The Third Third

A New Take on Dementia

  In a magazine article called [*A Second Life*][1],  British journalist Janice Turner examines a place called [Hogewey ][2]in the Netherlands (hence the site is in Dutch -- just look at the pix), where what she calls a revolutionary approach to caring for people with dementia began 20 years ago.  Like Edna Fernandes in the [Daily Mail][3]  a few months ago, she describes a new residential facility that redefines quality of life for that aging parent or loved one whose mind -- and very identity -- is eroding.  

Hogewey has created an environment which at every turn affirms each individual’s identity and personhood from some point in time when they were healthy.  Residents form small communities in 23 different homes based on what kind of decor, peers, activities, food, faith, economic and social status makes them -- keeps them -- most comfortable. There are “upper class” homes with crystal chandeliers and china cabinets, “working class” homes with huge TVs and coffee tables that work as footrests, “homely” homes filled with knick-knacks, a Christian house where grace is said at every meal, and two Indonesian houses where caretakers speak the language and the menu includes hot dishes and rice twice a day.   Such a customized arrangement sounds exorbitantly expensive, but a lot of it also seems to involve common sense and some experienced and very thoughtful caregivers’ intuition.  The fees run about $7,000 a month, (less than a high-end nursing home or dementia facility in the U.S.), and there are no extra charges for medical care, or even for Depends.   In Holland some costs are paid by the state and residents pay on a wealth-based sliding scale. Thereis, of course, a long waiting list of applicants.  It’s a fascinating alternative to trying to keep a loved one at home when you can no longer do so.   What I found myself thinking about, though, was what kind of “house” I would belong in, if it came to that.  Would my responses to the intake questionnaire make it clear, like the rooming survey which paired me with a non-smoking Lutheran minister’s daughter in college?  Or would I appear to be someone I’m not and end up trapped by yet another set of expectations about how I should behave?  Even if my mind were too far gone to realize what was happening, would I *feel *miscast and lonely, misunderstood or ghetto-ized and even more lacking in control over my life?  Or would it be clear, finally, for one glorious time in my life exactly who I was and where I might best belong?  And if so, to what end?  I probably wouldn’t be able to recognize it -- or myself.   So -- rather than worrying, “What if my husband or I get Alzheimer’s?” it seems far more productive to do the personal work of this particular developmental stage right now -- to exhume, expand, and explore our whole selves and to engage as if we are exactly where we belong doing exactly what we want to be doing.  Anything less, as the Hogewey developers decided 20 years ago, isn’t living; it’s just sitting around waiting to die. [1]: [2]: [3]:
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