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A Dutch Village Where Everyone Has Dementia (2014)
- ElFitz 3y agoIt has already been posted here before [1], but given how little nursing homes seem to have changed, I find it still relevant, and perhaps of interest to others who like me hadn’t read about it until today. [1]: https://news.ycombinator.com/item?id=8616383 https://news.ycombinator.com/item?id=8616383
- wdb 3y agoThere are a lot of activities organised on a city/town level by the Dutch Alzheimer Foundation chapters, such as Alzheimer Cafe, Creatieve Werkplaats, Bijzonder ontmoeten, Cooking Together, Choir, hiking/walking, etc
- mike_hock 3y agoI just visited a place called "Alzheimer's Cafe," but I can't remember the name of the place.
- mahathu 3y agoThat's not all, besides Alzheimer Cafe, Creatieve Werkplaats and Bijzonder ontmoeten, there are also Gezellige Kletsen, Gronkelstoot Spelletjes and Zorgzame Knoetelbijeenkomsten.
- wdb 3y agoThat’s great. Yeah, I am aware it’s not complete. Listed a few I am aware off because my mom helped organising them. Haven’t kept up-to-date with since she passed away
- isoprophlex 3y agoDid you run that through a GPT? What the hell is a Gronkelstoot, what is a Knoetel, and don't you need to drop the -e in "Gezellige Kletsen"?! Something fishy going on here ;)
- bell-cot 3y agoReaction: Lovely - but the article notes that it has 152 residents, vs. 250 full- and part-time staff. If more than a very small percentage of a country's older folks develop dementia, and the country's population is not growing exponentially...then such well-staffed solutions are physically impossible to implement at scale, for lack of working-age care staff.
- wak90 3y agoI don't think that's clear at all. Working age adults work from their early 20s to their 60s and end of life care does not typically last that long.
- EA-3167 3y agoEOL with dementia can linger for well over a decade, and it only gets more expensive as it goes on.
- Retric 3y agoMost people don’t experience dementia, and most of those who have it don’t need such extreme care. Taken to an extreme, this radio suggests under 5% of a steady state population would either have significant dementia or need to treat it. But again most such people are cared for by family members. The point of this Village is to minimize the cost of treating significant outliers while maximizing their quality of life.
- DiggyJohnson 3y agoSo it would need to scale out to 10s of thousands, no?
- Retric 3y agoIf everyone with dementia went to such a facility then we would need ~30,000 of them in the US. However, most people with dementia either don’t need such extreme care or have more severe medical issues, so the real number is probably a several hundred such facilities.
- londons_explore 3y agoSome people with dementia get violent. I bet it isn't a pretty sight when a bunch of 80 year olds start fighting over who stole Theodore's false teeth!
- swader999 3y agoOr tabs versus spaces. It's best just to hide the keyboards after 78.
- acumenical 3y agoAfter 78 characters on a line... right?
- deleted 3y ago[deleted]
- zial 3y agoSome funny math there saying it only costs $8k a month and then saying US costs an astonishing 90k a year. Do they realize 8*12 is 96k a year?
- themerone 3y agoMore than half that cost is subsidized. The maximum cost to residents is $43k, and it is on a sliding scale based on family income.
- deleted 3y ago[deleted]
- roughly 3y agoI think the comparison is between a lovely Dutch village in which the residents live comfortable fulfilling lives and whatever the hell it is that’s happening in US elder care facilities. Like an awful lot of things, it seems like the Dutch are getting a heck of a lot more for their money than we are.
- deleted 3y ago[deleted]
- rhelz 3y agoNow ask yourself: how do you know you are not already a resident of a village like that?
- praptak 3y agoWhy would I care?
- orblivion 3y agoI don't know anything about dementia but I gotta wonder how many people with it would even contemplate such a question.
- wyldfire 3y agoSigns to look for: 1. romantic opportunity stolen by a beachfront kidnapping by your love interest's father, who she claims not to know. 2. your father's untimely demise in a sailing accident. 3. falling lighting equipment, e.g. like a light to represent the dogstar. 4. radio station peculiarly addressing your specific concerns. 5. your wife and friends always enthusiastically endorsing particular brands. 6. no near future departures for Fiji at your local travel agent.
- BoxOfRain 3y agoAlternatively: 1. Only local maps being available. 2. Being addressed as 'number six'. 3. Being followed around by eerie white ball things. 4. Everything looks like the 1960s.
- nelox 3y agoOn a side note, getting the shingles vaccine may lower the risk of dementia by 20% in women: https://web.archive.org/web/20230613022921/https://www.nature.com/articles/d41586-023-01824-1/ https://web.archive.org/web/20230613022921/https://www.natur... Shingles is an awful affliction, so if you or a loved one is eligible for the vaccine, then you may also be helping to prevent dementia by getting it.
- briandear 3y agoI had forgotten about this story.
- johnea 3y agoDo HN users just generally prefer to talk about whatever interests them, while totally ignoring the article they are allegedly "commenting" on? There was nothing in the article about robots or AI, OK? Maybe that's what you like, but this article isn't about that. Current estimates are that ~6M people in the US have dementia today, out of a population of ~340M. Let's call that about 2%. Immediately obvious conclusion: There is not shortage of population to serve as caregivers. What there is a shortage of is anyone who would actually want to work in a US dementia care facility. It's one of the lowest paid, least appreciated and most grueling occupations. Emotionally grueling as well as physically. How many 80 year old's butts did you wipe on Zoom today? In spite of this, most staff I encountered were dedicated to the residents. Maybe you're ready to lock your senile parents in a room with a robot dog, but I'm here to tell you that the human interaction is one of the only decent things in US assisted living. This is 100% from the people n the trenches. Healthcare ownership are bloodsucking jackals. Once you remove that person to person contact, the only thing left is ownership exploiting the defenseless.
- science4sail 3y ago> Do HN users just generally prefer to talk about whatever interests them, while totally ignoring the article they are allegedly "commenting" on? Yep. Users frequently treat the link title as a writing prompt rather than clicking through to read the article. This can generate pretty jarring results if there are several different ways to interpret the title.
- watersb 3y agoDementia is often horrible and I shouldn't joke about it... but I read this headline and immediately thought it sounded like my kind of town. :-) More seriously, this town is a beautiful, compassionate idea and I'm glad it's there. Here in the United States, the final years of a person's life are usually overwhelmingly expensive. Either paying many thousands of dollars per month in an assisted living facility, or paying almost nothing to a family member who sacrifices their own life for a time to provide care at home. I've seen great results in mixed-generational care, where childcare and elder care have close interaction at least a couple of days per week. Amazing improvement in the elders living in relatively modest assisted living homes, and possible to provide at scale, more commonplace... But a global pandemic shut that down hard.
- sinenomine 3y agoRemember, this is going to be "it" instead of full-on science-driven "war on Alzheimer's". It is not that we cannot do more; it looks like the US public & private investment arms decided to avoid maximizing the research bandwidth available, with many life sciences grads not being able to find a research job. A shame, really, given the inflation happens anyway - except that without spending the other side of this equation on medical R&D you stall the pipeline and rob yourself of your future. Why is there not enough job openings for life scientists, given the urgency? Real tough question.
- fastball 3y agoI found this excerpt mildly annoying: The cost of care is nearly $8,000 per month, but the Dutch government subsidizes the residents—all of whom receive private rooms—to varying degrees; the amount each family pays is based on income, but never exceeds $3,600. To put it into perspective, a private room at a U.S. nursing home cost an average of $248 per day in 2012, or more than $90,500 annually—a figure that’s even more staggering when applied to the rapid increase in dementia patients globally. Making me do the math in my head only to find out that the private room in the US is actually cheaper than the Dutch one (at $96,000/year) feels pretty misleading. Sure, I bet the quality of care is much much better than what you'd find in the average US nursing home, but that's exactly why you don't need to be sneaky with the numbers!
- solumunus 3y agoIt’s cheaper but the government isn’t paying for more than half of it, I guess that’s the comparison. Poorly written though, for sure.
- fastball 3y agoSure, but subsidizing elderly care is a different discussion than how the elderly care is carried out. I'm sure the Dutch government would also be capping family expenses at $3600 even if this was just a run-of-the-mill nursing home we were talking about.
- dutchdev 3y agoHow much of that figure is paid by the government/insurance? I think it's more about comparing the costs that are actually paid by patients. The family of the patient never pays more then €43,200, and probably more close to half of that for most the families.
- ljlolel 3y agoI agree that was purposely chosen to hide the comparison
- jacquesm 3y agoIt's also off by a factor of 10 on the residents side. Not sure where that figure came from, and the residents do not have much privacy, they live with 6 people to a home, which has a fixed team of caretakers.
- jacquesm 3y agoThe costs quoted in the article are not at all in line with the costs that the facility quotes: https://www.vivium.nl/zorgeloos-wonen-concept https://www.vivium.nl/zorgeloos-wonen-concept More about this particular facility: https://www.vivium.nl/verpleeghuis-dementie-hogewey-de-hogeweyk-weesp https://www.vivium.nl/verpleeghuis-dementie-hogewey-de-hogew... Also, pretty sloppy to quote the name wrong in the article, it's not 'Hogeway' but 'Hogewey', the difference in dutch is between 'road' and 'meadow' (the latter in a weird spelling). On the facility website they also use 'weyk' which has yet another connotation (borough). I've seen and am seeing some family members and close friends at very advanced age go through this. They are utterly unaware that they are dementing, to them everything is fine and their memories of the things that go wrong fade so fast that you can't really have a meaningful conversation on the subject. Some 80+ year olds are sharp as can be, but they are the exception around me, the default is a body that is still there coupled with a mind that is slowly leaving, too slow for the mind itself to notice. Good genes may help keep your body alive but without a mind to go with it I'm not sure whether that's worth it. Personally I live in fear of ending up like that, depending on others for even the most basic needs.
- LatteLazy 3y agoI continues to concern me that we spend enormous resources on people who cannot appreciate them (the old, the severely disabled) but nothing on normal people...
- praptak 3y agoMaybe they cannot appreciate them but I kinda appreciate the society won't just let me die if I become disabled or old. This is true even though I am 100% intent of getting euthanasia one day.
- LatteLazy 3y ago<cynical I know> I think we absolutely will just let most people die when they get sick and disabled unless you fall into one of these special groups. If you need 2k a month for insulin and cannot afford it, you will absolutely be allowed to slowly die because you are not old/disabled enough to be saved. But 10k a month for a special village because you checked-out with dementia? Sure! Sorry to be the kill joy...
- b212 3y agoMy grandma has Alzheimer’s disease. I want to be euthanized if I ever get that. So do my siblings and my parents. Euthanasia is illegal in my country and my grandma never agreed how to proceed once she gets severe dementia but what she has is simply a hell not a life anymore. Not only for her but also for my mom. Terrible disease.