WEBVTT 00:00:00.659 --> 00:00:02.610 This is the Hogeweyk. 00:00:02.984 --> 00:00:07.365 It's a neighborhood in a small town very near Amsterdam, in the Netherlands. 00:00:07.881 --> 00:00:11.350 There are 27 houses for six, seven people each. 00:00:11.821 --> 00:00:16.341 There's a small mall with a restaurant, a pub, a supermarket, a club room. 00:00:16.900 --> 00:00:21.225 There are streets, alleys, there's a theater. 00:00:22.434 --> 00:00:24.434 It actually is a nursing home. 00:00:25.093 --> 00:00:30.727 A nursing home for people that live with an advanced dementia 00:00:30.751 --> 00:00:34.210 and that need 24-7 care and support. NOTE Paragraph 00:00:35.234 --> 00:00:38.497 Dementia is a terrible disease, 00:00:38.521 --> 00:00:41.739 and we still don't have any cure for it. 00:00:42.211 --> 00:00:45.838 It's getting to be a major problem in the world, 00:00:45.862 --> 00:00:47.710 for the people, for the politicians, 00:00:47.734 --> 00:00:50.705 for the world -- it's getting to be a big problem. 00:00:51.228 --> 00:00:54.473 We see that we have waiting lists in the nursing homes. 00:00:55.093 --> 00:00:58.893 Most people that come to the nursing homes with dementia are women. 00:00:59.855 --> 00:01:04.815 And that's also because women are used to taking care of people, 00:01:04.839 --> 00:01:08.692 so they can manage to take care of their husband with dementia, 00:01:08.716 --> 00:01:13.124 but the other way around is not so easy for the gentlemen. NOTE Paragraph 00:01:14.629 --> 00:01:18.962 Dementia is a disease that affects the brain. 00:01:18.986 --> 00:01:21.128 The brain is confused. 00:01:21.923 --> 00:01:24.684 People don't know anymore what the time is, 00:01:24.708 --> 00:01:27.446 what's going on, who people are. 00:01:27.470 --> 00:01:28.942 They're very confused. 00:01:28.966 --> 00:01:31.180 And because of that confusion, 00:01:31.204 --> 00:01:37.249 they get to be anxious, depressed, aggressive. NOTE Paragraph 00:01:38.728 --> 00:01:41.109 This is a traditional nursing home. 00:01:41.133 --> 00:01:43.188 I worked there in 1992. 00:01:43.641 --> 00:01:45.148 I was a care manager. 00:01:45.687 --> 00:01:48.703 And we often spoke together about the fact 00:01:48.727 --> 00:01:53.728 that what we were doing there was not what we wanted for our parents, 00:01:53.752 --> 00:01:57.060 for our friends, for ourselves. 00:01:57.815 --> 00:01:59.600 And one day, we said, 00:01:59.624 --> 00:02:02.378 "When we keep on saying this, nothing is going to change. 00:02:02.402 --> 00:02:03.775 We are in charge here. 00:02:03.799 --> 00:02:06.295 We should do something about this, 00:02:06.319 --> 00:02:09.683 so that we do want to have our parents here." NOTE Paragraph 00:02:10.773 --> 00:02:13.781 We talked about that, and what we saw every day 00:02:13.805 --> 00:02:17.498 was that the people that lived in our nursing home 00:02:17.522 --> 00:02:19.887 were confused about their environment, 00:02:19.911 --> 00:02:23.458 because what they saw was a hospital-like environment, 00:02:23.482 --> 00:02:27.593 with doctors and nurses and paramedics in uniform, 00:02:27.617 --> 00:02:29.284 and they lived on a ward. 00:02:30.069 --> 00:02:32.903 And they didn't understand why they lived there. 00:02:32.927 --> 00:02:36.236 And they looked for the place to get away. 00:02:36.617 --> 00:02:41.554 They looked and hoped to find the door to go home again. 00:02:42.022 --> 00:02:45.847 And we said what we are doing in this situation 00:02:45.871 --> 00:02:50.910 is offering these people that already have a confused brain 00:02:50.934 --> 00:02:52.220 some more confusion. 00:02:52.244 --> 00:02:55.778 We were adding confusion to confusion. 00:02:56.180 --> 00:02:58.631 And that was not what these people needed. NOTE Paragraph 00:02:59.084 --> 00:03:01.846 These people wanted to have a life, 00:03:01.870 --> 00:03:05.434 and the help, our help, to deal with that dementia. 00:03:05.957 --> 00:03:10.689 These people wanted to live in a normal house, 00:03:10.713 --> 00:03:11.863 not in a ward. 00:03:12.482 --> 00:03:15.307 They wanted to have a normal household, 00:03:15.331 --> 00:03:20.029 where they would smell their dinner on the stove in the kitchen. 00:03:20.966 --> 00:03:25.228 Or be free to go to the kitchen and grab something to eat or drink. 00:03:25.611 --> 00:03:27.841 That's what these people needed. 00:03:27.865 --> 00:03:30.364 And that's what we should organize for them. NOTE Paragraph 00:03:31.269 --> 00:03:35.990 And we said we should organize this like at home, 00:03:36.014 --> 00:03:40.966 so they wouldn't live with a group of 15 or 20 or 30, like in a ward. 00:03:41.434 --> 00:03:45.648 No, a small group of people, six or seven, family-like. 00:03:47.069 --> 00:03:48.942 Like living with friends. 00:03:50.709 --> 00:03:53.788 And we should find a way to select people 00:03:53.812 --> 00:03:56.566 based on their ideas about life 00:03:56.590 --> 00:03:59.690 so that they did have a good chance to become friends, 00:03:59.714 --> 00:04:01.282 when they lived together. 00:04:02.225 --> 00:04:06.385 And we interviewed all the families of the residents 00:04:06.409 --> 00:04:10.102 about "what is important for your father," "what's important for your mother," 00:04:10.126 --> 00:04:12.875 "what is their life like," "what do they want." 00:04:12.899 --> 00:04:17.144 And we found seven groups, and we call them lifestyle groups. NOTE Paragraph 00:04:17.709 --> 00:04:21.370 And for instance, we found this formal lifestyle. 00:04:21.851 --> 00:04:23.077 In this lifestyle, 00:04:23.101 --> 00:04:26.522 people have a more formal way of interacting with each other, 00:04:26.546 --> 00:04:27.839 a distant way. 00:04:27.863 --> 00:04:30.109 Their daily rhythm starts later in the day, 00:04:30.133 --> 00:04:31.855 ends later in the day. 00:04:31.879 --> 00:04:34.905 Classical music is more heard in this lifestyle group 00:04:34.929 --> 00:04:36.632 than in other lifestyle groups. 00:04:36.656 --> 00:04:38.140 And their menu, 00:04:38.164 --> 00:04:41.943 well, is more French cuisine than traditional Dutch. NOTE Paragraph 00:04:41.967 --> 00:04:43.559 (Laughter) NOTE Paragraph 00:04:43.583 --> 00:04:47.194 In contrary to the craftsman lifestyle. 00:04:47.218 --> 00:04:49.361 That's a very traditional lifestyle, 00:04:49.385 --> 00:04:51.955 and they get up early in the morning, go to bed early, 00:04:51.979 --> 00:04:55.981 because they have worked hard their whole life, mostly with their hands, 00:04:56.005 --> 00:05:00.608 very often had a very small family business, a small farm, a shop, 00:05:00.632 --> 00:05:04.767 or like Mr. B, he was a farmhand. 00:05:05.466 --> 00:05:08.966 And he told me that he would go to his work every morning 00:05:08.990 --> 00:05:11.194 with a paper bag with his lunch 00:05:12.014 --> 00:05:13.504 and one cigar. 00:05:14.824 --> 00:05:18.887 That one cigar was the only luxury he could afford for himself. 00:05:19.420 --> 00:05:22.553 And after lunch, he would have that one cigar. 00:05:23.460 --> 00:05:26.788 And until the day he died in the Hogeweyk, 00:05:26.812 --> 00:05:32.724 he was in this little shed, every day, after lunch, to smoke his cigar. NOTE Paragraph 00:05:35.201 --> 00:05:36.387 This is my mother. 00:05:36.411 --> 00:05:38.022 She's of the cultural lifestyle, 00:05:38.046 --> 00:05:40.512 she's been living in the Hogeweyk six weeks now. 00:05:41.236 --> 00:05:46.476 And that lifestyle is about traveling, meeting other people, other cultures, 00:05:46.500 --> 00:05:49.501 interest in arts and music. 00:05:50.072 --> 00:05:51.805 There are more lifestyles. 00:05:52.818 --> 00:05:56.551 But that's what we talked about, and that's what we did. NOTE Paragraph 00:05:57.766 --> 00:06:02.617 But that's not life in a house with a group of people, 00:06:02.641 --> 00:06:06.019 like-minded people, your own life, your own household. 00:06:06.434 --> 00:06:07.763 There's more in life, 00:06:07.787 --> 00:06:11.091 everybody wants fun in life and a meaningful life. 00:06:11.688 --> 00:06:13.109 We are social animals -- 00:06:13.133 --> 00:06:15.402 we need a social life. 00:06:15.817 --> 00:06:17.617 And that's what we started. 00:06:18.817 --> 00:06:22.293 We want to go out of our house and do some shopping, 00:06:22.317 --> 00:06:23.784 and meet other people. 00:06:24.698 --> 00:06:28.438 Or go to the pub, have a beer with friends. 00:06:28.462 --> 00:06:33.444 Or like Mr. W -- he likes to go out every day, 00:06:33.468 --> 00:06:36.084 see if there are nice ladies around. NOTE Paragraph 00:06:36.108 --> 00:06:38.096 (Laughter) NOTE Paragraph 00:06:38.465 --> 00:06:40.020 And he's very courteous to them, 00:06:40.044 --> 00:06:42.545 and he hopes for smiles and he gets them. 00:06:42.863 --> 00:06:45.196 And he dances with them in the pub. 00:06:46.014 --> 00:06:47.530 It's a feast every day. NOTE Paragraph 00:06:47.554 --> 00:06:50.768 There are people that would rather go to the restaurant, 00:06:50.792 --> 00:06:52.466 have a wine with friends, 00:06:52.490 --> 00:06:56.156 or lunch or dinner with friends and celebrate life. 00:06:56.180 --> 00:06:58.966 And my mother, she takes a walk in the park, 00:06:58.990 --> 00:07:00.673 and sits on a bench in the sun, 00:07:00.697 --> 00:07:03.823 hoping that a passerby will come and sit next to her 00:07:03.847 --> 00:07:06.410 and have a conversation about life 00:07:06.434 --> 00:07:09.669 or about the ducks in the pond. NOTE Paragraph 00:07:10.355 --> 00:07:12.616 That social life is important. 00:07:12.998 --> 00:07:17.574 It means that you're part of society, that you belong. 00:07:17.974 --> 00:07:20.041 And that's what we people need. 00:07:21.013 --> 00:07:24.561 Even if you're living with advanced dementia. NOTE Paragraph 00:07:25.482 --> 00:07:28.347 This is what I see from my office window. 00:07:28.371 --> 00:07:32.580 And one day, I saw a lady coming from one side, 00:07:32.604 --> 00:07:36.223 and the other lady from the other side, and they met at the corner. 00:07:36.247 --> 00:07:38.595 And I knew both ladies very well. 00:07:38.929 --> 00:07:42.281 I often saw them walking around outside. 00:07:42.618 --> 00:07:46.999 And now and then, I tried to have a conversation with them, 00:07:47.023 --> 00:07:49.776 but their conversation was ... 00:07:50.586 --> 00:07:53.072 rather hard to understand. 00:07:53.839 --> 00:07:57.498 But I saw them meeting, and I saw them talking, 00:07:57.522 --> 00:07:59.402 and I saw them gesturing. 00:07:59.426 --> 00:08:01.159 And they had fun together. 00:08:01.554 --> 00:08:04.632 And then they said goodbye, and each went their own way. 00:08:05.331 --> 00:08:08.569 And that's what you want in life, meeting other people 00:08:08.593 --> 00:08:10.640 and being part of society. 00:08:11.093 --> 00:08:13.227 And that's what I saw happening. NOTE Paragraph 00:08:14.148 --> 00:08:16.155 The Hogeweyk has become a place 00:08:16.179 --> 00:08:19.861 where people with very advanced dementia can live, 00:08:19.885 --> 00:08:21.821 have freedom and safety, 00:08:21.845 --> 00:08:26.329 because the professionals working there and the volunteers working there 00:08:26.353 --> 00:08:28.575 know how to deal with dementia. 00:08:29.093 --> 00:08:32.426 And the professionals know how to do their professional work 00:08:32.450 --> 00:08:37.482 in a way that it fits in a natural way in the life of our residents. 00:08:38.826 --> 00:08:43.506 And that means that the management has to provide everything 00:08:43.530 --> 00:08:45.864 those people need to do their work. 00:08:46.866 --> 00:08:50.710 It needs a management that dares to do this. 00:08:50.734 --> 00:08:53.871 To do things differently than we always have done 00:08:53.895 --> 00:08:56.028 in a traditional nursing home. NOTE Paragraph 00:08:58.989 --> 00:09:00.893 We see that it works. 00:09:02.006 --> 00:09:05.172 We think this can be done everywhere, 00:09:05.196 --> 00:09:07.396 because this is not for the rich. 00:09:07.863 --> 00:09:12.212 We've been doing this with the same budget 00:09:12.236 --> 00:09:16.315 as any traditional nursing home has in our country. 00:09:16.339 --> 00:09:19.116 We work only with the state budget. NOTE Paragraph 00:09:20.220 --> 00:09:27.092 (Applause) NOTE Paragraph 00:09:28.226 --> 00:09:31.798 Because it has to do with thinking different, 00:09:31.822 --> 00:09:34.552 and looking at the person in front of you 00:09:34.576 --> 00:09:38.257 and looking at what does this person need now. 00:09:39.352 --> 00:09:42.592 And it's about a smile, it's about thinking different, 00:09:42.616 --> 00:09:46.663 it's about how you act, and that costs nothing. 00:09:47.823 --> 00:09:51.490 And there's something else: it's about making choices. 00:09:51.903 --> 00:09:55.636 It's about making choices what you spend your money on. 00:09:56.855 --> 00:09:58.131 I always say, 00:09:59.323 --> 00:10:04.069 "Red curtains are as expensive as gray ones." NOTE Paragraph 00:10:04.093 --> 00:10:05.470 (Laughter) NOTE Paragraph 00:10:05.494 --> 00:10:08.017 It's possible, everywhere. NOTE Paragraph 00:10:09.263 --> 00:10:10.422 Thank you. NOTE Paragraph 00:10:10.446 --> 00:10:15.077 (Applause)