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This is the Hogeweyk.

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

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There are 27 houses[br]for six, seven people each.

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

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There are streets, alleys,[br]there's a theater.

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It actually is a nursing home.

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A nursing home for people[br]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[br]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[br]to be a big problem.

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

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

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

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

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

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Dementia is a disease[br]that affects the brain.

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The brain is confused.

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People don't know anymore[br]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,[br]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[br]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,[br]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[br]to have our parents here."

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We talked about that,[br]and what we saw every day

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was that the people[br]that lived in our nursing home

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were confused about their environment,

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because what they saw[br]was a hospital-like environment,

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with doctors and nurses[br]and paramedics in uniform,

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and they lived on a ward.

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And they didn't understand[br]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[br]the door to go home again.

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And we said what we are doing[br]in this situation

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is offering these people[br]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,[br]to deal with that dementia.

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These people wanted to live[br]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[br]on the stove in the kitchen.

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Or be free to go to the kitchen[br]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[br]organize for them.

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And we said we should[br]organize this like at home,

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

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No, a small group of people,[br]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[br]a good chance to become friends,

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when they lived together.

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And we interviewed[br]all the families of the residents

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

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"what is their life like,"[br]"what do they want."

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And we found seven groups,[br]and we call them lifestyle groups.

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And for instance,[br]we found this formal lifestyle.

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In this lifestyle,

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

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a distant way.

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Their daily rhythm[br]starts later in the day,

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ends later in the day.

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Classical music is more heard[br]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[br]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[br]in the morning, go to bed early,

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

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very often had a very small[br]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[br]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[br]he could afford for himself.

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And after lunch,[br]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,[br]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[br]in the Hogeweyk six weeks now.

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And that lifestyle is about traveling,[br]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[br]and that's what we did.

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

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like-minded people, your own life,[br]your own household.

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There's more in life,

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everybody wants fun in life,[br]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[br]and do some shopping,

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and meet other people.

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

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Or like Mr. W -- he likes[br]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[br]rather go to the restaurant,

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have a wine with friends,

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or lunch or dinner with friends[br]and celebrate life.

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And my mother,[br]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[br]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[br]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[br]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[br]coming from one side,

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and the other lady from the other side,[br]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[br]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,[br]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,[br]and each went their own way.

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And that's what you want in life,[br]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[br]dementia can live,

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have freedom and safety,

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because the professionals working there[br]and the volunteers working there

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know how to deal with dementia.

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And the professionals know[br]how to do their professional work

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

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And that means that the management[br]has to provide everything

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those people need to do their work.

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It needs a management[br]that dares to do this.

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To do things differently[br]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[br]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[br]with thinking different,

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and looking at the person in front of you

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and looking at what[br]does this person need now.

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And it's about a smile,[br]it's about thinking different,

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

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

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

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I always say,

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"Red curtains are[br]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)