譯/莊蕙嘉
“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,” Arendsen told Rudi ten Brink, 63, who sat at the wheel of the bus.
「我們迷路了。」當她們一同搭乘一輛市區巴士時,81歲的楚絲.烏姆斯對她的83歲友人安妮.艾倫德森這麼說。
艾倫德森對坐在巴士駕駛座、63歲的魯迪.滕.布林克說:「身為司機,你真的應該要知道我們身在何處。」
But she was joking.
不過她是在開玩笑。
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.
這三位是荷蘭東部一間照護中心內的失智症患者,他們的巴士之旅-在荷蘭鄉間有行道樹的平坦道路上行駛的路線-其實是每天會在三個螢幕上播放數次的模擬旅程。
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.
這是荷蘭各地醫師和照護人員一直在率先嘗試的失智症非正統療法的一部分。利用放鬆的力量、兒時回憶、感官輔具、柔和音樂、家族結構及其他工具,去治療、安撫和滋育入住者,而非依賴以往的方式:臥床休息、藥物,有時候甚至會用到身體約束。
“The more stress is reduced, the better,” said Dr. Erik Scherder, a neuropsychologist at the Vrije Universiteit Amsterdam and one of the country’s best-known dementia care specialists. “If you can lower stress and discomfort, it has a direct physiological effect.”
「減少愈多壓力,效果愈好。」荷蘭最知名的失智症治療專家之一、阿姆斯特丹自由大學神經心理學家艾瑞克.薛德說。「如果你能降低壓力和不適,就有直接的生理效果。」
Simulated trips in buses or on beaches — like one in a care facility in Haarlem, not far from a real beach — create a gathering point for patients. The shared experience lets them talk about past trips and take a mini holiday from their daily lives.
模擬的巴士或沙灘旅行-像是在哈倫一所照護機構舉辦的一場,距離真正的海灘也不遠-為病患創造了聚會的時機。這個共享的經驗讓他們談起過往的旅行,並且在日常生活中享受一個迷你假期。
Dementia, a group of related syndromes, manifests itself in a steep decline in brain functions. The condition steals memories and personalities. It robs families of their loved ones and saps resources, patience and finances.
失智症是多個相關症候群的統稱,主要顯現在大腦功能的急遽退化,這個病症會偷走記憶及個性,奪走家人深愛的人,並榨取資源、耐心與金錢。
Up to 270,000 Dutch people — roughly 8.4 percent of the 3.2 million residents over the age of 64 — have dementia, and the government expects that number to double in the next 25 years.
多達27萬人-在64歲以上的320萬居民中約占8.4%-罹患失智症,政府認為這個數字在未來25年將會增加一倍。
In recent years, the government has preferred to pay for home care rather than in a licensed facility so most people with dementia live at home. The facilities, which are privately run but publicly funded, are generally reserved for people in an advanced state of the disease.
近年來,政府偏好資助失智症患者的居家照護甚於送往有執照的機構,因此大多數患者住在家裡。這些由公家出資、民間經營的照護機構,通常保留給重度失智的病患。
In the 1990s, the Dutch started thinking differently about how to treat the disease, moving away from a medicalized approach.
在1990年代,荷蘭開始跳脫訴諸醫藥的角度,思考治療這種疾病的其他方法。
“In the ‘80s, clients were treated like patients in a hospital,” said Ilse Achterberg, a former occupational therapist, who was one of the pioneers of “snoezel” rooms, which feature light, aroma, massage and sound therapy, and let patients relax and access emotions that are often blocked in stressful clinical settings.
曾任職能治療師的伊爾絲.艾徹柏格說:「在80年代,個案在醫院被當成病人治療。」她是採行「多感官環境」療法的先驅之一,這種方法在房間中利用燈光、香氣、按摩和聲音治療,讓患者放鬆,釋放在充滿壓力的醫院環境中被封鎖的情緒。
These rooms were the forerunner of some of the techniques found today in many care facilities in the Netherlands.
這些多感官環境室,是現今荷蘭許多照護機構採行的一些技術的先驅。
※說文解字看新聞
本文介紹荷蘭失智症治療的最新方式,dementia的字源是拉丁語,由de-(遠離)和mens(心智)組合而成,指大腦功能的退化疾病。阿茲海默症、血管型失智症、路易氏體失智症都是失智症的一種。
絕大多數的失智症尚未找出治療方法,因此研究人員也在尋找醫療之外的其他改善方式。orthodox有「正統的、東正教的、猶太教正統派的」等意思,加上un-就成了「非正統的」,意指醫療之外的其他方法。
文中形容失智症時使用了擬人手法,steals memories and personalities、robs families of their loved ones以及saps resources,用了偷竊、搶奪及榨取等三個動詞,描繪失智症患者喪失記憶、性格大變等症狀,以及照顧的家人承受的折磨。
最後一段的「snoezel」是荷語字,動詞是snoezelen,由「snuffelen」(sniff,嗅聞)和「doezelen」(doze,小睡)兩字組合而成,在1970年代由兩名荷蘭治療師創造,英文為multisensory environment(多感官環境),利用燈光、芳香、音樂等環境設置,在無壓力的前提下,激發失智症患者的感官能力。多感官環境也用於協助自閉症或腦傷患者,但並非醫療。