My mother had alzheimer's. The best advice I can give is to go along with their musings and conversations. You will only frustrate them and yourself if you try to correct them. When my mom said we were food shopping, I helped her make a list. When she said we were at the beach, I asked about the water temperature. And when she pet my childhood dog, I asked if she wanted to give him a biscuit. Her facility had baby dolls for the residents to soothe and cuddle. They may be gone from you but they are still busy and happy in their own minds.
101
This story is about a place that has excellent palliative care for people dying of dementia. But the headline is misleading. This is not about “treatment” or “fighting the disease”. We still do not have treatments that restore people enough to function with independence. A less stressed and peaceful environment is of course a very good thing. But staring at pictures of nature on my ceiling does not seem much of a life and is not a treatment but rather comfort care.
44
My father had Alzheimer's. It's a myth that it's only the loved ones who suffer from the disease; he was in a constant state of agitation. When he became too much for my mother to cope with, he ended up in a nursing home. It was probably the best anyone could do for him given the state of health care in this country. But it was a needlessly horrible end given that the Dutch have shown that there is another way. It's just not the "American way." It's maddening.
71
This article ties in nicely to your recent report on the very large (25,000+ participants if I recall correctly) study on dementia completed in Norway. This study confirmed the importance of maintaining adequate blood pressure in the elderly to ensure normal cerebral blood flow. Our excessive focus on prevention of hypertension means that many older individuals live with chronic low blood pressure and inadequate cerebral perfusion, leading to dementia. Staying active, as described here, in order to maintain normal blood pressure is essential. The challenge is getting the elderly to maintain their exercise routines. Perhaps alternative approaches which raise blood pressure in the elderly in order to increase blood flow to the brain may be a useful intervention strategy. This may slightly raise the risk of a cardiac event, but far better than living with dementia.
39
A very interesting article, even though such facilities will never be available to any but the wealthiest Americans. Another problem not mentioned is that loss of hearing and vision in many elders exacerbates or possibly might be an additional cause of dementia. For those, the virtual bus rides and beach trips would not help. Familiar surroundings and sharing memories with family members is probably best, but few family members have the time, money, or patience to care for an elder at home.
There are many manifestations of dementia, how much of it has been studied? Or do we all just have to make up what to do as we go along.
23
Sounds like a good direction. Anything that can be done to move from traditional (and, sadly, often indifferent) custodial care is a step in the right direction.
Many adults are uncomfortable around people with dementia. In our experience, other adults are supposed to make sense. When others offer replies which are non-sequiturs or say things which are 'off the wall' to us, our tendency is to feel embarrassed for them. We want to flee and then avoid them. Shutting them away then seems like a good option.
Yet, it is quite possible for folks even with moderate dementia to enjoy life. Experiences as described here which evoke multi-sensory memories can help. For those who are suffering profoundly, clearly various sensory stimulation can help to ease agitation and offer a calmer, more soothing life.
The scary part is that many of us will end up in a similar state. It is truly to our own benefit to encourage and support efforts to improve the quality of life for folks with dementia.
51
This is such a shining example of compassionate, open-hearted caregiving. Appreciate all the wonderful ideas in this story, especially the projection of calming images on the ceiling. Hoping I can do this (or a version of it) for my dad, whom we are caring for at home and who spends much time staring at the ceiling above or gazing at the wall to the right of his bed.
53
Thank you for this wonderful article. After reading the comments below, there is not anything to add - except - the general public of the USA will not ever lose their fear of 'social government'. Therefore, they will not ever come close to what life is like in Europe. Born in the USA? Great if you are a billionaire.
78
This seems like a great idea. It might help but even if it does not, it still is positive and seems better than alternate treatment.
"The facilities, which are privately run but publicly funded, are generally reserved for people in an advanced state of the disease."
I'd be happy to read more on the nature and workings of that publicly funded support.
34
Some dementia facilities in the US are doing a good job.
The facility my 87 year old father was at (he died in Nov), knew what they were doing in the Netherlands, and was trying to copy it. They had a huge mural put in about 2 years ago that covered an entire wall of a small room so it felt like you were in a beautiful outdoor nature scene. They also had a big television in the sitting room that they would put on videos of kittens, puppies or other animals for it's calming effect, plus stuffed animals, different sensory objects they could hold in their hands, life-like dolls and accessories, music groups and therapy animals they were bringing in all the time, among other things.
When you read this article you notice they are mentioning different facilities, so it is not one facility that has all these cool things in it, but they are spread out in several facilities. I'm sure there are good and bad places over in the Netherlands too. We might just have to hunt harder to find really good places in the US, and possibly pay more, although the one my father was at was not any higher in price than 2 others we had also considered.
32
Sign me up.
15
How lovely. Apparently if I get dementia I need to move to the Netherlands.
32
Fortunately, most Dutch people are fluent in English!
13
I compare this love, thoughtfulness, and innovation with what is happening in the UK where social care has been all but privatised, and most homes are run entirely for profit, where the carers are paid minimum wage, where they often work by themselves overnight, one carer looking after more than 20 residents in “homes” that are often cold, damp, and smelly, and i despair of the callousness of the system here where money is king.
I am a doctor.
It is a crime when one says constantly “God forbid my parents end up in a place like this. God forbid I ever have to be in a place like this .... I would rather die.”
I blame this society we are in but most of all, I blame this callous government where increasingly, one has to be very rich to have any quality of life and a modicum of dignity in old age.
80
Patients with Dementia are treated with the utmost respect in the Netherlands. I have experienced relatives of mine becoming very forgetful, and it increasingly gets worse for them. They begin to forget the things that make up their identity, which evidently causes sadness. I believe that every senior citizen home should include the simulations shown in this article. It seems to not only allow them to use their brain, but to evoke happiness as well.
48
https://www.nytimes.com/2018/08/22/world/europe/dementia-care-treatment-...
Dementia has recently started to effect the loved ones around me. I have a grandmother that lives in mexico that has just been diagnosed with dementia. Dementia can not be cured but can be reduced or at least slowed down. I believe that what they are doing in Denmark is remarkable. They are giving these people a chance to grasp on to what little they have left. Sadly that is not the case for many countries. Giving the elders memories from their childhood and life before they got dementia is so heart warming and is being proved to be effective. I'm so glad they have come up with a way to help others
25
My grandmother suffers from late stages of Parkinson's disease. She lives on the Jersey shore but she has not been able to even see the beach since her conditions have worsened. The highlight of her day is to move from couch to couch in the house. A simulation like the beach would mean the world to her. To give her a sensation of somewhere without four walls. As Dr. Erik Scherder stated, "If you can lower stress and discomfort, it has a direct physiological effect." If my grandmother has any chance of improvement, this might just be it. The medicine she is taking has not made her any better. I may be able to talk to my grandmother again if she is put in a comfortable setting.
24
@Matt R Maybe a (live?) video from the ocean displayed on a large television (through say a Chromecast) would come near to that experience? With a Google Home picking locations to watch would not even require fiddling with a phone or tablet, which I'd imagine would be problematic with severe Parkinson's.
18
Americans have so much to learn from The Netherlands and Scandinavia (and even Germany, Canada and the UK, to name a few). I am truly thankful for these societies as beacons of hope, innovation, and above all, compassion and social responsibility.
52
I was born in Holland and, after growing up in Australia, went back at age 22 to meet relatives. I worked in a very well appointed home for people with dementia and lived upstairs with other carers, many from Indonesia. In the political discussions I have had over the last 20 years, there has been, as Paul Krugman points out, a misunderstanding between democratic socialism and far left socialism. The former provides a cradle to grave safety net. It is accepted that taxes provide for an acceptable standard of living for all, as well as for the necessary infrastructure (roads, transport, water, electricity) that define modern cities. What is extraordinary and encouraging about this look at caring for Dutch patients in decline, is it runs counter to another modern trend for which Holland is known, that of assisted suicide. This story puts the lie to the idea that a libertarian view of end of life issues will result in a disregard for the elderly and others no longer able to take care of themselves.
66
@Boomer
Euthanasia overall, but especially in the Netherlands is often misunderstood and misrepresented in the media. In truth, very few people get euthanasia, and rarely do these people have a form of Dementia. Dementia means by law that you can no longer make a well informed decision, and as such, you can not apply for euthanasia anymore. And while it is possible to put together documents to ask for it in advance, these are usually disregarded in cases of dementia, as the wish can no longer be confirmed with certainty. Euthanasia is a last resort, it is about dying with dignity, above all it is about the quality of life. In that way euthanesia does not run counter to the measures we see here.The measures we see in the article are similarly about quality of life, the highest good and the least thing that we owe these people who built our country.
28
I think of both of my parents, my father with Parkinsonian dementia and my mother with Alzheimer's, and it just makes me cry to see this. They were intelligent people who lived well within their means, saved for old age, all that jazz. Fortunately, my father had worked for a large corporation and had good insurance. Even with that, he ended up in a locked ward (because he "wandered") in what was considered a good nursing home, but was actually quite dreary, in Arizona.
After he died, my mother moved into an apartment house with other elderly residents and, when that became too much, into a continuing care facility. We paid $8,000 per month for several years (with supposed long-term insurance that helped for 3 years), and she had a hospital-type room with only a curtain between her door and her neighbor's. At least she had a window, and we could take her into a courtyard for fresh air.
It makes me so angry that that was how they lived out their last few years. It was a diminished existence degraded further by our health-care-less system.
I pray that Paul Ryan, Mitch McConnell, and all the other slimeballs in Congress who cannot imagine that other people's lives are just as important as theirs--I fervently hope that they get what they deserve.
171
I think of both of my parents, my father with Parkinsonian dementia and my mother with Alzheimer's, and it just makes me cry to see this. They were intelligent people who lived well within their means, saved for old age, all that jazz. Fortunately, my father had worked for a large corporation and had good insurance. Even with that, he ended up in a locked ward (because he "wandered") in what was considered a good nursing home, but was actually quite dreary, in Arizona.
After he died, my mother moved into an apartment house with other elderly residents and, when that became too much, into a continuing care facility. We paid $8,000 per month for several years (with supposed long-term insurance that helped for 3 years), and she had a hospital-type room with only a curtain between her door and her neighbor's. At least she had a window, and we could take her into a courtyard for fresh air.
It makes me so angry that that was how they lived out their last few years. It was a diminished existence degraded further by our health-care-less system.
I am reminded of how very much good reason I have to hate Paul Ryan, Mitch McConnell, and all the other slimeballs in Congress who think that crappy care is good enough for other people, as long as they're all right. I hope there's a special little spot in hell for them.
19
While this approach to dementia management in the Netherlands is well-intentioned, economically sound, and possibly even beneficial, I find the concept of providing hospitalised (incarcerated?) dementia patients with simulated, indoor environments rather chilling; it is clear evidence of how urban society has become disconnected from the natural world. Instead of providing them with a fake beach with sound effects and sand, why don't they just put them in a (real) bus and take them to to a (real) beach?
7
@Talia Morris - where they might wander off and endanger themselves, or get sunburned very badly, or become overwrought by weather or crowds, or have to be carried onto the sand because of their wheelchairs? nature is all well and good, but it is notoriously unfriendly to the aged and impaired.
57
@Talia Morris
Have you worked with dementia patients in a nursing home? I have and the idea of putting 2 or more patients with severe dementia in a bus and transporting them to the beach is just ludicrous. So many issues to navigate...the inevitable incontinence issues (which sometimes require 2 caregivers to resolve) while on public transport...at least one patient will get into a panic (that can easily escalate) because they want to go back home now because mother will be mad if they're late...the rest will get agitated by some aspect of the trip, loud noises, lots of stimulation from traffic etc and will start acting out. Let's not even get into meal times....
69
One of the things that I've really tuned into as I get older and am starting to become fragile is how oblivious young people are, which totally makes sense but is also very scary. I was walking to a bus stop when a young woman went sprinting past me to make the street crossing before the light changed and although she only lightly grazed me, she did so when I was on an uneven spot on the sidewalk and the unfortunate confluence of these two events was that I momentarily lost my balance, twisted my ankle and went slamming to the sidewalk. This happened in mid-June and my left knee is still discolored from the bruising that for several weeks went from my ankle and the top of my foot to the very top of my knee (which no longer hurts but is still discolored). Had I not been headed to a job interview in another town, I would have gone straight to an emergency room. The really scary thing is knowing it could have been much worse.
33
This is news?
About 15 years ago my good friend went through early dementia and it was wrenching to watch this intelligent, beautiful woman fade away. I spent a significant amount of time with her and because we had been just good friends, we had no negative baggage that got in the way.
When she would start to slip into a dark place, I would take her hands and tell her to go to a place that made her laugh or smile.
Sometimes I played music for her that she liked and took her back to her youth.
That approach would usually bring her back to reality for a decent period of time and she would be her old self: Until another dark wave of confusion would sweep over her.
I think this disease is probably the only one that is more difficult for those of us who care about the person suffering the disease than for the person affected. At some point, the patient loses themselves completely while those of us who loved her were forced to watch this horrific illness steal the beautiful person I knew.
75
@Richard Marcley - this is news because these are institutions doing that and other, more complex activities, not an individual in a one-on-one relationship with one other individual.
20
@Richard Marcley,
This is news, to residents of the United States, because the kind of facilities seen commonly in the Netherlands cannot be found here in the United States (or if so, rarely). The news to Americans is that there are other ways. I have been with relatives as they age, I have a bedbound relative who is in a locked ward, and the best Seattle facility I could find falls way short of the effort and compassion shown in this story but costs a fortune suited to the upper ten percent. Creating these comfort environment is neithervrocket science, nor does it cost all a country's treasure. The news is it can be done, despite the protestation of those who say our care system is best bar none - it falls way short, and to some that is news.
30
First, please don't use the word "treat" in regard to dementia. This only furthers the misunderstanding of the disease. Dementia can not be "treated" as say, a bad cold, can be. This article is about "caring" for those with dementia. There is no "treatment," just continuing debilitation.
43
A true story. When my dad was in a nursing home for a couple of weeks while recovering from a broken hip, I was eating lunch with him and an aide was eating across from me. She told me she'd rather be taken out in a field and shot than have to stay in a nursing home. This from someone who worked in one!
19
@Linda And she said this right in front of your dad?
9
@Linda - After experiencing this world with my mom, I am strongly in favor of right to die legislation. I believe most of us boomers will support that after caring for our loved ones.
21
@Linda-that’s not an option she will have. Dementia patients are not considered competent to decide their own fate.
3
There is lots of evident that nature heals. Trees in particular seem to have calming effects.
My experience with nursing homes is that they never take the residents outside to experience nature or get any sunlight My mom, who had Lewy Body dementia, had to spend 20 days in a nursing home while she recovered from a hospital stay. When she first went there, I saw a big cage full of beautiful lovebirds. Outside there were flowers and picnic tables. The birds and the flowers were for visitors. The residents were never allowed out of their sections of the home to see anything, not even the birds in the lobby. Because the residents have mental problems, staff was reluctant to let relatives take them outside. At least when my dad was in a nursing home after breaking his hip, they let us take him outside, though the staff never took anyone outside.
Residents in American nursing homes not only lack nature, they're bored to death, literally. There are activity directors but all the activities I witnessed were lame. There has to be something better for those who are too ill to live at home, but alive enough to want something more than sitting in a wheelchair staring at a TV.
72
Linda@Oklahoma, to your point, I ended up living with my brother and sister-in-law in Oregon for nearly a year until I finally got a job in this small coastal town in California (I was born in the San Francisco Bay Area and spent nearly all of my adult life in SF), and I was really surprised by how viscerally I missed redwood trees. Anytime I need to drive from FB inland, I spend a half-hour on a beautiful road that winds its way through a redwood grove and I drive in near delirium. I had no idea that Coastal Redwoods were part of my psyche, but now that I do know, I don't ever want to be away from them again.
11
Since people with dementia can have good long term memory (problem is the short term memory more), this is a great (and cheap) way to help them retain those memories of years ago! I would think that changing room decor, giving patients familiar foods and use of the therapeutic robot seal are not as expensive as pumping drugs into people.
People are commenting that it's expensive - it's cheaper but it means less profits for the big pharmaceutical companies, right? Put the patient first! And ask your political reps who take thousands of dollars from big pharma to Put the Patient First!
https://www.opensecrets.org/industries/recips.php?ind=H4300&cycle=20...
38
The article shows how the Dutch have done wondrous work to help their citizens with dementia, but many people are not aware of similar efforts some have made here. As one example, take a look at the Senior Star organization, www.seniorstar.com, and their Memory Support Programs, including their use of Snoezelen multi-sensory environments. Originally inspired by Dutch therapists’ efforts to improve the lives of people with intellectual disabilities, these environments have been in use in North America for 25 years, but clearly far more are needed. A few years ago, the Dept of Veterans Affairs took a major step forward by implementing Snoezelen environments in VA centers throughout the country for veterans with dementia. Anyone interested to learn more should visit www.snoezelen.info. Help for your loved ones is out there.
40
Your tax dollars at work, sorry, my mistake, I meant to say euros...
15
Beautiful to see how Dutch people are cared for in old age.
(As opposed to here, where we've been reading about a married couple, both women, who were told they couldn't move into Friendship Village in St. Louis because their marriage does not fit the board's idea of what the bible requires.)
72
It is good to read about care that is possible, even if it is, sadly, available to people with dementia, at all income levels, only in another country.
I am quite bothered, though, by the article's headline, "Fighting Dementia With Memories . . ." To my mind, it reflects and reinforces an approach to interaction with people with dementia that is known to be ineffective and detrimental to quality of life. Enough with the fighting. This is about nurturing.
25
Caring about people and valuing our individual lives is so yesterday.
13
What a thoughtful and lovely way to deal with such a devastating condition. Bravo to the Dutch!
49
Is there nothing in which the Dutch are not superior??! ;-) Seriously though...it's remarkable to me...how 'common sense'...how emotionally-intelligent...the Dutch are, esp. as compared to the sorry state of the USA.
I also remember hearing about entire 'fake towns and villages' that exist in parts of the Netherlands... 'villages' that are created expressly to house those with Alz and dementia. In most respects they mimic a fully-functioning town, complete with supermarket, post office, movie theatre etc., but with some type of a wall or barrier around the town, to prevent residents from wandering off and getting lost. All of the residents are afflicted, and all of the workers are 'in on the secret'...they understand that all the residents have Alz or dementia, and presumably all/most are trained/licensed in dealing with such residents. The idea is that such villages give residents a sense of freedom, a somewhat normal life, while at the same time they are safer and much happier than those who are 'institutionalized', a la the US version.
35
@Lisa
That's . . . weird. Sounds just like "The Prisoner." Or "The Truman Show."
1
@Rita Rousseau It would not seem "weird" to you if you were caring for a loved one who gets lost in his own home. It would seem miraculous and kind.
10
@Rita Rousseau
But much safer...
3
Looking at the accompanying photos, I'm also struck by the fact that, overall, the residents look better, and more content, than your typical Alz/dementia patient in the US.
Also note the healthcare aid who is dressed in normal clothing, versus a clinical 'hospital outfit'. This in turn makes the aid worker look more human, more 'warm', and not like someone who's 'overworked, underpaid, not appreciated, and who's just another cog in the for-profit healthcare system wheel'.
82
I understand completely. My mom died of Alzheimer's when she was 94. Letting her do things that she enjoyed, like hitting golf balls off a driving range, helped us both immensely. It eased her anxiety, which eased mine in terms of dealing with her. I even wrote a book about our experiences: "My Mother Has Alzheimer's and My Dog Has Tapeworms: A Caregiver's Tale."
15
Great title!
2
Common approach in my mother's care home in the UK. It drives her crazy, the constant looping of memorabilia, WW" movies, Vera Lynn,etc. She has dementia but not Alzheimers.
7
It's just some more of the nasty, brutal, inhuman socialism that the Nordic countries punish their citizens with. Why can't these people sleep on the streets, in dumpsters, bus depots like good old capitalistic, free market, loveless, homeless, abused seniors do in the good old USA!
219
without an army of lobbyists like those that push for more money to buy more military toys from the large manufacturers of armaments and the suppliers they support, most old folks are just going to have to sit at the back of the budget bus. The US "can't afford it" unless it is "for the troops" - which is Congressional code meaning for "Lockheed Martin, Raytheon" and the rest of the "military-industrial complex" that sucks up more money every year for weapons that we have not used for decades (and theoretically do not want to use) - but which we need to buy more of and maintain and update every year.
Virtually nobody in Congress is willing to stop that insanity (our military budget is larger than the next 10 countries' budgets combined) so some federal funds might be freed up for health care (including care of the elderly), education, infrastructure, etc... Instead, it's "We can't afford it" - as if we need nuclear weapons and aircraft carriers to root out terrorist cells.
103
I wonder how the Dutch find, train, retain and find the money to pay the staff. In Canada, many residential care employees are recent immigrants with limited English and even more limited skills. Few Canadians want the difficult work or can afford to live on the wages. Funding is so tight that staffing levels are dangerously low and care is consequently poor. It's easy if you're affluent to get fancy, resort-style supported accommodation, but as soon as you become demented or too frail to function independently, into an under-resourced and, all too often, poor quality facility you will go. Sure it's largely publicly funded, but no one would choose to live under the prevailing conditions.
43
I'm an American married to a Dutch citizen. I'm a R.N. While I'm working on getting my credentials recognized and studying Dutch, I have been lucky to start a job just this week as a carer on the dementia floor of a care home in North Holland. I can confirm that the experience of dementia patients in the Netherlands is completely different from the experience of most Americans with dementia. This article tells the story very accurately. Our facility, called Overvest, is run by a larger but still local company called Omring. Omring is a Dutch word which means a circle of care and support. I was very lucky to meet Jolanda H., the CEO of Omring, on the terrace of a local cafe one weekend in June. This meeting led to interviews and a job offer with Omring as the nursing shortage is acute here as well as in the USA. On my first tour of Overvest, I was astonished at the beauty of the facility, with a soaring atrium and homey decor. There is cafe in the atrium for the residents, a grocery store and a gift shop. On the second floor, the physical therapy department overlooks the atrium in an open-air situation. No cold, sterile white walls to be seen. The dementia floor on the third level has four day rooms, called "huiskamers". Each room has comfortable chairs, tables, seating and dining areas, and an open kitchen where fresh meals are prepared three times per day. The residents move at their own speed, get up in the morning at their preferred times, just like at home.
122
Not all of these ideas are new or unique to the Netherlands, though its done so very well there.
I read an article about 10 years ago in the 'New Yorker' about a nursing home in the southwest that had some similar techniques to keep patients calm. It was said to cost more, it was private. At the time I found is depressing to think more states didnt have that type of home available. Nursing homes vary quite a bit from state to state.
8
My dear mother is 94 years old and currently resides in the dementia ward of one of the "better" facilities. She is usually unresponsive, although when I sing to her (old songs, showtunes from the 1940s), she often smiles.
This article made my heart ache. I wish so much that she could have had something like this when she still had most of her eyesight and cognition. Instead, in the U.S. we park our loved ones in front of a TV for much of the day.
What also really caught my eye in this story was the part about the government paying for home care. We need socialized health care and we need it, fast.
95
@Mia
It's a sad reflection on Americans to say this, but I think it's more likely to happen now that the verbiage has become "single-payer healthcare" rather than "socialized medicine."
5
Wow.
What is the cost of these beautiful homes to the patient and the families?
Meanwhile here in the US a patient gets put in a warehouse, if he/she is one of the "lucky" ones whose family can afford it. But god forbid we have socialized medicine here.
50
The cost to them is zero. All Dutch have insurance from cradle to grave. You pay according to your means for the coverage. I'm a healthy 49-year-old woman with a past history of breast cancer. My monthly premium for my Dutch health insurance is €125. I have an annual deductible of €385, which is everyone's deductible. I go to the doctor and pay zero. I go to the pharmacy and pick up my medication for zero euros. I'm an American married to a Dutch citizen and I'm gobsmacked at what a great system they have here in the Netherlands.
181
@Kosher Dill The goverment pays the bill. It is free of cost for the patient as it in included in the healthcare insurance.
16
@Kosher Dill ... I understand that their taxes are significantly higher though. That would be totally fine with me. It all seems like a so much more humane system for living, my comparison being with the U.S., of course.
19
The words 'humane, compassionate, loving, thoughtful' describe this treatment. It breaks my heart that here in the U.S.A, the words 'how many dollars will it cost the shareholders of the company?"
Where did we fall off the humanity train??
196
@deb
I think all of us who can need to advocate for more humane care; clearly it is possible.
None of these situations or facilities, and the thoughts/emotions that established them, are irreversible.
How do the Dutch do it?
I have a friend who cares for her 96 year old mother at my friend's home. This 96 year old has some dementia but the quality of the environment: food, conversation, pets, etc, contributes to creating a healthier world for our elder than the facilities we are familiar with.
And, lest we forget, I believe the caregivers look happy in images shared.
17
@deb,
I think we “fell off the humanity train” right about near the intersection where the “Aynn Rand Boulevard” approaches the onramp to the “corporations are people” toll expressway.
33
I care for my mother, who is nearing the 100-year-old mark, in my home and although she does not have Alzheimer's nor is she senile, I have used various techniques to keep her calm, happy and optimistic.
I usually have a variety of music playing in my home, some soothing classical pieces as well as songs from her Depression era days. She enjoys this so much and the music prompts her to go into a reverie of her younger days. Sometimes we just dance to the music of the Big Bands.
I also search for YouTube videos of places she loved in her NYC youth, such as Coney Island, and sit her down to watch and reminisce. There are an amazing number of things you can find on YouTube. We even found videos of the small town in Italy where her mother was born, and she marvels at them.
When she despairs at not being able to travel any longer, I order travel shows from Netflix, or, again, use YouTube to review places she has gone and I ask her for commentary on her trips.
I encourage her to recount highlights of her life, and the times that were hard and took courage to get through. With each telling, I learn a detail I hadn't heard before, or maybe I'm listening more carefully now. I praise her for her fortitude and remind her that she has lived a good life.
No, caregiving is not a walk in the park. We have our difficult times.
But I believe there are many simple ways to give comfort to the aged, methods that can sooth them and can prove to sooth us as well.
210
@TM - what good fortune your mother has - to have such a caring daughter or son.
40
@TM
Please, please audio or video record as many of these wonderful conversations you two share. An audio memory book for you and your family to share will be priceless. You might also transcribe conversations and include them in a photo album.
13
@TM ... you're lucky your mother is mentally in good health and not violent. It's a very, very different story for adult children trying to care at home for mentally deteriorated parents who have also become violent. There's not the kind of beauty in it that you experience.
5
The care and compassion with which the Dutch treat their elderly with dementia is reflective of the way they care for everyone in their society. The way a society treats the most vulnerable relates to how everyone is treated.
In our country, where the gospel of personal responsibility is simply another way of saying, you're on your own, we're too busy being resentful of others who seem to have it better than us - whether it's prisoners who get free medical care or illegal immigrants working dirty low wage jobs.
Our politicians prefer to show they value life by refusing to let women get abortions, and supporting people with private insurance who want to keep loved ones on life support forever...
142
brings tears to my eyes to see the thoughtful care given these elders. i am 72 and should I have to deal with dementia, i'd love some of these opportunities to connect, both outside and in.
54
@sayitstr8
Can you find/create groups to advocate?
I suggest contacting everyone you know and start a movement!!!
Possible.
6
I hope that this sort of care becomes more the norm. Even just a spark of an old memory can bring comfort - both to the patient, and to their family members who might share it.
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What a beautiful way to help those with horrible, life-robbing dementia symptoms. Even though the United States' healthcare industry might never evolve and adopt this humane Dutch model, we can use this information when our family members are stricken. As a caregiver to my late mother who suffered from dementia's assault, I know how familiar music brought great joy and revived the spirit of the girl that lived within Mom. Please take notes; more of us will need to know what makes an end of life experience humane and soothing.
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My mother recently died from complications related to dementia. Despite our best efforts (and using every last dime of available resources), nothing she experienced even came close to this type of humane support. Her last few years would have been far more vibrant and memorable had a better system been in place. Shame on the US for our treatment of those needing memory care; we should take lessons from the Dutch.
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My mother also died last March at 89 and had severe dementia in her final months. But it was progressive.These techniques are wonderful for earlier stages especially. But medication should not be easily discounted. It made a tremendous difference in my mother's ability to recall and in relieving her agitation and depression. Someone with severe dementia could actually become very frightened and agitated suddenly seeing flying ducks on the ceiling....
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@Wanda
My father is in late stages of Alzheimers and we have tried giving him Lorazapam but it doesn't seem to help relieve his stress. Could you share what drugs you found helpful with your mother's depression? Thank you.
4
@stephanie Hart I'm not the OP, but my mother experienced a precipitous decline this year after two TIAs in January and March. She went from doing the NY Times daily x-word in ink and following every twist of national and local politics to hallucinating, confused about time/date/place, and unable to safely walk even with her walker -- all within six months. We burned through her liquid savings to pay for 24/7 in-home caregivers, with me picking up 20 hours on weekends (I work full time). Mom even grew combative and uncooperative -- a horrible change from her former personality -- and night-shift carers despaired of keeping her safe as she'd refuse to use her wheelchair tho' unsteady on her feet. We talked with her doctor and three consulting RNs or eldercare advisors, and settled on trialing Seroquel, a 25 mg dose at bedtime and lunchtime. It has made all the difference: she sleeps soundly at night, and the fears and confusion of sundowning are significantly reduced. It's not for everyone, but since she is 94, and had enjoyed a happy, satisfying life, we are willing to risk the trade-offs.
3
My mother died last year at 89 from complications related to dementia, and I constantly encouraged my sister who cared for her to incorporate many of these ideas instead of asking, "Don't you remember?", her attempt to reverse a devastating disease that takes our loved ones back to infancy is such a cruel way.
I organized focus groups as part of a NIH study of caregivers, and many alzheimer caregivers spoke of this and offered other caregivers reassurance they weren't alone. Playing old music, showing old TV shows, etc. The moderator asked one women if she was concerned her husband drifted off into dreamworld and believed he was a supervisor back at work walking around the house telling hallucinations what they needed to do. She said absolutely not, at least he was living a dream and far from the depression that comes with knowing your mind is blown. My mother said essentially the same thing early in her disease when she spoke about waking one morning knowing something clicked in her brain and she'd never be the same.
38
im lucky to live in an country thats on the forefront globally in social care
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@yvo van der hoek
I'm unfortunate to live in a country where the government outsources health care to private enterprises out to make the largest possible profits.
13
What a great article on this humane way to deal with a terrible disease. Apparently the Dutch can think out of the box.
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@mariamsaunders
We can too.
Advocate.
You, obviously, can already.
6
Sweet. . That kind of creativity and the attendant investment only possible in a society providing universal, single payer (socialized - gasp!) health care and elder care. So much savings possible not to say improved quality of life. But, oh no, not for us freedom loving Americans.
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@operadog The Netherlands does not have a single payer health care model. It does have mandated, universal coverage and community rating.
22
@operadog Health care in the Netherlands is complicated. Everyone is covered: even if you dont pay. Every person has to buy an personal insurance at a private company, that costs 94 per month. When you have a job, 5.6% is deducted for health insurance from your wages, the employer pays 6.9% over your wage. Both limited until a year income of 54,000. That means 6,750 a year max. That money is collected together with incometax. The state pays the insurance companies what the loose in the insurance. The total government budget for health is 80 billion. There are some limitations: medicin that cost more than 100,000 a year is generally not provided.
13
It's nice to see such a facility but it will never happen here. The U.S. has at least 5 million with dementia and the cost would be enormous. This is the problem of trying to solve healthcare problems for a country of 330 million plus with a country whose population is only ten or fifteen million. The laws of scalability become very restrictive. That said, there is a lot we can do simply with the design of our care facilities which most currently are horror shows for patients and families.
5
@Cato,
As a proportion of the population, the costs are no more enormous for us than they are for the Dutch. Your argument makes no sense whatsoever
13
@Cato
Sorry, I do not understand how these programs are not scalable. All use current technology, most versions of off-the-shelf variety. So you hire an extra IT person. S09und like it would be good for the economy as well.
16
@Cato If scale is the problem, then the US ought to be able to handle it state by state. If anything the scale problem is reversed - how would Wyoming or North Dakota do this with < 1 million people? By the way the Netherlands would be the 5th largest state, so it's not that small (think two New Jerseys), and besides the US is quite a bit richer than the Netherlands (about 20% more GDP per capita).
The difference is that the Dutch are willing to tax themselves to pay for this (which Americans are not), while providers are as a rule not profit-maximizing corporations, which allows costs to be better controlled (which Americans do not do). And Dutch wealth is more equally distributed.
Case in point: the Vreugdehof care center mentioned in the article is managed by a foundation (Stichting Amstelring) with more than 5,000 employees. It is subsidized by both municipal and national governments. Precisely three employees make more than 100k euros/year, and none more than 250K euros/year, as disclosed by the foundation (this is as of 2013, but I doubt it has changed massively). Different incentives with different outcomes.
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This is what a group of people or a country can come up with, if they would only think outside the box and re-imagine the best way to treat dementia. I believe that we in the US are also capable of such groundbreaking thought and initiative. We need support from policy-makers, owners of cost budgets, administrators, etc. Not everything needs to be run like a business, with an eye to lowering costs down to the basement and doing the bare minimum to avoid getting sued. Improving people’s lives and kindness can also be goals. I have a dream.
79
At last...
At the care home near our house in England, there was a permanently immobile car on the lawn, so residents could 'go for a drive'. This is even better.
As long as dementia remains incurable, every scrap of happiness and calm that can be enjoyed by people with dementia is solid gold.
110
If only we can implement some or all of these concepts here in our treatment of dementia. Kinda hard to imagine the underpaid, undertrained and overtaxed personnel working with dementia and Alzheimers patients being able to incorporate these simple and humane aspects of therapy, sad to say...
40
The US could implement these simple and thoughtful policies and practices and not because of staff. If the profit motive were reversed to be a person prioritized model, the issue of underpaid or inconsistent or untrained staff would flip in a nano second. The country does not have the will power to put people first and business second. Until then .....
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