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4 Countries With the Right Approach to Dementia Care

4 Countries With the Right Approach to Dementia Care


By the year 2050, 277 million aging adults are expected to be dependent on  others for personal care. Of those 277 million, approximately half will be  struggling with symptoms of dementia, according to the newly released World  Alzheimer’s Report 2013. (Discover the common signs  of dementia.)

“All governments should make dementia a priority,” according to the authors  of the report, which calls upon policymakers across the globe to “transform  their system of priorities” and infuse dementia research and support efforts  with a tenfold increase in funding.

These statements echo the pleas made over the years by countless individuals  and advocacy groups; a universal cry to address the threat of the “silver  tsunami” that looms ever larger in the world’s rear view mirror.

The report itself highlights many current caregiving issues that advocates  warn will only become more concerning as time goes on. Why are family  caregivers so undervalued? What factors force people to place their loved  one in a long-term care facility? How can we preserve the quality of life of  individuals with dementia and their caregivers?

Progress is being made to address each of these problems, with different  countries adopting different strategies to find a solution to the dementia  care crisis.

The United States joins eleven other countries (Norway, Australia,  Netherlands, Scotland, Denmark, Finland, England, Wales, France, Republic of  Korea and Northern Ireland) in releasing a formal plan to address Alzheimer’s  and other dementias in their respective domains.

Improving support (both financial and emotional) for those affected by  dementia, enhancing the quality of care provided by long-term care facilities  and reducing the overall costs associated with dementia top the lists of  priorities in these plans.

Similar aims, different approaches

The global community appears to agree on the overall goals of dementia care,  but a surprising number of differences in execution occur, depending on  geography and cultural practices.

“Different places are going to have different variations in care,” says Cathy  Greenblatt, PhD, author of Love, Loss and Laughter: Seeing Alzheimer’s  Differently. “But the same things that are important in Florida are important in  Bangalore.”

After watching her grandparents (both of whom had dementia) receive little  more than maintenance care in a local facility, Greenblatt acquired a dim view  of dementia care. “The people working with my grandparents had bought in to the  idea that they were ‘gone.’ I grew up with no evidence that any kind of care  could make a meaningful difference.”

After retiring from her professorial post at Rutgers University,  Greenblatt—inspired by her childhood experiences with her grandparents and a  budding passion for photography—crisscrossed the globe in search of examples of  high quality dementia care.

Despite the cultural disparities and ideological differences of the regions  Greenblatt visited there was one central theme that united them all. No matter  which country she found herself in—India, Japan, France, or the Dominican  Republic—Greenblatt discovered that the best dementia care practices were the  ones that focused on celebrating the ongoing humanity of the person with the  disease. “The things that make a difference are the things that are  universal—treating people with dignity, being in the moment,” she says.

Here are just a few examples of the ways different countries are infusing  dignity into dementia care:

India: Money is always a significant factor when caring for  someone with dementia, no matter what side of the Equator they live on. Having  fewer finances often amplifies the burden of dementia on a person and their  family. But low-income elders in Cochin, India receive special treatment, thanks  to a group of professional staff and volunteers from the Alzheimer’s and Related  Disorders Society of India (ARDSI). While traveling around India, Greenblatt  visited the home of a woman with advanced dementia whose bed consisted of little  more than a wooden frame with a piece of cardboard over it. Still the woman was  able to receive a treatment plan and regular in-home visits from ARDSI  caregivers and social workers.

France: Greenblatt describes the remarkable transformation  of a dementia-stricken Frenchman named Marcel. In a special Snoezelen room at  the Villa Helios in Nice, France, Marcel, whose condition was causing him to act  angry and violent, was changed into a gentler, more caring soul. Snoezelen rooms  are used to calm those with cognitive disorders, such as autism  and dementia. They contain an array of different sensory stimuli, including  water beds, soothing scents, soft lighting, and even big water tubes with  bubbles piped into them.

The Netherlands: Just beyond the outskirts of Amsterdam lies  Hogewey, a quaint village occupied by just over a hundred people. The town has a  theatre, a grocery store, a beauty salon, restaurants and cafes. What makes  Hogewey different from the traditional European hamlet is the fact that nearly  half of its inhabitants have moderate or severe dementia. The remaining “residents” are in fact specially-trained caregivers who pose as beauticians and  restaurant staff, all the while making sure those with cognitive impairment  remain safe and calm.  The so-called “dementia village” is actually an innovative care facility  designed to make those suffering from memory loss feel as though they are living  regular lives and remain engaged with their environment. Residents’ rooms are  decorated based on their hobbies and interests, food preparation and service are  tailored towards individual preferences and there are always staff members  available to provide hands-on care for those who need it. Other caregivers  surreptitiously keep an eye on the residents as they go out shopping or to the  salon, always ready to step in and make sure no one endangers themselves. The  village’s single exit is manned by a staffer who tells any approaching resident  that the door is either broken or barred and offers an alternative path. This  prevents residents from wandering away and becoming lost—an especially common  concern for those with profound dementia.

The United Kingdom: The Pan-London Dementia Action Alliance  recently announced a formal push to make London the world’s first  dementia-friendly capital city. Unlike Hogewey—a self-contained village created  specifically for those with dementia—London aims to integrate the  cognitively-impaired into its pre-existing metropolis more effectively. This  will involve the coordination of countless smaller initiatives, such as making  landmarks more accessible and instructing fire fighters, policemen and bus  drivers how to identify and communicate with the dementia-stricken.

Across the world, person-centered dementia care is rapidly replacing the  outdated paradigms that relegated the cognitively impaired to wheelchairs in  locked wards.

Greenblatt is cheered by these shifting tides because that means fewer and  fewer people with dementia will be treated like her grandparents were. “It’s a  tragic disease and you have no control over the cards you’re dealt. But you do  have control over how you play the hand. There are ways to make the situation  livable for everyone involved.”

By Anne-Marie Botek,  Editor


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