This is the Hogeweyk. It's a neighborhood in a small town very near Amsterdam, in the Netherlands. There are 27 houses for six, seven people each. There's a small mall with a restaurant, a pub, a supermarket, a club room. There are streets, alleys, there's a theater. It actually is a nursing home. A nursing home for people that live with an advanced dementia and that need 24-7 care and support.
Isto é Hogeweyk. É un barrio dunha pequena cidade moi preto de Ámsterdam, en Holanda. Hai 27 casas con seis ou sete persoas en cada unha. Hai un pequeno centro comercial cun restaurante, un bar, un supermercado e un pub. Tamén ten rúas, canellas, un teatro... En realidade trátase dunha residencia de anciáns. Unha residencia para persoas con demencia avanzada que necesitan atención 24 horas 7 días á semana.
Dementia is a terrible disease, and we still don't have any cure for it. It's getting to be a major problem in the world, for the people, for the politicians, for the world -- it's getting to be a big problem. We see that we have waiting lists in the nursing homes. Most people that come to the nursing homes with dementia are women. And that's also because women are used to taking care of people, so they can manage to take care of their husband with dementia, but the other way around is not so easy for the gentlemen.
A demencia é unha enfermidade terrible para a que aínda non temos cura. Estase a converter nun problema grave no mundo para a xente, para os políticos, para todos... estase a converter nun problema moi serio. Sabemos que nas residencias de anciáns hai lista de espera. A maior parte das persoas con demencia que entran nunha residencia son mulleres. Isto débese a que as mulleres están acostumadas a coidar persoas, así que amáñanse para coidar os seus maridos con demencia. Pero pola contra, para os homes, non é tan fácil.
Dementia is a disease that affects the brain. The brain is confused. People don't know anymore what the time is, what's going on, who people are. They're very confused. And because of that confusion, they get to be anxious, depressed, aggressive.
A demencia é unha enfermidade que afecta o cerebro. O cerebro está confundido. A xente xa non sabe que hora é, que pasa, quen son as demais persoas. Están moi confundidos. E por culpa desa confusión póñense nerviosos, deprimidos, agresivos...
This is a traditional nursing home. I worked there in 1992. I was a care manager. And we often spoke together about the fact that what we were doing there was not what we wanted for our parents, for our friends, for ourselves. And one day, we said, "When we keep on saying this, nothing is going to change. We are in charge here. We should do something about this, so that we do want to have our parents here."
Esta é unha residencia de anciáns tradicional. Traballei alí en 1992. Eu era a responsable do servizo de coidados. A miúdo falabamos de que o que faciamos alí non era o que quereriamos para os nosos maiores, para os nosos amigos, para nós mesmos. E un día dixemos: "Por moito que falemos, nada vai cambiar. Nós estamos ao cargo. Deberíamos facer algo de maneira que queiramos traer os nosos pais aquí".
We talked about that, and what we saw every day was that the people that lived in our nursing home were confused about their environment, because what they saw was a hospital-like environment, with doctors and nurses and paramedics in uniform, and they lived on a ward. And they didn't understand why they lived there. And they looked for the place to get away. They looked and hoped to find the door to go home again. And we said what we are doing in this situation is offering these people that already have a confused brain some more confusion. We were adding confusion to confusion. And that was not what these people needed.
Falámolo, e o que viamos a diario era que as persoas que vivían na nosa residencia estaban confundidas con respecto á súa contorna porque o que vían era un ambiente de hospital con médicos, enfermeiros e paramédicos de uniforme, e vivían permanentemente nunha sala. E non entendían por que estaban alí, entón buscaban lugares polos que saír. Buscaban con esperanza a porta para volver para a casa. E pensamos que o que estabamos facendo nesa situación era darlle a esa xente, que xa ten a mente confusa, máis confusión. Estabamos engadindo máis confusión á confusión. E iso non era o que esa xente necesitaba.
These people wanted to have a life, and the help, our help, to deal with that dementia. These people wanted to live in a normal house, not in a ward. They wanted to have a normal household, where they would smell their dinner on the stove in the kitchen. Or be free to go to the kitchen and grab something to eat or drink. That's what these people needed. And that's what we should organize for them.
Esa xente quería ter unha vida, e axuda, a nosa axuda, para lidar con esa demencia. Esta xente quería vivir nunha casa normal non nunha sala. Querían ter un fogar normal onde puidesen ulir a cea ao lume na cociña. Ou ser libres de ir á cociña por algo para comer ou beber. Iso era o que esa xente necesitaba. E iso era o que debíamos ofrecerlles.
And we said we should organize this like at home, 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. Like living with friends. And we should find a way to select people based on their ideas about life so that they did have a good chance to become friends, when they lived together. And we interviewed all the families of the residents about "what is important for your father," "what's important for your mother," "what is their life like," "what do they want." And we found seven groups, and we call them lifestyle groups.
Pensamos que debiamos organizar este lugar coma unha casa, de xeito que non vivisen cun grupo de 15, 20 ou 30 persoas nunha sala. Non, un grupo pequeno de seis ou sete, coma nunha familia. Como vivir con amigos. E debiamos encontrar un modo de agrupalos segundo a súa maneira de pensar para que tivesen a oportunidade real de facerse amigos cando vivisen xuntos. Entrevistamos as familias dos residentes e preguntámoslles "Que é importante para teu pai?" "Que é importante para túa nai?" "Como é a súa vida?" "Que desexos teñen?" E identificamos sete grupos aos que chamamos "grupos de estilo de vida".
And for instance, we found this formal lifestyle. In this lifestyle, people have a more formal way of interacting with each other, a distant way. Their daily rhythm starts later in the day, ends later in the day. Classical music is more heard in this lifestyle group than in other lifestyle groups. And their menu, well, is more French cuisine than traditional Dutch.
E, por exemplo, encontramos un estilo de vida formal. Nese estilo de vida a xente interactúa de maneira máis formal, máis distante. O seu ritmo diario empeza tarde e acaba tarde. Neste estilo de vida escóitase máis música clásica ca nos outros grupos. En canto ao menú, ben... é máis afín á cociña francesa que á holandesa tradicional.
(Laughter)
(Risas)
In contrary to the craftsman lifestyle. That's a very traditional lifestyle, and they get up early in the morning, go to bed early, because they have worked hard their whole life, mostly with their hands, very often had a very small family business, a small farm, a shop, or like Mr. B, he was a farmhand. And he told me that he would go to his work every morning with a paper bag with his lunch and one cigar. That one cigar was the only luxury he could afford for himself. And after lunch, he would have that one cigar. And until the day he died in the Hogeweyk, he was in this little shed, every day, after lunch, to smoke his cigar.
É o oposto ao estilo de vida do obreiro. Este é un estilo moi tradicional. A xente érguese cedo e déitase cedo porque traballaron duro toda a vida, especialmente coas mans. En moitos casos tiveron un pequeno negocio familiar, unha pequena granxa, unha tenda ou coma o Sr. B., que traballaba no campo. Contoume que ía traballar cada mañá coa súa comida nunha bolsa de papel e un puro. Ese puro era o único luxo que se podía permitir. E despois de comer fumábao. E ata o día que morreu en Hogeweyk, ía cada día despois de comer para este pequeno alboio fumar o seu puro.
This is my mother. She's of the cultural lifestyle, she's been living in the Hogeweyk six weeks now. And that lifestyle is about traveling, meeting other people, other cultures, interest in arts and music. There are more lifestyles. But that's what we talked about, and that's what we did.
Esta é miña nai. Pertence ao estilo de vida cultural. Leva seis semanas vivindo en Hogeweyk. Este estilo de vida vai de viaxar, coñecer xente, outras culturas, o interese pola arte e a música... Hai máis estilos de vida. Pero diso foi do que falamos e iso foi o que fixemos.
But that's not life in a house with a group of people, like-minded people, your own life, your own household. There's more in life, everybody wants fun in life and a meaningful life. We are social animals -- we need a social life. And that's what we started. We want to go out of our house and do some shopping, and meet other people. Or go to the pub, have a beer with friends. Or like Mr. W -- he likes to go out every day, see if there are nice ladies around.
Aínda que vivas nunha casa cun grupo de persoas de ideas afíns, non é a túa propia vida, non é o teu fogar. Hai máis cousas na vida. Todo o mundo quere divertirse e darlle sentido á súa vida. Somos animais sociais e precisamos vida social. E iso é o que puxemos en marcha. Queremos saír da casa, ir de compras, coñecer xente... Ou ir ao bar e tomar unha cervexa con amigos. Ou coma o Sr. W, a quen lle gusta saír a diario para ver se hai mulleres bonitas pola volta.
(Laughter)
And he's very courteous to them, and he hopes for smiles and he gets them. And he dances with them in the pub. It's a feast every day.
É moi cabaleiroso con elas; só espera que lle sorrían e conségueo. E baila con elas no bar. Cada día é unha festa.
There are people that would rather go to the restaurant, have a wine with friends, or lunch or dinner with friends and celebrate life. And my mother, she takes a walk in the park, and sits on a bench in the sun, hoping that a passerby will come and sit next to her and have a conversation about life or about the ducks in the pond.
Hai quen prefire ir a un restaurante, tomar un viño cos amigos, ou xantar ou cear con amigos e celebrar a vida. Miña nai pasea polo parque e senta nun banco ao sol. esperando que veña alguén e sente ao seu lado para falar sobre a vida, ou sobre os patos da lagoa.
That social life is important. It means that you're part of society, that you belong. And that's what we people need. Even if you're living with advanced dementia.
Esa vida social é importante. Significa que es parte da sociedade, que tes o teu lugar. E iso é o que todos precisamos. incluso se temos demencia avanzada.
This is what I see from my office window. And one day, I saw a lady coming from one side, and the other lady from the other side, and they met at the corner. And I knew both ladies very well. I often saw them walking around outside. And now and then, I tried to have a conversation with them, but their conversation was ... rather hard to understand. But I saw them meeting, and I saw them talking, and I saw them gesturing. And they had fun together. And then they said goodbye, and each went their own way. And that's what you want in life, meeting other people and being part of society. And that's what I saw happening.
Isto é o que vexo dende a ventá da miña oficina. Un día vin a unha señora que viña dun lado, e a outra señora que viña do outro, e atopáronse na esquina. Eu coñecíaas moi ben ás dúas. A miúdo víaas pasear por fóra. Nalgunha ocasión tratei de conversar con elas, pero a súa conversa era... bastante complicada de entender. Pero vinas reunirse, vinas falar vinas xesticular. E divertíanse xuntas. Despois despedíronse e cada unha marchou polo seu lado. Isto é o que queremos na vida: encontrarnos con outra xente e formar parte da sociedade. E isto é o que vin alí.
The Hogeweyk has become a place where people with very advanced dementia can live, have freedom and safety, because the professionals working there and the volunteers working there know how to deal with dementia. And the professionals know how to do their professional work in a way that it fits in a natural way in the life of our residents. And that means that the management has to provide everything those people need to do their work. It needs a management that dares to do this. To do things differently than we always have done in a traditional nursing home.
Hogeweyk converteuse nun lugar onde xente cun estado de demencia avanzado pode vivir, ter liberdade e seguridade, porque os profesionais e voluntarios que traballan alí saben como tratar a demencia. E os profesionais saben como facer o seu traballo de maneira que se axuste con naturalidade á vida dos residentes. E iso significa que a dirección ten que proporcionar todo o que esa xente precisa para facer o seu traballo. Necesítase unha dirección que se atreva a facelo, a facer as cousas de xeito diferente a como sempre se fixeron nunha residencia de anciáns tradicional.
We see that it works. We think this can be done everywhere, because this is not for the rich. We've been doing this with the same budget as any traditional nursing home has in our country. We work only with the state budget.
Sabemos que funciona. Cremos que isto se pode facer en todas as partes porque isto non é para ricos. Conseguímolo co mesmo presuposto que ten calquera residencia de anciáns tradicional no noso país. Traballamos só co presuposto estatal.
(Applause)
(Aplausos)
Because it has to do with thinking different, and looking at the person in front of you and looking at what does this person need now. And it's about a smile, it's about thinking different, it's about how you act, and that costs nothing. And there's something else: it's about making choices. It's about making choices what you spend your money on. I always say, "Red curtains are as expensive as gray ones."
Porque ten que ver con pensar diferente, con mirar a persoa que está fronte a ti e decatarse do que esa persoa necesita agora. Trátase de sorrir, de pensar diferente, de como actuar, e iso non custa nada. E hai algo máis: trátase de tomar decisións. Trátase de decidir en que gastas os cartos. Eu sempre digo: "As cortinas vermellas son tan caras coma as grises"
(Laughter)
(Risas)
It's possible, everywhere.
É posible, en todas partes.
Thank you.
Grazas.
(Applause)
(Aplausos)