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.
Ovo je Hogevek. To je kraj u jednom malom gradu veoma blizu Amsterdama u Holandiji. Tu postoji 27 kuća, svaka za po šestoro, sedmoro ljudi. Postoji mali tržni centar sa restoranom, kafana, supermarket, klub. Tu su i ulice, prolazi, pozorište. To je u stvari dom za stare. Dom za stare koji žive sa uznapredovalom demencijom i kojima je potrebna pomoć i briga 24 sata.
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.
Demencija je strašna bolest i još uvek za nju nemamo nikakav lek. Ona postaje veliki problem u svetu, za ljude, za političare, za svet - postaje veliki problem. Vidimo liste čekanja u domovima za stare. Većina onih koji sa demencijom dolaze u domove su žene. To je delom zato što su žene navikle da brinu o drugima, pa mogu da brinu o svom mužu koji ima demenciju, ali obrnuto nije tako jednostavno za gospodu.
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.
Demencija je bolest koja utiče na mozak. Mozak je zbunjen. Ljudi više nemaju pojam o vremenu, šta se dešava, ko su ljudi. Veoma su zbunjeni. I zbog te zbunjenosti postaju anksiozni, depresivni, agresivni.
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."
Ovo je tradicionalni dom za stare. Tamo sam radila 1992. Bila sam menadžer za negu. Često smo razgovarali o činjenici da to što tamo radimo nije ono što želimo za svoje roditelje, za svoje prijatelje, za nas same. I jednog dana smo rekli: "Kad samo pričamo o tome ništa se neće promeniti. Mi ovde upravljamo. Trebalo bi da uradimo nešto povodom ovoga, da bismo želeli da nam roditelji budu ovde."
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.
Razgovarali smo o tome i svakog dana smo viđali da su ljudi koji žive u našem domu zbunjeni u vezi sa svojom okolinom, jer su videli nešto nalik bolnici, sa doktorima i sestrama i tehničarima u uniformama, a oni žive na odeljenju. I nisu razumeli zašto žive tu. Tražili su mesto na koje mogu da pobegnu. Tražili su i nadali se da će naći vrata da ponovo odu kući. Rekli smo da mi u toj situaciji nudimo ljudima sa već zbunjenim mozgom samo još više zbunjivanja. Nagomilavamo konfuziju. A to ovim ljudima nije potrebno.
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.
Oni žele da imaju život i imaju pomoć, našu pomoć, u nošenju sa tom demencijom. Oni žele da žive u normalnoj kući, ne na odeljenju. Žele da imaju normalno domaćinstvo, gde mogu da omirišu večeru na šporetu u kuhinji. Ili da slobodno odu u kuhinju i uzmu nešto za jelo ili piće. To je njima bilo potrebno. I to bi trebalo da im omogućimo.
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.
Rekli smo da bi to trebalo da bude kao kod kuće, da ne moraju da žive kao na odeljenju u grupi od 15, 20, 30 ljudi. Ne, mala grupa ljudi, šestoro ili sedmoro, nalik porodici. Kao da živite sa prijateljima. I trebalo bi da možemo da odaberemo ljude na osnovu njihovih zamisli o životu kako bi imali priliku da postanu prijatelji kada budu živeli zajedno. Razgovarali smo sa svim porodicama stanara o tome "šta je važno vašem ocu", "šta je važno vašoj majci", "kakav je njihov život", "šta žele". Pronašli smo sedam grupa i nazvali ih grupama životnih stilova.
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.
Na primer, otkrili smo formalni životni stil. U ovom životnom stilu ljudi na formalniji način komuniciraju međusobno, udaljeniji su. Njihov dnevni ritam počinje kasnije, završava se kasnije. Kod njih se više čuje klasična muzika nego kod drugih životnih stilova. A njihov jelovnik više čini francuska kuhinja nego tradicionalna holandska.
(Laughter)
(Smeh)
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.
Nasuprot zanatskom životnom stilu. To je veoma tradicionalan životni stil, oni ustaju rano, idu na spavanje rano, jer celog života su naporno radili, uglavnom svojim rukama, često su imali mali porodični posao, malo gazdinstvo, prodavnicu, ili kao gospodin B, koji je bio radnik na farmi. Rekao mi je da je išao na posao svakog jutra noseći papirnu kesu sa ručkom i jednu cigaru. Ta jedna cigara je bila jedini luksuz koji je sebi mogao da priušti. I posle ručka bi je popušio. I do dana kada je umro u Hogeveku, on je bio u ovoj maloj šupi, svakog dana, posle ručka i pušio cigaru.
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.
Ovo je moja majka. Ona pripada kulturnom stilu, živi već šest nedelja u Hogeveku. Taj životni stil obuhvata putovanja, upoznavanje drugih ljudi, kultura, interesovanje za umetnost i muziku. Postoji još životnih stilova. Ali o tome smo razgovarali i to smo uradili.
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.
Ali to nije život, u kući sa grupom ljudi, ljudi sličnih razmišljanja, vaš život, vaš dom. Život je više od toga, svi žele zabavu u životu, smislen život. Mi smo društvene životinje - potreban nam je društveni život. I mi smo to započeli. Želimo da izađemo iz kuće i obavimo kupovinu, da sretnemo druge ljude. Ili da odemo u kafanu i popijemo pivo sa prijateljima. Ili kao gospodin V - on voli da izlazi svakog dana, da vidi da li ima zanimljivih dama.
(Laughter)
(Smeh)
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.
On im se udvara, nada se osmesima i dobija ih. I pleše sa njima u kafani. Svaki dan je slavlje.
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.
Postoje ljudi koji bi radije otišli u restoran, popili čašu vina sa prijateljima, ručali ili večerali sa prijateljima i slavili život. A moja majka šeta u parku, sedi na klupi na suncu, nadajući se da će neki prolaznik naići i sesti pored nje i razgovarati o životu ili o patkama u jezeru.
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.
Taj društveni život je važan. Znači da ste deo društva, da pripadate. To je nama ljudima potrebno. Čak i ako živite sa uznapredovalom demencijom.
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.
Ovo je pogled sa prozora moje kancelarije. Jednog dana sam videla jednu gospođu kako dolazi s jedne strane, i drugu kako dolazi s druge strane i srele su se na uglu. Obe sam ih dobro poznavala. Često sam ih viđala kako šetaju napolju. I povremeno sam pokušavala da zapodenem razgovor s njima, ali njihov razgovor je bio... prilično težak za razumevanje. Ali videla sam kako se sreću i videla sam da razgovaraju, da gestikuliraju. I zabavljale su se zajedno. A onda su se pozdravile i svaka je otišla na svoju stranu. To je ono što želite u životu, da srećete druge ljude i budete deo društva. I to je ono što sam videla da se dešava.
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.
Hogevek je postao mesto gde ljudi sa veoma naprednom demencijom mogu da žive, da budu slobodni i sigurni, jer profesionalci i volonteri koji tamo rade znaju kako da se nose sa demencijom. Profesionalci znaju kako da rade svoj posao na način koji se na prirodan način uklapa u život naših stanovnika. A to znači da uprava mora da obezbedi sve što je tim ljudima potrebno da bi radili svoj posao. Potrebna im je uprava koja se usuđuje da ovo radi. Da radi stvari drugačije nego što smo uvek radili u tradicionalnim domovima za stare.
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.
Mi vidimo da to funkcioniše. Mislimo da ovo može da se uradi svuda, jer ovo nije za bogate. Mi ovo radimo sa istim budžetom koji ima bilo koji tradicionalni dom za stare u našoj zemlji. Radimo samo sa državnim budžetom.
(Applause)
(Aplauz)
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."
Tu se radi o drugačijem razmišljanju, o gledanju u osobu pred sobom i razumevanju šta je njoj sada potrebno. I radi se o osmehu, drugačijem razmišljanju, o načinu ponašanja, a to ništa ne košta. I ima još nešto: tu se radi o izborima. O biranju na šta trošite novac. Ja uvek kažem: "Crvene zavese koštaju jednako kao i sive."
(Laughter)
(Smeh)
It's possible, everywhere.
Moguće je, svuda.
Thank you.
Hvala vam.
(Applause)
(Aplauz)