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  • This is the Hogeweyk.

    譯者: Lilian Chiu 審譯者: Bruce Sung

  • It's a neighborhood in a small town very near Amsterdam, in the Netherlands.

    這是霍格威。

  • There are 27 houses for six, seven people each.

    它是荷蘭一個小鎮上的鄰里, 非常靠近阿姆斯特丹。

  • There's a small mall with a restaurant, a pub, a supermarket, a club room.

    那裡有 27 間房子, 每間有 6~7 人。

  • There are streets, alleys, there's a theater.

    有一個小型購物中心,內有餐廳、 酒吧、超級市場、俱樂部房間。

  • It actually is a nursing home.

    那裡有街道、巷弄, 也有一間戲院。

  • A nursing home for people that live with an advanced dementia

    它其實是一間療養院。

  • and that need 24-7 care and support.

    這間療養院所住的是 重度失智症患者,

  • Dementia is a terrible disease,

    他們一天 24 小時,一週七天 都需要照護和支持。

  • and we still don't have any cure for it.

    失智是一種很糟的疾病,

  • It's getting to be a major problem in the world,

    我們仍然沒有方法治療它。

  • for the people, for the politicians,

    它漸漸成為世界上的 一個重大問題,

  • for the world -- it's getting to be a big problem.

    對人民、對政治人物、

  • We see that we have waiting lists in the nursing homes.

    對世界來說—— 它漸漸成為一個大問題。

  • Most people that come to the nursing homes with dementia are women.

    我們知道,在療養院有等候名單。

  • And that's also because women are used to taking care of people,

    大部分到療養院的 失智症患者是女性。

  • so they can manage to take care of their husband with dementia,

    那也是因為女性很習慣照料人,

  • but the other way around is not so easy for the gentlemen.

    所以她們的先生若得了失智症, 她們也能負責照顧,

  • Dementia is a disease that affects the brain.

    但在相反的情況中, 對男性而言就沒這麼容易了。

  • The brain is confused.

    失智是一種會影響大腦的疾病。

  • People don't know anymore what the time is,

    大腦很困惑。

  • what's going on, who people are.

    患者不再知道現在是什麼時間、

  • They're very confused.

    有什麼事有發生,也認不得人了。

  • And because of that confusion,

    他們非常困惑。

  • they get to be anxious, depressed, aggressive.

    因為那種困惑,

  • This is a traditional nursing home.

    他們會變得很焦慮、

  • I worked there in 1992.

    憂鬱、有侵略性。

  • I was a care manager.

    這是一間傳統的療養院。

  • And we often spoke together about the fact

    1992 年時我在那裡工作。

  • that what we were doing there was not what we wanted for our parents,

    我是照護經理。

  • for our friends, for ourselves.

    我們常常聚在一起談,

  • And one day, we said,

    說我們在那裡所做的事, 並不是我們希望我們的父母、

  • \"When we keep on saying this, nothing is going to change.

    我們的朋友、我們自己 若失智時會得到的照護。

  • We are in charge here.

    有一天,我們說:

  • We should do something about this,

    「我們一直說這些, 什麼都改變不了。

  • so that we do want to have our parents here.\"

    這裡是我們主導的。

  • We talked about that, and what we saw every day

    我們應該要來採取行動,

  • was that the people that lived in our nursing home

    做到讓我們也希望 我們的父母住到這裡。」

  • were confused about their environment,

    我們談了這件事, 以及我們每天所看到的

  • because what they saw was a hospital-like environment,

    都是住在我們療養院的病人

  • with doctors and nurses and paramedics in uniform,

    對於他們的環境感到非常困惑,

  • and they lived on a ward.

    因為他們看到的是 一個像醫院的環境,

  • And they didn't understand why they lived there.

    都是穿著制服的醫生、 護士、急救護理人員,

  • And they looked for the place to get away.

    且他們住在病房中。

  • They looked and hoped to find the door to go home again.

    他們不了解為什麼他們住在那裡。

  • And we said what we are doing in this situation

    他們會想要想辦法逃離。

  • is offering these people that already have a confused brain

    他們會尋找並希望 能找到回家的那扇門。

  • some more confusion.

    我們說,在這個 情況下我們所做的事

  • We were adding confusion to confusion.

    是帶給這些頭腦已經 非常困惑的病人

  • And that was not what these people needed.

    更多的困惑。

  • These people wanted to have a life,

    我們在困惑上再加上困惑。

  • and the help, our help, to deal with that dementia.

    那並不是這些人所需要的。

  • These people wanted to live in a normal house,

    這些人想要有個人生,

  • not in a ward.

    想要得到協助,我們的協助, 來處理失智的問題。

  • They wanted to have a normal household,

    這些人想要住在一般的房子裡,

  • where they would smell their dinner on the stove in the kitchen.

    而不是病房。

  • Or be free to go to the kitchen and grab something to eat or drink.

    他們想要有個正常的家庭,

  • That's what these people needed.

    在這個家庭裡,能聞到 廚房的爐子傳來晚餐的香味。

  • And that's what we should organize for them.

    或者他們能夠自由進入廚房, 隨手抓些東西來吃或喝。

  • And we said we should organize this like at home,

    那才是這些人需要的。

  • so they wouldn't live with a group of 15 or 20 or 30, like in a ward.

    那才是我們應該為他們安排的。

  • No, a small group of people, six or seven, family-like.

    我們說,我們應該 把環境安排成像家一樣,

  • Like living with friends.

    讓他們不用和 15、20,或 30 個人 住在一起,像住病房一樣。

  • And we should find a way to select people

    不要,應該一小群人就好, 6 或 7 個人,就像個家庭。

  • based on their ideas about life

    就像和朋友同住。

  • so that they did have a good chance to become friends,

    我們得要想出一種方式來挑選人,

  • when they lived together.

    依據他們對於人生的想法來挑選,

  • And we interviewed all the families of the residents

    這麼一來,當他們住在一起時,

  • about \"what is important for your father,\" \"what's important for your mother,\"

    才會更有機會成為朋友。

  • \"what is their life like,\" \"what do they want.\"

    我們和所有居民的家人進行面談,

  • And we found seven groups, and we call them lifestyle groups.

    談「你父親重視什麼」、 「你母親重視什麼」、

  • And for instance, we found this formal lifestyle.

    「他們的人生是什麼樣子的」、 「他們想要什麼」。

  • In this lifestyle,

    我們分出了七種族群, 被我們命名為生活方式分組。

  • people have a more formal way of interacting with each other,

    比如,我們發現了 一種正式生活方式,

  • a distant way.

    在這種生活方式中,

  • Their daily rhythm starts later in the day,

    人們和彼此互動的方式比較正式,

  • ends later in the day.

    比較有距離。

  • Classical music is more heard in this lifestyle group

    他們每天的日常節奏 開始得比較晚,

  • than in other lifestyle groups.

    結束得也比較晚。

  • And their menu,

    比起其他生活方式分組, 在這種生活方式分組中

  • well, is more French cuisine than traditional Dutch.

    更常聽到古典音樂。

  • (Laughter)

    他們的菜單,

  • In contrary to the craftsman lifestyle.

    比較多是法國菜 而不是傳統荷蘭菜。

  • That's a very traditional lifestyle,

    (笑聲)

  • and they get up early in the morning, go to bed early,

    相對的分組則是工匠生活方式。

  • because they have worked hard their whole life, mostly with their hands,

    那是種非常傳統的生活方式,

  • very often had a very small family business, a small farm, a shop,

    他們早上很早起床, 很早上床睡覺,

  • or like Mr. B, he was a farmhand.

    因為他們一生中都辛勤工作, 大部分都是要動手去做,

  • And he told me that he would go to his work every morning

    很常見的是經營小型 家族事業、小農場、小店,

  • with a paper bag with his lunch

    或像 B 先生,他是農場工人。

  • and one cigar.

    他告訴我,他每天早上去工作時,

  • That one cigar was the only luxury he could afford for himself.

    會用紙袋裝著午餐一起帶去,

  • And after lunch, he would have that one cigar.

    裡面還有一根雪茄。

  • And until the day he died in the Hogeweyk,

    那根雪茄是他唯一能 負擔得起的奢侈品。

  • he was in this little shed, every day, after lunch, to smoke his cigar.

    午餐之後,他就會抽那根雪茄。

  • This is my mother.

    到他在霍格威過世的那一天之前,

  • She's of the cultural lifestyle,

    每天午餐後他都在這間小屋抽雪茄。

  • she's been living in the Hogeweyk six weeks now.

    這是我母親。

  • And that lifestyle is about traveling, meeting other people, other cultures,

    她的分組是文化生活方式,

  • interest in arts and music.

    現在她已經在霍格威住了六週了。

  • There are more lifestyles.

    那種生活方式的特點是旅行、 認識其他人、其他文化、

  • But that's what we talked about, and that's what we did.

    對藝術和音樂感興趣。

  • But that's not life in a house with a group of people,

    還有更多其他生活方式。

  • like-minded people, your own life, your own household.

    但,那就是我們在談的, 也是我們所做的。

  • There's more in life,

    但,那並不只是和一群人 住在一間房子裡的生活,

  • everybody wants fun in life and a meaningful life.

    和想法相似的人, 你自己的人生,你自己的家庭。

  • We are social animals --

    人生不只如此,

  • we need a social life.

    大家都希望人生有樂趣且有意義。

  • And that's what we started.

    我們是社交的動物——

  • We want to go out of our house and do some shopping,

    我們需要社交生活。

  • and meet other people.

    那就是我們開始做的事。

  • Or go to the pub, have a beer with friends.

    我們想要走出 我們的房子,去購物,

  • Or like Mr. W -- he likes to go out every day,

    去見見其他人。

  • see if there are nice ladies around.

    或是去酒吧,和朋友喝杯啤酒。

  • (Laughter)

    或像是 W 先生—— 他喜歡每天都出門,

  • And he's very courteous to them,

    看看附近有沒有美女。

  • and he hopes for smiles and he gets them.

    (笑聲)

  • And he dances with them in the pub.

    他對她們非常有禮,

  • It's a feast every day.

    他希望能得到微笑, 也確實得到了。

  • There are people that would rather go to the restaurant,

    他和她們在酒吧跳舞。

  • have a wine with friends,

    每天都是盛宴。

  • or lunch or dinner with friends and celebrate life.

    有些人寧願去餐廳,

  • And my mother, she takes a walk in the park,

    和朋友喝葡萄酒,

  • and sits on a bench in the sun,

    或和朋友吃午餐 或晚餐,頌揚生命。

  • hoping that a passerby will come and sit next to her

    而我母親,她會在公園散步,

  • and have a conversation about life

    在太陽下坐在長凳上,

  • or about the ducks in the pond.

    希望有人路過,坐在她旁邊,

  • That social life is important.

    和她聊聊人生,

  • It means that you're part of society, that you belong.

    或是池塘裡的鴨子。

  • And that's what we people need.

    那種社交生活很重要。

  • Even if you're living with advanced dementia.

    那意味著你是社會的 一部分,你有歸屬。

  • This is what I see from my office window.

    那是我們人類的需求。

  • And one day, I saw a lady coming from one side,

    即使你得到重度的失智症也一樣。

  • and the other lady from the other side, and they met at the corner.

    這是我從我辦公室的 窗戶所看見的景象。

  • And I knew both ladies very well.

    有一天,我看見 一位女士從一邊過來,

  • I often saw them walking around outside.

    另一位女士從另一邊過來, 她們在街角相遇。

  • And now and then, I tried to have a conversation with them,

    我很熟識這兩位女士。

  • but their conversation was ...

    我常常看到她們在外面行走。

  • rather hard to understand.

    偶爾,我會試著和她們交談,

  • But I saw them meeting, and I saw them talking,

    但她們的對話……

  • and I saw them gesturing.

    蠻難理解的。

  • And they had fun together.

    但我看見她們相遇, 看見她們說話,

  • And then they said goodbye, and each went their own way.

    看見她們比手劃腳。

  • And that's what you want in life, meeting other people

    她們在一起很開心。

  • and being part of society.

    接著,她們道別,各自上路離開。

  • And that's what I saw happening.

    這就是你在人生中想要的, 和其他人會面,

  • The Hogeweyk has become a place

    成為社會的一部分。

  • where people with very advanced dementia can live,

    而我就看到了這樣的狀況發生。

  • have freedom and safety,

    霍格威變成了一個不同的地方,

  • because the professionals working there and the volunteers working there

    在這裡,重度失智症病人可以

  • know how to deal with dementia.

    自由且安全地生活,

  • And the professionals know how to do their professional work

    因為在那裡工作的 專業人士以及志工

  • in a way that it fits in a natural way in the life of our residents.

    知道如何處理失智。

  • And that means that the management has to provide everything

    專業人士知道如何 做他們的專業工作,

  • those people need to do their work.

    且採用的方式能很自然地 融入到我們居民的生活中。

  • It needs a management that dares to do this.

    那就表示,管理階層得要提供他們

  • To do things differently than we always have done

    工作所需要的一切。

  • in a traditional nursing home.

    管理階層需要有膽識這麼做。

  • We see that it works.

    採不同的方式來做事,

  • We think this can be done everywhere,

    不同於傳統療養院慣用的方式。

  • because this is not for the rich.

    我們知道這是行得通的。

  • We've been doing this with the same budget

    我們認為這種方式 可以用在任何地方,

  • as any traditional nursing home has in our country.

    因為它不是給富人專用的。

  • We work only with the state budget.

    我們這麼做所使用的預算

  • (Applause)

    和我們國內任何傳統 療養院的預算都一樣。

  • Because it has to do with thinking different,

    我們只用州提供的預算。