
262126
2749
04:24
And we found seven groups, and we call them lifestyle groups.
70
264899
4245
04:29
And for instance, we found this formal lifestyle.
71
269709
3661
04:33
In this lifestyle,
72
273851
1226
04:35
people have a more formal way of interacting with each other,
73
275101
3421
04:38
a distant way.
74
278546
1293
04:39
Their daily rhythm starts later in the day,
75
279863
2246
04:42
ends later in the day.
76
282133
1722
04:43
Classical music is more heard in this lifestyle group
77
283879
3026
04:46
than in other lifestyle groups.
78
286929
1703
04:48
And their menu,
79
288656
1484
04:50
well, is more French cuisine than traditional Dutch.
80
290164
3779
04:53
(Laughter)
81
293967
1592
04:55
In contrary to the craftsman lifestyle.
82
295583
3611
04:59
That's a very traditional lifestyle,
83
299218
2143
05:01
and they get up early in the morning, go to bed early,
84
301385
2570
05:03
because they have worked hard their whole life, mostly with their hands,
85
303979
4002
05:08
very often had a very small family business, a small farm, a shop,
86
308005
4603
05:12
or like Mr. B, he was a farmhand.
87
312632
4135
05:17
And he told me that he would go to his work every morning
88
317466
3500
05:20
with a paper bag with his lunch
89
320990
2204
05:24
and one cigar.
90
324014
1490
05:26
That one cigar was the only luxury he could afford for himself.
91
326824
4063
05:31
And after lunch, he would have that one cigar.
92
331420
3133
05:35
And until the day he died in the Hogeweyk,
93
335460
3328
05:38
he was in this little shed, every day, after lunch, to smoke his cigar.
94
338812
5912
05:47
This is my mother.
95
347201
1186
05:48
She's of the cultural lifestyle,
96
348411
1611
05:50
she's been living in the Hogeweyk six weeks now.
97
350046
2466
05:53
And that lifestyle is about traveling, meeting other people, other cultures,
98
353236
5240
05:58
interest in arts and music.
99
358500
3001
06:02
There are more lifestyles.
100
362072
1733
06:04
But that's what we talked about, and that's what we did.
101
364818
3733
06:09
But that's not life in a house with a group of people,
102
369766
4851
06:14
like-minded people, your own life, your own household.
103
374641
3378
06:18
There's more in life,
104
378434
1329
06:19
everybody wants fun in life and a meaningful life.
105
379787
3304
06:23
We are social animals --
106
383688
1421
06:25
we need a social life.
107
385133
2269
06:27
And that's what we started.
108
387817
1800
06:30
We want to go out of our house and do some shopping,
109
390817
3476
06:34
and meet other people.
110
394317
1467
06:36
Or go to the pub, have a beer with friends.
111
396698
3740
06:40
Or like Mr. W -- he likes to go out every day,
112
400462
4982
06:45
see if there are nice ladies around.
113
405468
2616
06:48
(Laughter)
114
408108
1988
06:50
And he's very courteous to them,
115
410465
1555
06:52
and he hopes for smiles and he gets them.
116
412044
2501
06:54
And he dances with them in the pub.
117
414863
2333
06:58
It's a feast every day.
118
418014
1516
06:59
There are people that would rather go to the restaurant,
119
419554
3214
07:02
have a wine with friends,
120
422792
1674
07:04
or lunch or dinner with friends and celebrate life.
121
424490
3666
07:08
And my mother, she takes a walk in the park,
122
428180
2786
07:10
and sits on a bench in the sun,
123
430990
1683
07:12
hoping that a passerby will come and sit next to her
124
432697
3126
07:15
and have a conversation about life
125
435847
2563
07:18
or about the ducks in the pond.
126
438434
3235
07:22
That social life is important.
127
442355
2261
07:24
It means that you're part of society, that you belong.
128
444998
4576
07:29
And that's what we people need.
129
449974
2067
07:33
Even if you're living with advanced dementia.
130
453013
3548
07:37
This is what I see from my office window.
131
457482
2865
07:40
And one day, I saw a lady coming from one side,
132
460371
4209
07:44
and the other lady from the other side, and they met at the corner.
133
464604
3619
07:48
And I knew both ladies very well.
134
468247
2348
07:50
I often saw them walking around outside.
135
470929
3352
07:54
And now and then, I tried to have a conversation with them,
136
474618
4381
07:59
but their conversation was ...
137
479023
2753
08:02
rather hard to understand.
138
482586
2486
08:05
But I saw them meeting, and I saw them talking,
139
485839
3659
08:09
and I saw them gesturing.
140
489522
1880
08:11
And they had fun together.
141
491426
1733
08:13
And then they said goodbye, and each went their own way.
142
493554
3078
08:17
And that's what you want in life, meeting other people
143
497331
3238
08:20
and being part of society.
144
500593
2047
08:23
And that's what I saw happening.
145
503093
2134
08:26
The Hogeweyk has become a place
146
506148
2007
08:28
where people with very advanced dementia can live,
147
508179
3682
08:31
have freedom and safety,
148
511885
1936
08:33
because the professionals working there and the volunteers working there
149
513845
4484
08:38
know how to deal with dementia.
150
518353
2222
08:41
And the professionals know how to do their professional work
151
521093
3333
08:44
in a way that it fits in a natural way in the life of our residents.
152
524450
5032
08:50
And that means that the management has to provide everything
153
530826
4680
08:55
those people need to do their work.
154
535530
2334
08:58
It needs a management that dares to do this.
155
538866
3844
09:02
To do things differently than we always have done
156
542734
3137
09:05
in a traditional nursing home.
157
545895
2133
09:10
We see that it works.
158
550989
1904
09:14
We think this can be done everywhere,
159
554006
3166
09:17
because this is not for the rich.
160
557196
2200
09:19
We've been doing this with the same budget
161
559863
4349
09:24
as any traditional nursing home has in our country.
162
564236
4079
09:28
We work only with the state budget.
163
568339
2777
09:32
(Applause)
164
572220
6872
09:40
Because it has to do with thinking different,
165
580226
3572
09:43
and looking at the person in front of you
166
583822
2730
09:46
and looking at what does this person need now.
167
586576
3681
09:51
And it's about a smile, it's about thinking different,
168
591352
3240
09:54
it's about how you act, and that costs nothing.
169
594616
4047
09:59
And there's something else: it's about making choices.
170
599823
3667
10:03
It's about making choices what you spend your money on.
171
603903
3733
10:08
I always say,
172
608855
1276
10:11
"Red curtains are as expensive as gray ones."
173
611323
4746
10:16
(Laughter)
174
616093
1377
10:17
It's possible, everywhere.
175
617494
2523
10:21
Thank you.
176
621263
1159
10:22
(Applause)
177
622446
4631
About this website

This site will introduce you to YouTube videos that are useful for learning English. You will see English lessons taught by top-notch teachers from around the world. Double-click on the English subtitles displayed on each video page to play the video from there. The subtitles scroll in sync with the video playback. If you have any comments or requests, please contact us using this contact form.

https://forms.gle/WvT1wiN1qDtmnspy7