August 22, 2018

"'We’re lost,' said Truus Ooms, 81, to her friend Annie Arendsen, 83, as they rode a city bus together."

"'As the driver, you should really know where we are,' Ms. Arendsen told Rudi ten Brink, 63, who sat at the wheel of the bus. But she was joking. The three are dementia patients at a care facility in the eastern Netherlands. Their bus ride — a route on the flat, tree-lined country roads of the Dutch countryside — was a simulation that plays out several times a day on three video screens. It is part of an unorthodox approach to dementia treatment that doctors and caregivers across the Netherlands have been pioneering: harnessing the power of relaxation, childhood memories, sensory aids, soothing music, family structure and other tools to heal, calm and nurture the residents, rather than relying on the old prescription of bed rest, medication and, in some cases, physical restraints."

From "Fighting Dementia With Memories of Childhood and Happy Times" (NYT). Lots of interesting photographs at the link. Really worth reading if you're dealing with dementia or think some day you will.

34 comments:

Sydney said...

That’s certainly better than blasting CNN at them all day.

Ralph L said...

My father won't believe anything I tell him. It's annoying.

Darrell said...

That’s certainly better than blasting CNN at them all day.

Or having the lyin' NYT read to them.
It might help if they don't speak English, though.

Sydney said...

In American hospitals, the TV in the room is often set on the news. Demented people often have the experience that what is happening on the screen is happening to them. So CNN in a dementia patient’s room can be a real problem. It can make them more combative and fearful.

rhhardin said...

Alexander (Smbat) Abian (January 1, 1923 – July 24, 1999)[1] was an Iranian-born Armenian-American mathematician who taught for over 25 years at Iowa State University and became notable for his frequent posts to various Usenet newsgroups....

Abian gained a degree of international notoriety for his claim that blowing up the Moon would solve virtually every problem of human existence...

wiki

He was also a classical piano player.

rehajm said...

Just getting rid of hospital smell would go a long way to reducing aggression and the need for sedation.

Ignorance is Bliss said...

Cathy, I'm lost, I said though I knew she was sleeping
And I'm empty and aching and I don't know why...

Ralph L said...

Demented people often have the experience that what is happening on the screen is happening to them

Yeah, my father is certain he's met famous people like Elvis and the Queen or been to the place on the screen. But he has been to some of them, and his USNA roommate did meet the Queen on the day her engagement was announced in 1947.

Eleanor said...

If my husband ever began suffering from dementia putting him on a city bus would put him over the edge.

Tina Trent said...

Loneliness is the worst affliction on earth. Dementia is a sort of three-dimensional loneliness, a loss of the past as well as the present. Pubs, kitchens that look like childhood, familiar bus routes -- pure genius for a nursing home.

We do some of these things too. In college, I volunteered in a low-income nursing home in Sarasota. We dressed up the residents for visits from the minister. Hats were very important. We did wheelchair aerobics. There were several amputees among the participants. The exercise was fabulous for mood and focus. Whenever the instructor called "raise your legs" one old woman without legs would shout back "raise 'em if you've got 'em."

The residents seemed very happy there. The food was familiar. I learned to love collard greens. I also learned that the staff wasn't kidding when they warned me to keep my hands and clothing out of reach of one man who had been an Amtrak engineer but had reverted to a sort of oral way of experiencing the world. He could, and would get an entire bedsheet in his mouth in moments. I got too close once and he bit off my uniform pocket. His jaws were enormous, chomping from overuse like an alligator's. Still he was treated with kindness.

So. Here is a question: if it is so admirable to recreate a stable and unchanging culture for dementia patients, and it produces such saluatory results, why does anyone else desiring to sustain their culture (if they are the usual scapegoats) get treated like a fascist reactionary in the current political climate?

Carol said...

Just getting rid of hospital smell would go a long way to reducing aggression and the need for sedation.

Modern hospitals smell fabulous (except for the wet-diaper wing of course).

Not at all like the the hospitals or even doctors' offices of my youth.

Ralph L said...

I learned to love collard greens.

The dementia rubbed off on you. So sorry.

Ralph L said...

Modern hospitals smell fabulous
And the nursing homes, too?

rehajm said...

I spent a week at Tufts. It is by any measure a modern hospital. It does not smell fabulous.

Rob said...

We don’t need no stinking simulators. In the good old U.S., the demented are right there on the road driving two-ton automobiles.

Phil 314 said...

Many years ago while taking a Family Practice resident to nursing home I visited I pointed out the patients day room that had old (1940s) pictures displayed and swing music playing overhead. I commented that some time in the future the music will be “Ina godda da vida”

Following on this Dutch example, the “patients” will be passing a joint around. I would fear the “sex” part of that “sex, drugs and rock and roll” scenario.

If you're down and confused
And you don't remember who you're talking to
Concentration slip away
Because your baby is so far away

Well there's a rose in a fisted glove
And the eagle flies with the dove
And if you can't be with the one you love, honey
Love the one you're with

The Crack Emcee said...

It's the NewAge, where no one's ever wrong, because no one can pass judgement on the insane.

Home sweet home.

Roger Sweeny said...

Really worth reading if you're dealing with dementia or think some day you will.

Oh, you will.

William said...

There's that story by Stephen King, "It", that details how at a certain point the bad memories of childhood revisit you. They haven't been dormant. They've been accumulating compound interest and they come back with a ferocity and vividness that matches the original events......Maybe this is just me, but I can remember the unhappy events of my childhood in great detail and they come back unbidden. I suppose I inadvertently stumbled onto a few happy memories, but those memories are vague and evanescent.......I don't suppose happy or unhappy childhoods are much of a predictor of dementia, but maybe people with unhappy childhoods suffer more from their dementia. In any event there's no rosy glow to the past as I experienced it, and I don't want to live there. Television was really terrible.

Sebastian said...

"childhood memories"

Which ones?

"heal, calm and nurture the residents"

Calm and nurture, yes; heal, no.

"rather than relying on the old prescription of bed rest, medication and, in some cases, physical restraints."

Sets up a straw man. That is not how many dementia patients are treated today.

MadTownGuy said...

I worked for about a year as a home-based caregiver for seniors. In a couple of cases, as they shared their histories with me, I found it helpful to research some of the places and people they talked about and find photos or video of those places which gave them a look back at those times or a view of how things look there now. They were grateful for the opportunity to see these places again and I got to learn about places I would not have thought about otherwise, as a virtual traveler.

Christy said...

I tried the music with Mom, all those Time-Life Collections of various eras, old time gospel. She never noticeably responded. When she first started losing it, she would watch one of the country music channels and became the family expert on George Strait, she who would never ever choose a country station.

It took me too long to realize all she had was what she could see in front of her at the moment. She wanted to talk, but I allowed myself to become irritated that she would harp all day about some little thing. Finally I realized if I just talked, family news, family memories, she was happiest. She had a connection, the kind TV doesn't provide.

Ralph L said...

I can remember the unhappy events of my childhood in great detail and they come back unbidden.
It's my embarrassing, stupid, or ill-mannered ones I cringe over daily, and they extend to ten minutes ago.

My dad was convinced he'd loaned his senior HS yearbook to someone, then we found 2 of them (his parents got one because he was in it so many times), and he goes through them weekly.

JAORE said...

My mother-in-law suffered from Parkinson's related dementia for the last few years of her life. At some point we brought in music from her youth and watched her relax and smile for the first time in a long time.

JAORE said...

"....the old prescription of bed rest, medication and, in some cases, physical restraints."

Sets up a straw man. That is not how many dementia patients are treated today."

You'd be surprised. My M-I-L was in a elder care facility we carefully chose (and paid for). She had some of the best years of her life there. Good food, caring staff. She had her own apartment. Fantastic place. Judy and I used to joke that when we met the age requirement, we'd move in too. (Sadly there was no motorcycle parking.)

Other family members, when they thought they might be on the financial hook, took us all on tours of government funded nursing homes.

Nightmares of cold, uncaring grey. Heavy on medically induced this-one-won't-be-a-bother-now. (Gee, kind of like how we dope up our youth in school). Despite that most of the family said, "Well, it just has to be that way".

Once my wife and I said we'd cover whatever her modest income would not, everyone agreed the facility we found was the only choice.

Yancey Ward said...

My father, who passed away on Saturday, suffered from dementia of Alzheimers and Lewy Body from his Parkinson's. My mother and I had struggled for the last year in dealing with the hallucinations and the loss of memory. I would have liked to have something like the Dutch system for dealing with it. What was striking to me was that his older memories were firmer than any he had made in the last 25 years. To the extent I could, I often simply played into his beliefs about where he was and what he was doing, but that wasn't often possible.

Ann Althouse said...

I’m sorry to hear about your father, Yancey.

Rabel said...

Who in the God Damn Fuck gave the New York Times permission to run video of a poor old lady rambling mindlessly in her hopeless senility so they could sell advertising and promote their political goals?

Somebody needs the their ass kicked. Or sued. If it was my Mother I'd go for the former.

Bilwick said...

I've been on city buses where the bus driver got lost. No joke, and happened more than once.

Bad Lieutenant said...
This comment has been removed by the author.
Bad Lieutenant said...

Ann Althouse +1
Rabel +1

Yancey Ward said...

Thanks, Ann. His passing wasn't sudden- my mother and I had been preparing for it for some time.

wildswan said...

Yancey Ward said...
My father, who passed away on Saturday, suffered from dementia of Alzheimers and Lewy Body from his Parkinson's.

Yancey, I have some feeling for all you went through since my father also suffered from Parkinson's and some kind of stubbornness / anger / dementia related to the drugs for Parkinsons. We kept him in an apartment with his wife till the end but couldn't keep him in his own familiar surroundings as far as the outside went. I always wish I knew from the start what I realized by the end about how the disease and the drugs affect the person. Hope you stay OK.

Openidname said...

"Really worth reading if you're dealing with dementia or think some day you will."

But by then, I won't remember it.