Remember ME - You Me and Dementia

September 28, 2005

NETHERLANDS: Multi-ethnic Holland Grows Old Together

. THE HAGUE, NETHERLANDS, September 28, 2005 By Eric Prideaux, The Japan Times Growing old can be difficult, especially if you are in an alien land. But in the Netherlands, famous for its openness towards other nationalities, one organisation is trying to make that plight a little easier. That is De Schildershoek public nursing home in The Hague, where 60 percent of clients were born overseas and respect for cultural identity is a top priority. The cultural diversity at De Schildershoek public nursing home, in a low-income section of The Hague, comes as a surprise even in a city teeming with diplomats -- and a country where nearly a fifth of the population was born abroad.
Stebana Decaster, 68, from the Netherlands Antilles,
in her "assisted-apartment" in The Hague.
Here at the nursing home, internationalism is the order of the day. Just past the entrance you encounter an elegant Chinese wall-hanging; a chart on the second floor lists the times when members of various religions can use a multi-faith prayer room where markers on the floor point to Mecca. At Schildershoek, and its 300 housing units for semi-independent living, at any time you can find staffers and residents locked in conversation (the staffers mainly in Dutch and the residents in, well, whatever), and when vocabulary fails there's always improvised sign language to fall back on. Schildershoek is one giant ethno-socio-linguistic Babel. Yet, somehow it works. Sticky challenges "No one is a stranger at Schildershoek," says Head Nurse Jessica Zalmann. "You might say the place has developed its very own culture." Though the Netherlands' elderly-care system is famed throughout the world, with all legal residents required by law to be covered by national insurance, the country faces the same sticky challenges in offering care to seniors as its industrialized peers. With a birth rate that's falling and medical advances prolonging life expectation, Holland is "graying" rapidly just as the numbers paying into its social-security coffers are becoming fewer. Indeed, the ratio of people 65 and older to the overall population of 16.4 million is expected to swell from its current level of 14.1 percent to 22 percent by 2030. Meanwhile, the average age of Schildershoek residents is about 80, and centenarians there are not so unusual. By comparison, Italy is reportedly the "oldest" major industrialized country, with almost 20 percent of its population already age 65 or older. Greece, Germany and Japan are expected to catch up soon. So, as if providing for their own seniors wasn't a daunting enough task for the Dutch, this multiethnic nation faces an even tougher challenge in living up to its own staunchly liberal ideals by attending to aging foreign residents and their complicated dietary and religious needs. That's where Schildershoek comes in. Since it was built in 1988 in the distinctly mixed neighborhood of Schilderswijk, the staff have tried to strike a balance between institutional efficiency and human compassion. Barriers to understanding Alas, making even simple decisions at times proved vexing, what with all the barriers to understanding cropping up between the countries represented by staff and residents -- among them (as improbable as it may seem), the former Dutch colony of Suriname, Turkey, Morocco, Italy, Ireland, Portugal, the countries of former Yugoslavia, Hong Kong, Taiwan, Indonesia (another one-time colony), Vietnam . . . (Breathe here) . . Cape Verde, the Dominican Republic, Belarus, Jordan, Iran, Iraq, Pakistan, Afghanistan, Ghana, Egypt, Rwanda, Ethiopia, Somalia, Eritrea, India, South Africa, Togo, Liberia, Germany and Colombia. Consider that Suriname alone comprises cultures rooted in pre-Columbian South America, India, West Africa, Java and China and you begin to get the idea. In total, only 40 percent of the approximately 250 clients and 30 percent of the roughly equal number of staff at Schildershoek are Dutch. Now, as everybody knows, there are as many approaches to human relations are there are humans. But to paraphrase an old saying, at Schildershoek they know that one way to a resident's heart is through the stomach. After more than a decade of planning, the home this year phased in its "intercultural menu cycle" designed to keep everybody as happy at mealtime as possible. "We had to bear so many things in mind," said Nurse Zalmann. "The different kinds of meat, the ritual slaughter, unknown vegetables from Suriname and southern Europe. The recipes." Families of residents pooled their expertise, for example suggesting what seasoning would make a Turkish dish really taste Turkish. Today, chefs using a computer to track meals can serve Halal cuisine for Muslims as handily as vegetarian dishes for Hindus, all the while avoiding screw-ups and observing health-and-hygiene standards. And in minced or liquefied form, too, with low salt, no less. The Schildershoek ethos, though, is just as determined to provide nourishment for the soul. In a larger room for communal prayer, a Hindu priest leads services for his chanting, silver-haired flock before an image of an Indian deity. Soon afterward, a Christian cleric draws a curtain to replace that icon with that of the Virgin and Child to cater to his Catholic congregation. One more tug reveals a depiction of the Holy Trinity preferred by devout Protestants. On another day, an imam wails "Allah is the greatest!" And so on . . . "All religions are equal here," explains Schildershoek's Wolfgang Lob, a Protestant vicar. That resolve seems solid. When Theo van Gogh, an outspoken filmmaker (and great-grandnephew of painter Vincent van Gogh) was murdered on November 2, 2004 by a resentful Moslem radical after he openly criticized Islam, some observers believed the Netherlands' liberal attitudes toward foreigners might be in jeopardy. Cultural sensitivity Not so at Schildershoek, said Head Nurse Zalmann. "All the political rumbling outside the doors of the nursing home, we keep it outside," she said. Such cultural sensitivity toward the elderly is still rare even in the progressive Netherlands, which probably explains why 68-year-old, wheelchair-bound resident Stebana Decaster, a native of the island of Bonaire in the Netherlands Antilles off Venezuela, looks so happy to be at Schildershoek. After a series of debilitating strokes, she said she's content spending time with friends at the main center when she's not with family at her "assisted-living" apartment across the street. Asked how she rates that arrangement, she beamed and tossed out the Dutch word "heerlijk." Or, to you and me, "wonderful." By Eric Prideaux The Japan Times

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