如果你要入住老安院社，你希望過甚麽樣的生活呢？相信大家會不約而同地說：「像在家生活一樣。」就是基於這個原因，全世界首個專為患有腦退化症的長者而設的小鎮霍格威 (Hogeweyk) 便在2009年落成，由構思到啟用衹花了一年時間。
這確實是一個小鎮，沒有傳統安老院舍的規劃，更沒有穿白袍的護理人員。患有腦退化症的長者處身在一個自己不認得、缺乏與外界連結的地方時，容易感到惶恐與焦慮。所以小鎮使用懷舊療法，建築風格仿造1950、1970及2000年代的設計，為長者增添熟悉感。小鎮上有一條大街，路線清楚， 設有餐廳、理髮店、超市、酒吧、 CD租賃店等。另一條通道連接劇院和公園，環境優美閒適。長者可自由地在鎮上走動，如購物、到酒吧聊天，或參與各式社交活動。這些活動大大減低他們的行為問題和焦慮情緒，令他們減少依賴藥物。由於白天有足夠的活動量，晚上就自然能安睡。
A Free World for Dementia patients 2019-06-25
What would you expect if you had to stay in an elderly home? Everyone would probably agree on "just like living at home." For this reason, the first town in the world built specially for the elderly with dementia, Hogeweyk, was established in 2009. It took only one year from concept development to actual completion.
Hogeweyk looks more like a small town, rather than a traditional residential care home. The nursing personnel here does not wear white uniforms. Elders with dementia are prone to having fear and anxiety when they are in environments that they are not familiar with and lack connections with the outside world. Therefore, the town adopts the reminiscence therapy. The architectural style imitates the design of the 1950s, 1970s and 2000s, which can build up a sense of familiarity for the elderly. It is easy to get around the town – there is only one boulevard; the routes are clearly marked with restaurants, beauty salons, supermarkets, bars, CD rental shops and others along the way. Another passage connects the theatre with the park, and all together provide a beautiful and relaxing environment. The elderly is free to move around the town, such as shopping, chatting in the bar, or participating in various social activities. These activities greatly reduce their behavioral problems and anxiety, leading to less dependency on drugs. Since there are enough physical activities during the day, the residents fall into sleep easier at night.
Traditional nursing homes usually classify the elderly by the intensity of the care they need. However, here they abandon the traditional approach and innovatively divide the residents by the lifestyles they choose. The designs of the 23 houses are in six themes, including urban style, formal style, tropical Indonesian style, traditional/ homely style, cultural style and Christian style. Classical music and films are played in the cultural style houses; pop music is played in the urban style houses. Each house can accommodate 6-8 elders with similar lifestyles, each with their own room, which can be decorated to suit their personal preferences. The living room, dining room and kitchen are shared. Just like living at home, the residents here follow their own life routine and take care of themselves with assistance from household helpers. They can also join double-bicycle trip outside the town with a rental tandem.
Another feature is that Hogeweyk breaks the traditional way of providing treatment for dementia patients and builds a truly people-oriented service. The shop-keepers and waiters working there have received professional medical training. From the nursing personnel to the cleaners, they learn to listen to the needs of the elderly and understand their backgrounds. Their aims are not to provide treatment or discuss the behavioural problems of the elderly, but to create a comfortable and safe living environment and to encourage them to do what they are capable of doing. Their duty is not to guard the elders, but to make them as comfortable as if they are living in a community. Of course, they will provide appropriate assistance when the elders are lost or in need.
Although Hogeweyk is famous all over the world, it does not adopt expensive or trendy geron-technology. There is only one exit in the town, stationed by the receptionist. Each building has installed security cameras to ensure the elders’ safety. The most special one is the acoustic listening system, which allows the night care staff to monitor the houses in the reception area. If there are any noises, it will alert the staff to check on the elders. This reduces the frequency of in-person checks, which often disturb residents from sleep.
Hogeweyk’s philosophy is that: since the elderly with dementia are unable to live in their original community, so it brings the community to them instead. In addition to creating a small town, the management welcomes families and friends of the elderly to visit them. They can dine at the restaurant, shop at the supermarket, and accompany the elderly to participate in various activities. According to the feedback, the satisfaction rate of the participants is very high, and the frequency of which the elderly need to take medicine or use adult diapers have also been greatly reduced.
However, it is not cheap to build such an elderly-friendly town. The construction cost was about US$25 million, of which US$22 million was funded by the Dutch government. The government has to provide a subsidy of 250 Euros per day, or 7,500 Euros monthly per resident. Applicants to the elderly town still outnumber the available spots. Some European countries and the United States are building similar care homes using Hogeweyk as the blueprint to provide quality home-care services for the elderly. Looking back to Hong Kong, what should we do to deal with the rising number of elderly people with dementia?