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Old Holland to New Holland - The Topaz Experience

Presentation Overview
‘Old Holland to New Holland – renewing the Dutch connection’;

Nursing home physicians, small scale living in large buildings, Huntington wards.
Wilco Achterberg, elderly care physician and professor of elderly care Medicine, Topaz Leiden and Leiden University Medical Center, Leiden the Netherlands
Susan Kurrle, professor of geriatrics, Sydney
Lia de Jongh, CEO of Topaz nursing home organisation, Leiden
Martine Hereur, director of Dementia Expertise Center Topaz, Leiden
Marian Jaspers Fayer, music therapist, Topaz, Leiden

Just as in Australia, the Netherlands have several challenges in the care for the frailest old people. The Netherlands have been very fortunate to have had a very good insurance system for long term care, which provided good funding for nursing home care. That is why in a typical Dutch Nursing home you can find, next to nurses, therapists like physiotherapists, occupational therapists, psychologists, dieticians and nursing home physicians. In 1989, a 2 year post graduate medical training program started, and ‘nursing home physician’ became an officially recognised medical specialism.  Now, the training program is 3 years, with also attention to care in the community. In this presentation the trainings program is discussed, and the effects it has on the care in nursing homes. For instance, there is a very low transition rate of nursing home patients to the emergency room, and a very low hospitalisation rate. What may be feasible in Australia?
Presenters: Wilco Achterberg, Susan Kurrle

The standard now for personalised homelike care for institutionalised people with dementia is small (8-12) group housing. However, most facilities still have old larger buildings, and it is not financially feasible for all of them to build new facilities within a few years.  However, it is possible to redesign old style large scale buildings so that in fact small scale group care can be delivered. We will show a case from a Topaz nursing home in Leiden. Next to the design of the environment, we were not satisfied with the old style education that our nurses received and that was too much based on providing ADL care. Together with some other facilities, Topaz decided to develop a different trainings program, based on the idea that nursing home care, especially for people with dementia, is about adding value and quality of life. What may be feasible in Australia?
Presenters: Lia de Jongh, Martine Heruer, Susan Kurrle

In the 1990’s, patients with Huntington’s disease were poorly treated, often locked up in psychiatric hospitals. Topaz was successful in creating a long term care Huntington center, that has 72 inpatients and over 100 ambulant patients. The care that is given is multidisciplinary and covers a wide range of expertise including counseling, and management of behavioural, psychiatric and neurological symptoms. The younger age combined with the complex problems of the patients has challenged us to be innovative in our therapies and approach.
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