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

翻译人员: Nancy Cai 校对人员: jacks peng

This is the Hogeweyk.

这是Hogeweyk。

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

它是位于荷兰阿姆斯特丹旁边的 一个小镇的一个社区。

There are 27 houses for six, seven people each.

这儿有27所住户，每家有6，7个人，

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

这儿有一个小商场，里面有一个餐厅， 一个酒吧，一个超市，和一个娱乐室。

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

这儿有街道和小巷， 还有一个剧场。

It actually is a nursing home.

它其实是一个疗养院，

A nursing home for people that live with an advanced dementia

为那些患有重度痴呆的人

and that need 24-7 care and support.

提供24小时的护理和关怀。

Dementia is a terrible disease,

痴呆是一个很可怕的疾病，

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

而且我们目前仍然没法治愈它。

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

它正在成为一个全世界的重大问题，

for the people, for the politicians,

给人民，政治家 ，还有全世界

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

都带来了很大的问题。

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

我们看到疗养院还有等候名单。

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

大部分来疗养院的痴呆患者都是女性，

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

这也是因为女性很习惯于照顾别人，

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

如果她们的丈夫患了痴呆， 她们就可以照顾他们，

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

但反过来对丈夫们就没有那么简单。

Dementia is a disease that affects the brain.

痴呆是一种影响大脑的疾病。

The brain is confused.

患者的大脑变得十分混乱，

People don't know anymore what the time is,

不知道几点了，

what's going on, who people are.

发生了什么事，也不认识人。

They're very confused.

他们变得非常糊涂，

And because of that confusion,

还因此变得

they get to be anxious, depressed, aggressive.

焦虑，抑郁，和易怒。

This is a traditional nursing home.

这是一个传统的疗养院，

I worked there in 1992.

我1992年的时候在那里工作，

I was a care manager.

我负责照料患者。

And we often spoke together about the fact

我们经常会讨论，

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

如果我们的父母、朋友、 甚至是自己生病了，

for our friends, for ourselves.

我们不会想让他们来这里。

And one day, we said,

有一天，我们意识到，

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

我们只是一直这么说是没用的，

We are in charge here.

在这里我们做主，

We should do something about this,

我们应该做点什么，

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

让这里变成一个我们放心 自己父母来的地方。

We talked about that, and what we saw every day

我们每天看到的是

was that the people that lived in our nursing home

住在这里的患者

were confused about their environment,

对周边的环境感到迷茫，

because what they saw was a hospital-like environment,

因为他们看到的是像医院一样的环境，

with doctors and nurses and paramedics in uniform,

有医生、护士、穿着制服的护理人员，

and they lived on a ward.

而且他们住在病房里。

And they didn't understand why they lived there.

他们不明白为什么他们住在这里，

And they looked for the place to get away.

他们想尽快离开。

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

想要找到那个通往家的门。

And we said what we are doing in this situation

我们发现，在这种情况下，

is offering these people that already have a confused brain

我们让这些本来就糊涂的人，

some more confusion.

变得更糊涂了。

We were adding confusion to confusion.

我们在混乱之上增添混乱，

And that was not what these people needed.

这反而是在帮倒忙。

These people wanted to have a life,

这些人想要有一个生活，

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

还需要我们帮助他们来面对痴呆。

These people wanted to live in a normal house,

他们想生活在一个正常的房子里，

not in a ward.

不是病房里。

They wanted to have a normal household,

他们想要一个正常的家，

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

想闻到厨房里炉子上 飘出的晚饭的香气，

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

或是能自己走到厨房里， 拿点什么吃的喝的。

That's what these people needed.

这是他们所需要的，

And that's what we should organize for them.

也是我们应该给他们提供的。

And we said we should organize this like at home,

我们觉得，为了营造家的氛围，

不能让他们十几个或者几十个人 住在一起，像在病房一样，

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.

他们以6-7个人为团体 住在一起，像家一样。

Like living with friends.

就好像和朋友住在一起。

And we should find a way to select people

我们应该想办法

based on their ideas about life

筛选出生活兴趣相同的人，

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

这样他们住在一起的时候

when they lived together.

能变成好朋友。

And we interviewed all the families of the residents

我们也采访了所有患者的家人，

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

问他们“你的爸爸重视什么？” “你的妈妈重视什么？”

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

“他们的生活是什么样的？” “他们想要什么？”

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

然后我们成立了7个小组， 叫做“生活方式小组”。

And for instance, we found this formal lifestyle.

比如，有一个小组的生活方式很正式，

In this lifestyle,

在这种生活方式下，

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

大家互相交往的方式都很正式，

a distant way.

保持适当的距离。

Their daily rhythm starts later in the day,

他们每天的生活开始得较晚，

ends later in the day.

结束得也较晚。

Classical music is more heard in this lifestyle group

这个小组的人比别的小组

than in other lifestyle groups.

更喜欢听经典音乐。

And their menu,

他们更喜欢法国美食，

well, is more French cuisine than traditional Dutch.

而不是传统的荷兰美食。

(Laughter)

（笑）

In contrary to the craftsman lifestyle.

另外一种“手艺人”的 生活方式则很不同。

That's a very traditional lifestyle,

这是一个很传统的生活方式，

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

他们很早起床，很早睡觉，

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

因为他们一生都在努力工作， 通常是用他们的双手为生，

他们通常有一个很小的家庭生意， 一个小农场，一个小商店。

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

or like Mr. B, he was a farmhand.

比如B先生，他曾是个农场工人。

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

他告诉我，他每天早上去工作，

with a paper bag with his lunch

包里装着午饭，

and one cigar.

还有一支雪茄。

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

那一支雪茄就是他能 负担得起的唯一的奢侈品。

And after lunch, he would have that one cigar.

吃完午饭，他就抽那支雪茄。

And until the day he died in the Hogeweyk,

一直到他在Hogeweyk去世的那一天，

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

他每天午饭后都在 这个小棚子里抽雪茄。

This is my mother.

这是我的母亲，

She's of the cultural lifestyle,

她喜欢文艺的生活方式，

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

她住在Hogeweyk六周了，

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

这种生活方式包括旅行， 结识不同的人和不同的文化，

interest in arts and music.

探索艺术和音乐。

There are more lifestyles.

还有更多别的生活方式。

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

这是我们设想的，也是我们最终做到的。

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

但是这并不是生活的全部 ——在自己的房子里，

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

和一群志同道合的人在一起， 过自己的生活。

There's more in life,

生活中还有别的，

everybody wants fun in life and a meaningful life.

每个人都要想要有乐趣的 生活和有意义的生活，

We are social animals --

我们都是社会动物，

we need a social life.

我们需要社交生活。

And that's what we started.

而这就是我们所做的。

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

人们都想出门去，去购物，

and meet other people.

认识不同的人，

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

或者去酒吧，和朋友一起喝酒。

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

或者像W先生那样——他喜欢每天出门，

see if there are nice ladies around.

看看周围有没有漂亮的姑娘。

(Laughter)

（笑）

And he's very courteous to them,

他对她们非常礼貌，

他想得到微笑，于是他得到了，

and he hopes for smiles and he gets them.

And he dances with them in the pub.

他每天都在酒吧里和她们跳舞，

It's a feast every day.

每天都是一场盛宴。

There are people that would rather go to the restaurant,

还有的人更愿意和朋友去饭店，

have a wine with friends,

喝点红酒，

or lunch or dinner with friends and celebrate life.

或者和朋友共进午餐 或晚餐，庆贺人生。

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

我母亲喜欢在公园里走走，

and sits on a bench in the sun,

坐在长椅上晒晒太阳，

hoping that a passerby will come and sit next to her

希望一个路人会过来坐在她身旁，

and have a conversation about life

和她讨论人生，

or about the ducks in the pond.

或者讨论池塘里的鸭子。

That social life is important.

社交生活是很重要的，

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

它意味着你是社会的一份子，

And that's what we people need.

人们需要这种归属感，

Even if you're living with advanced dementia.

即使患有严重痴呆的人也需要。

This is what I see from my office window.

这是从我的办公室窗户看出去的景色，

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

有一天，我看到一位女士从一边走过来，

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

另一位女士从另一边走过来， 她们在拐角处碰到了，

And I knew both ladies very well.

我跟她们两个都很熟，

I often saw them walking around outside.

经常看到她们在外面散步。

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

我会时不时地和她们对话，

但是她们的对话——

but their conversation was ...

rather hard to understand.

很难理解。

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

但我看到她们碰面、交谈，

and I saw them gesturing.

我看到她们做手势，

And they had fun together.

她们在一起很开心，

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

然后她们互相道别，继续各自行路了。

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

这就是你在生活中想要的，

结识不同的人，融入社会。

and being part of society.

And that's what I saw happening.

这也是我看到正在发生的，

The Hogeweyk has become a place

Hogeweyk已经变成了一个

where people with very advanced dementia can live,

能让患有严重痴呆的人居住，

have freedom and safety,

并且感到自由和安全的地方。

because the professionals working there and the volunteers working there

因为这里的专业人员和志愿者

know how to deal with dementia.

知道如何应对痴呆，

And the professionals know how to do their professional work

这里的专业人员知道如何 既完成他们的工作，

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

又不影响患者的正常生活。

And that means that the management has to provide everything

这意味着管理层需要为他们提供

those people need to do their work.

他们工作中需要的一切。

It needs a management that dares to do this.

这需要一个敢于付诸行动的管理层，

To do things differently than we always have done

敢于在一个传统的疗养院里，

in a traditional nursing home.

用不同寻常的方法做事。

We see that it works.

我们看到了它是有效的，

We think this can be done everywhere,

我们认为这在任何地方都能实现，

because this is not for the rich.

因为这不是只有富人才能享受的。

We've been doing this with the same budget

我们的预算

和我们国家每一个传统疗养院都一样，

as any traditional nursing home has in our country.

We work only with the state budget.

我们只有州政府的财政预算。

(Applause)

（鼓掌）

Because it has to do with thinking different,

这需要的是改变思路，

and looking at the person in front of you

看看你面前的人，

and looking at what does this person need now.

想想这个人现在需要什么。

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

这需要的是一个微笑， 需要的是换一个方式思考，

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

需要的是做出行动， 而这些都不需要花钱。

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

还有一点，关乎如何做选择，

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

选择把钱花在什么地方。

I always say,

我经常说，

"Red curtains are as expensive as gray ones."

”红窗帘和灰色窗帘一样贵。“

(Laughter)

（笑）

It's possible, everywhere.

在任何地方，我们都能做到。

Thank you.

谢谢！

(Applause)

（鼓掌）