The Social Approach: Redefining Care for People with Dementia

As humans we have many roles. We are a parent and/or child, partner, grandparent, neighbor, colleague, teammate and much more. When someone becomes seriously ill, there is often only one role left: that of patient.

For everyone, the sick person is a ‘patient’ and receives mainly disease-oriented attention. People speak louder, even when someone is less mobile but there is no problem with their hearing. With furrowed eyebrows and a concerned look, the question follows: ‘How are you doing now?’ or: ‘Are you still okay?’ The same often applies to older people and people with disabilities.

A caring approach strengthens one’s role as a patient

The caring approach is often well-intentioned, but strengthens a person’s role as a patient and often undermines his or her independence and self-reliance. When someone is consistently approached as a patient, that person will automatically conform to that image. Empowered people can still deal with this and still stand up for themselves a bit stubbornly. But people with cognitive limitations are undermined gently but emphatically. This applies, for example, to people with dementia. Because their mental resilience decreases, they are more susceptible to emotions and a worrying approach is hard. These people can often still do a lot, especially in the initial phase of the disease. They often forget things about the here and now, but still remember a lot about the past. People with dementia can change behavior, and that can be difficult. But they can do many other things such as walking, singing, playing ball, laughing, listening to music or dancing.

In the Netherlands, approximately 300,000 people now live with dementia. By 2040 there will be an estimated half a million. One in three women and one in seven men will be diagnosed with dementia at some point in their lives. If you include all informal caregivers, family and acquaintances, almost everyone will be closely affected by the disease. Although there is no medical treatment yet, people with dementia almost always end up in care at some point, with a strong emphasis on the patient role.

Extensive experiments have been started in several places in the Netherlands with the so-called ‘social approach’, instead of the ‘care approach’ that we are used to. With the social approach, people with dementia continue to live in their own home and receive attention from people in the area. The number of professionals is limited and a situation is created in which patients, together with others, have more everyday contacts and are active.

In one of the experiments, it turned out after a few years that the admission of the participating patients to a nursing home was delayed by an average of nine months. As a result, the savings on healthcare expenditure were a multiple of the costs incurred while living at home. But more importantly: everyone felt that the quality of life had improved thanks to the experiment. A dream that turns out to be reality.

This means that if residents in an active neighborhood interact with each other as normally as possible, the dependency on care of sick people decreases. We have somewhat forgotten this social approach in recent decades, but in practice it appears that it can be quickly relearned.

2024-02-09 11:08:33
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