00:05Now let's throw the ball, yes, throw it and hit the white ball. Perfect.
00:13At this facility, people with dementia are encouraged to do as much as possible on their own.
00:19And at this one, they're allowed to do absolutely nothing.
00:24Two facilities, one in France, one in Germany.
00:27Two different approaches to helping people with dementia.
00:30The number of people needing memory care is growing.
00:33But which approach is better?
00:35Encouraging and challenging residents or simply letting them be?
00:39How can people with dementia live with dignity?
00:57Hello, Ren.
00:59I was asleep.
01:00Sorry, did I wake you?
01:02My head is spinning.
01:05May I come in?
01:07Yes, of course. Why?
01:09I'm your caretaker, Valentin.
01:12In Dax in southwestern France, Valentin Chu is used to introducing himself every day to the same people.
01:18It's just part of the job.
01:21Good morning, Elizabeth.
01:23He's a caregiver in a special community.
01:26Everything okay?
01:28All the residents here live with the same condition.
01:33Alzheimer's.
01:34Alzheimer's is the most common form of dementia, accounting for 60 to 70 percent of all cases.
01:40It causes nerve cells in the brain to degenerate.
01:43In the early stages, it typically results in memory loss or poor orientation.
01:47In later stages, it makes it difficult to follow conversations or perform familiar tasks.
01:53As the disease progresses, mood and behavior are often affected.
01:57In its final stages, patients no longer recognize loved ones and need help with all aspects of daily life.
02:04Valentin makes his morning rounds with his colleague, Lilou.
02:07They check to see if everyone is doing well and distribute medication.
02:11This requires empathy, like with this patient who pretends to be asleep.
02:17Can you hear me?
02:19Can you answer me?
02:21Open your eyes, please.
02:23Do me that favor.
02:26May I sit down?
02:32Don't worry.
02:33Everything is all right.
02:38Given how she reacted when I tried to get closer to her, it's not going to work.
02:43And I don't want to violate her privacy either.
02:46I respect her decision.
02:49At this facility in Germany, which loosely translates to lazy lounge,
02:54self-determination is part of the approach to care.
02:56Here, residents are allowed to decide for themselves whether or when to have breakfast, for example.
03:03That can be a challenge for manager Christian Löbel and his team.
03:07Would you like something else in your roll?
03:09Yeah.
03:11Something else like cheese?
03:13Cheese?
03:14Mm-hmm.
03:15That's something I've thought about.
03:17I'll get you a roll with cheese.
03:22Yes, but...
03:23I'll get you a roll with cheese.
03:27Since most people with advanced dementia are no longer able to make such distinctions,
03:32you just have to see what works.
03:35You'll get it wrong ten times until you'll finally get it right.
03:38We'll see right away whether a roll with cheese was right.
03:43Hi there.
03:44Bon appetit.
03:47I've got a roll with cheese for you.
03:49May I give you half?
03:53I'll just put it down here.
04:01Again, it's about self-determination.
04:03It's important I didn't just take away the piece with the jam on it.
04:06I know a decision made five minutes ago isn't necessarily relevant now.
04:12Letting people with dementia just do their own thing, even nothing at all.
04:18That's the idea behind the Lazy Lounge in Mahl.
04:20We take a different approach here.
04:24The residents are free to laze around, to just relax.
04:27They can plan their own day.
04:29There are limits, of course.
04:31Nursing care must be provided and medication must be administered.
04:38The village Lendee, Alzheimer in Dax, has been France's first and only Alzheimer's village since opening in 2020.
04:47What makes it special is that its 120 residents have their own residential complex to move about freely.
04:55There's a small salon, a library and a supermarket.
05:01The goal is to make life as normal as possible.
05:09You can't tell who's a caregiver.
05:11Our staff all wear normal clothing, so you can't tell right away who's who.
05:15We focus on social interaction and participation, involving volunteers and families.
05:20People with cognitive impairments often live in closed facilities.
05:24I'm not a doctor, but I think that can make their problems worse.
05:28We want this place to feel like home, with lots of colour, light and nature.
05:32You can hear the birds chirping.
05:33All of this can be calming and help reduce anxiety.
05:39CĂ©cile Berthet runs the pilot programme at the Alzheimer's village.
05:44Care and support cost about 40% more than in a traditional nursing home.
05:49One hundred and eighty-four euros per day instead of one hundred and thirty.
05:55The regional government picks up the additional costs.
05:59An accompanying research project has shown that costs are saved elsewhere.
06:09In 2025, we cared for 30 residents until the end of their lives.
06:14In traditional homes, about one-third of deaths occur in hospitals.
06:18We're expensive, but still less expensive than a hospital.
06:22Dementia is one of the greatest health challenges facing ageing societies.
06:28In Europe alone, more than 12 million people live with dementia.
06:33By 2050, that number is expected to reach just under 20 million, a 64% increase.
06:39Rising life expectancy is the main reason.
06:43As people age, their risk of developing the disease increases.
06:47Dementia is the seventh leading cause of death worldwide and a key reason older adults require long-term care.
06:55And this has significant financial implications.
06:58In 2019, this care cost approximately 1.1 trillion euros worldwide.
07:05By 2030, that figure is projected to reach 2.4 trillion euros.
07:11People with dementia are often denied their right to self-determination.
07:16In many countries around the world, patients in nursing homes that have dementia are still restrained or sedated.
07:26To the left, to get to the wardrobe.
07:29No.
07:33We can go this way, right?
07:36I'll follow you, Miss Novacki.
07:38I can just go here.
07:40That's fine.
07:41It's fine.
07:46Would you like to sit for a bit?
07:48Take a little break.
07:49Rest for a sec.
07:50No.
07:51Do you?
07:52No.
07:53Just a few minutes.
07:55Okay, let's go.
07:56Okay.
07:57Here?
07:58Yep.
07:59We can manage.
08:01Christiane Loebel can make time for residents because of more flexible scheduling.
08:08The lazy lounge doesn't have more money or staff than other care facilities.
08:14It's part of a social welfare association in Maal.
08:21Founded in 2023, it's the first residential group where lazying around has been implemented as a therapeutic method.
08:30And it has been successful.
08:34The problems in senior centers usually stem from the fact that residents who are mentally alert constantly correct those who
08:42are disoriented.
08:44At some point, they then respond with what is seen as challenging behavior.
08:48We've been able to minimize these challenges by accepting and accommodating residents without correcting them.
08:56Separating those residents without dementia from those with it also helped.
09:02As a result, we've not only improved the well-being of dementia patients, but have also been able to reduce
09:08their long-term use of medications.
09:13Try again.
09:14You want to stand up?
09:16Why?
09:23Now let's throw the ball.
09:24Throw it and hit the white ball.
09:28Perfect.
09:29At the Alzheimer's village in France, caretakers offer residents daily activities.
09:35Today's activity is pétanque with physical therapist Coralie Beranger.
09:41With Ludie, we're working on the upper body, with her arms.
09:47But I didn't say I want to work.
09:51That's why we won't use the word work.
09:53It gets in the way.
09:56And in the fitness room, there is a very special Tour de France underway.
10:00Everyone in the village works together to rack up kilometers on the stationary bikes.
10:05The goal isn't athletic performance, but rather to maintain existing skills for as long as possible,
10:11including getting back off the bike.
10:15Do you want to get off?
10:18I think so.
10:20Come with me, get off.
10:23A little exercise, a short ride.
10:27Get down Michel, come on.
10:30Okay, okay.
10:33Take your feet off the pedals.
10:36Let's go.
10:37Let's go.
10:39If you try to get better.
10:44Okay, stay on the bike.
10:47We try to tailor our activities to the residents' hobbies and interests.
10:52This allows them to focus on enjoying themselves and having fun.
10:56And I believe that's exactly what's needed when dealing with this disease.
11:05Gaëlle Marie Bayeul specializes in the care of older adults with mental and neurological disorders
11:12and coordinates medical care at Village Landet.
11:18In her view, the village demonstrates how quality of life can be ensured in the face of a disease that
11:25gradually worsens.
11:28Sometimes things become possible when we think differently,
11:32when we all share some of the responsibility
11:36and allow the residents their freedoms.
11:39The right to walk around, even to fall down once in a while.
11:43To lead a life where not everything is sterile.
11:47I don't think it's necessarily about prolonging life,
11:50but about improving the quality of life that we have left.
11:57When the world we know keeps getting smaller,
11:59moments of happiness can mean something different for everyone.
12:03For Ren in Dax, it's the flowers she picks in the garden.
12:07For Ms Schmidt in Mal, it's her doll Anna.
12:11So nice to have you back.
12:14Two approaches, one goal.
12:16The French Alzheimer's village and the German Lazy Lounge
12:20both allow people with dementia to age with dignity.
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