I have never delved into the issue, but the model that Japan and other countries have adopted where the young take care of the old, has always seemed to me the most humane and stimulating solution for the elderly. I don't feel it corresponds well with how modern society works, and my impression is that that model is fading in popularity in Japan as well, but I certainly believe there are innumerable positives to extract from that kind of care-taking.
Along with other speculation such as a seafood-heavy diet, it seems to me to be the reason that Japanese people live the longest.
(Nope, not a single thread of evidence in my post, Sorry. A quick google search somewhat agrees though)
There's some side effects of the custom as well. For example, in Japan and Korea (and possibly parts of China), the custom is for the woman to move in with the husband's family where she'll spend most of her time providing household services and attending her parents-in-law every wish. Her mother-in-law, having done the same thing is now ready to relinquish her role as the home caretaker and well...mother-in-law/daughter-in-law friction (at truly dysfunctional levels) is a common theme in conversation, movies, tv shows, books, etc.
In Korea, being cursed with a difficult mother-in-law is a leading cause of divorce.
It more or less guarantees to take women out of the workforce as they now have a house to run, take care of the kids and the in-laws. And unless you don't have kids or your husband's parents are dead or otherwise able to care for themselves, there's nothing you can do about it.
Not surprisingly Japan and South Korea have among the lowest female workforce participation among OECD countries.
It also means that incentive for higher education among women is mostly as a social marker for marriage, but then any education is thrown away once she gets married (and especially once she has a child).
This also puts enormous pressure on the husband to be the sole provider for himself, his wife, any kids, and his parents.
What about the daughter-in-law's parents? Well, they better have had a son at some point who finds a wife who will take care of them.
The list of social issues that come from this arrangement are long and madness inducing to study (or live with).
It is the most humane for the elder, I'll agree with that. But the sheer amount of stress and expectation it puts on the next generation?
Not to mention the total nullification of privacy. Not everything I do I want my parents to see, and I'm not even gay, transgender, of a different religion than my parents, or any other controversial topic your parents might disown you for.
And you thought having kids was bad? Try dealing, day to day, with your dementing parents that shit themselves and do not recognize you anymore.
> Deliberate use of colour cues can also help significantly. For example, one study with people with advanced Alzheimer's disease showed that changing to highly visible red cups and plates led to a 25 per cent increase in food intake and an 84 per cent increase in liquid consumption. Brightly coloured toilet doors have also been used successfully in a variety of care settings to help people with dementia find the toilet independently, and more readily.
But these losses of visual ability are masked when someone is in their familiar home. People don't realise that the older person can't see the mug - they just assume the older person is not thirsty.
There are many other reasons, many elder people are very active physically especially when compared to NA car/suburb lifestyle. This summer I hiked climbed quite a bit in Japanese alps and was struck by number of people in their 60s-70s with massive backpacks, hiking up scary trails at 2-3k elevation. Sometimes I felt scared for them(a couple that we passed on a really scary traverse in rain and lashing wind, both were probably late 60s early 70s?). That are has about 30 lethal accidents a year and since one has to die anyway, might as well fall to your death doing something awesome. This is absolutely different then when I hike climb in Rockies for example, there are always few really hardcore alpinist/climber old school guys in their 60s but almost no retirees doing anything past trailer camping.
On less extreme side, my inlaws play mallet golf religiously. Wake up every day at 6am then they spend most of the day walking around playing, they have a whole room dedicated to their trophies.
Parents usually live alone but close to their children. I think the biggest factor is that most of the elderly don't just sit at home on vacation once they retire. Most people participate in some kind of class to keep their minds sharp. My volunteer Japanese class is almost entirely made up of retirees.
I don't want to burden my kids like that. If that was the only option, I'd make sure to have an "accident" before I reach the point where I can't take care of myself any more.
Japan also has a strong social bond culture where elders will stay friend and meet often making their lives much more meaningful. Seen in a documentary.
Senior care is actually quite innovative. The Pebble Project (https://www.healthdesign.org/pebble) works on design of healthcare facilities to promote patient safety (among other things). I attended a lecture by one of the directors, he talked about things like lining dementia units with dark tile. Dementia patients like to walk and often will wander away. The contrast between dark and light tile creates a sense of water or a hazard, and patients tend not to cross it. So at the entrance and exit of nursing units, at doorways to medication rooms, they lay a row of dark tiles to prevent wandering.
Inconsistent spelling of names in the article: is it Hogeway or Hogewey? (It's Hogewey. Or De Hogeweyk, which is the name of the fake neighbourhood, whereas Hogewey is the name of the nursing home operating in it.) And the town it's in is called Weesp rather than Wheesp.
Other than that, cool article. It's not far from where I live, but I'd never heard of it. Hard to get in, apparently. I hope they open more places like this before my parents get to the point where they might need it.
After reading several articles on euthanasia in Dutch papers, I get the impression that quite some people seem to think going to a nursing home is worse than dying (and a substantial part of them thus see euthanasia as a good alternative).
Last year I had to return to Belgium, where I grew up for the most part, to say my goodbyes to my grandfather. He had been diagnosed with mesothelioma and decided at his age he had lived a good life and was opting for euthanasia. I'm pretty Americanized at this point, and being away from the openess of this option made it quite tough - even though I have been pro giving people this option. While not a direct correlation to a nursing home, he didn't want to spend the last of his life in a hospital bed, receiving treatment - instead he opted to use the good time he still had and spent it with the family, and even went on a cruise to Norway that he and my grandmother had wanted to go on since when they first got married but never had the opportunity to go.
I think part of the mentality is that he got to go out on his own terms, with a sound mind, and knowing he had taken care of everything he wanted to - and living in a home is a burden and not a pleasant way to spend the remainder of your days, wondering who will visit you and when.
I thought this was a fairly common attitude all over. After seeing my grandparents go through it, I'd definitely prefer to just die right away rather than live out the rest of my days in a nursing home. Maybe I'd change my mind once faced with it... but of course the big fear is that I'd no longer be capable of making the choice.
Nitpicking: Why do they give the cost for this solution "per month", and then for comparison the costs in the US "per day" and "per year"? Did they choose to make it harder to make a comparison??
Here's some photos of the village: http://www.allgenerationscare.com/amazing-village-designed-j... it's in the small town of Weesp, in Holland. It's a really neat, self-contained world with restaurants, cafes, supermarket and more. Doors are kept unlocked and residents have the freedom to go out within the village whenever they please. Though it does look like an expensive facility, I'm sure there are ways to make it more affordable in other areas of the world to accommodate more of our aging population that suffers from dementia.
Did anyone else figure out this comment, or is it just author bias?
"But because cost is one of the greatest barriers to making self-contained villages the standard in dementia care, it would be extremely difficult to implement in a non-socialized healthcare system—meaning that in the U.S., a facility like Hogewey might be impossible for the forseeable future."
--
From other parts of the article:
"The cost of care [at Hogeway] is nearly $8,000 per month..."
"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" => $7541.67/month
--
So, the average cost in the US is the same, but "due to the high cost" the US (with its non-socialized medicine) could never build a comparable program?
FTA: 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.
I'm pretty confident that the healthcare system in the US would not be able to bring down the cost down to ~4k/family.
> But because cost is one of the greatest barriers to making self-contained villages
I think they're talking about up-front capital, not recurring/maintenance costs, but it's hard to tell since we don't know whether the $8,000 a month includes the amortized costs...
If you are interested in more images or detail, the village is called 'Hogeweyk'(meaning: higher area/borough), not Hogewey or Hogeway as the article states.
Wow, this was a great read. I live in The Netherlands and was unaware of this project. Too bad it's one of a kind and only accomodates so little people; I'd love to be cared for in this way should I ever need it.
I live in the Netherlands too, and I also never heard of it. But what I understand from it, it's not really a village, it's just a large complex in the city of Weesp (the article misspelled it as "Wheesp").
Despite having never heard of it, it saddens me we don't have more of these style of nursing homes. Last year my grandma passed away as a result of Ahlzheimer disease, she spent the last year of her life in a traditional nursing home, which was a really depsressing place, she would been far better of in a place like Hogewey.
[+] [-] MrJagil|11 years ago|reply
Along with other speculation such as a seafood-heavy diet, it seems to me to be the reason that Japanese people live the longest.
(Nope, not a single thread of evidence in my post, Sorry. A quick google search somewhat agrees though)
[+] [-] bane|11 years ago|reply
In Korea, being cursed with a difficult mother-in-law is a leading cause of divorce.
It more or less guarantees to take women out of the workforce as they now have a house to run, take care of the kids and the in-laws. And unless you don't have kids or your husband's parents are dead or otherwise able to care for themselves, there's nothing you can do about it.
Not surprisingly Japan and South Korea have among the lowest female workforce participation among OECD countries.
It also means that incentive for higher education among women is mostly as a social marker for marriage, but then any education is thrown away once she gets married (and especially once she has a child).
This also puts enormous pressure on the husband to be the sole provider for himself, his wife, any kids, and his parents.
What about the daughter-in-law's parents? Well, they better have had a son at some point who finds a wife who will take care of them.
The list of social issues that come from this arrangement are long and madness inducing to study (or live with).
(edit) I'd add, there's a culture-bound psychological syndrome that's related to this https://en.wikipedia.org/wiki/Hwabyeong
[+] [-] orlp|11 years ago|reply
Not to mention the total nullification of privacy. Not everything I do I want my parents to see, and I'm not even gay, transgender, of a different religion than my parents, or any other controversial topic your parents might disown you for.
And you thought having kids was bad? Try dealing, day to day, with your dementing parents that shit themselves and do not recognize you anymore.
[+] [-] DanBC|11 years ago|reply
"Eldar abuse" is a significant cause of harm to older people.
Dementia is not a simple illness. Next time you visit a specialist dementia hospital ask why their crockery is red. http://www.bcf.nhs.uk/docs/14053_1922582528.doc
> Deliberate use of colour cues can also help significantly. For example, one study with people with advanced Alzheimer's disease showed that changing to highly visible red cups and plates led to a 25 per cent increase in food intake and an 84 per cent increase in liquid consumption. Brightly coloured toilet doors have also been used successfully in a variety of care settings to help people with dementia find the toilet independently, and more readily.
But these losses of visual ability are masked when someone is in their familiar home. People don't realise that the older person can't see the mug - they just assume the older person is not thirsty.
[+] [-] tlear|11 years ago|reply
On less extreme side, my inlaws play mallet golf religiously. Wake up every day at 6am then they spend most of the day walking around playing, they have a whole room dedicated to their trophies.
[+] [-] Larrikin|11 years ago|reply
[+] [-] wobbleblob|11 years ago|reply
[+] [-] agumonkey|11 years ago|reply
[+] [-] giarc|11 years ago|reply
[+] [-] mcv|11 years ago|reply
Other than that, cool article. It's not far from where I live, but I'd never heard of it. Hard to get in, apparently. I hope they open more places like this before my parents get to the point where they might need it.
[+] [-] thisjepisje|11 years ago|reply
[+] [-] elliottcarlson|11 years ago|reply
I think part of the mentality is that he got to go out on his own terms, with a sound mind, and knowing he had taken care of everything he wanted to - and living in a home is a burden and not a pleasant way to spend the remainder of your days, wondering who will visit you and when.
[+] [-] mikeash|11 years ago|reply
[+] [-] danmaz74|11 years ago|reply
Nitpicking: Why do they give the cost for this solution "per month", and then for comparison the costs in the US "per day" and "per year"? Did they choose to make it harder to make a comparison??
[+] [-] giarc|11 years ago|reply
Hogewey = $8,000/month or $96,000/year.
US Average = $90,500/year.
Perhaps their comparison was to point out that for roughly the same cost, you get much better care (outcomes) in the unique facility.
[+] [-] mcv|11 years ago|reply
[+] [-] barrystaes|11 years ago|reply
[+] [-] elleferrer|11 years ago|reply
[+] [-] chris_va|11 years ago|reply
"But because cost is one of the greatest barriers to making self-contained villages the standard in dementia care, it would be extremely difficult to implement in a non-socialized healthcare system—meaning that in the U.S., a facility like Hogewey might be impossible for the forseeable future."
--
From other parts of the article:
"The cost of care [at Hogeway] is nearly $8,000 per month..."
"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" => $7541.67/month
--
So, the average cost in the US is the same, but "due to the high cost" the US (with its non-socialized medicine) could never build a comparable program?
[+] [-] misterbwong|11 years ago|reply
I'm pretty confident that the healthcare system in the US would not be able to bring down the cost down to ~4k/family.
[+] [-] scott_karana|11 years ago|reply
I think they're talking about up-front capital, not recurring/maintenance costs, but it's hard to tell since we don't know whether the $8,000 a month includes the amortized costs...
[+] [-] aapje|11 years ago|reply
[+] [-] huuu|11 years ago|reply
In the town Sliedrecht there is also an area called 'Merwebolder' which is a small 'wijk' for mentally disabled people housing around 400 people.
[+] [-] NKCSS|11 years ago|reply
[+] [-] feulix|11 years ago|reply
[+] [-] LeonM|11 years ago|reply
[+] [-] edwinjm|11 years ago|reply
Untold Stories: Dementia Village
https://www.youtube.com/watch?v=LwiOBlyWpko