When it comes to our aging population, sometimes it’s good to look at what other countries are doing to evaluate if their ideas might have merit here. Take the Netherlands, for instance. They have some seriously innovative and successful approaches to senior housing, including multi-generational residences that provide benefits to both young and old. Another interesting concept is this unique community committed to those with cognitive decline.
Not far from Amsterdam in the small town of Weesp is the gated community of Hogewey (Hogeweyk), affectionately dubbed “Dementia Village.” Opened in 2009, the whole thing is actually a senior care facility built like a town.
The elderly inhabitants are free to roam and live a full, familiar life with facilities like a town square, grocery store, post office, hair salon, park and theater to enjoy. Cameras monitor the residents about town to make sure everyone is safe and content, and all the staff at the town establishments are actually geriatric nurses or caregivers trained to assist people with dementia. The round-the-clock surveillance and locked entrance is in place to ensure nobody wanders off, which is a common concern with dementia patients.
The community currently has 23 residential units shared by six to eight people, plus a caretaker. Each resident gets a private room, and everything is decorated in a familiar retro style of their era so they feel quite at home. Residents are encouraged to help with cooking and household tasks, which helps lend structure and responsibility to their days. No money is exchanged within the confines of the village, as monetary transactions are often a source of stress for dementia patients. If someone gets lost or confused while they go about their day, there is always a “villager” nearby to assist.
Hogewey was founded by two nurses who were unhappy about the options they saw out there to care for their own aging parents. They wanted nursing homes to be more livable and less of a departure from reality for the patients. The concept has struck a chord with many people looking for some sort of assisted living solution for their elderly loved ones, or thinking ahead to how they want their own senior years to unfold.
Having a semblance of normal village life provides some psychological comforts to the residents, and staying active and engaged has benefits for their general physical health too. Even with advanced dementia, these seniors maintain a sense of freedom and purpose that is difficult to achieve in traditional nursing home setting. The residents of Dementia Village apparently eat better, take fewer medications and live longer than those residing in a typical seniors home. There tends to be less agitated or aggressive outbursts here, which is a common concern among Alzheimer’s patients. While it’s difficult to measure happiness, anecdotal evidence suggests these Hogewey residents seem more joyful than many elderly people whose quality of lives are reduced by dementia.
Proponents believe the recreated village setting allows residents to maintain a sense of quasi normal life in their twilight years. They can go for a walk or pop into the shop whenever they want. They eat communal dinners family style and are able to visit with friends if they wish. There is plenty of time and opportunity for socialization, but also time for quiet solitude if one prefers. Family and friends are encouraged to visit. If you are struggling to find a senior housing solution for an aging parent with dementia, this sounds about as good as it gets.
Naturally, there are some naysayers who disapprove of this approach to senior care. They fear it is being deceptive to the residents, somehow stripping them of some dignity as they are fooled into thinking they are living an authentic village life. However, compared to what is offered at most nursing homes, this generally seems to be a more compassionate approach to dementia care.
Of course, the biggest barrier to setting up and running a cutting-edge elderly care facility like this are the costs. Hogewey cost just over $25 million to build, and $22 million of that came from the Dutch government. Residents pay about $7,000 to $8000 monthly, which is also subsidized by the government. The amount each family has to pay out of pocket is based on their income, but it never exceeds $3,600.
If that seems outrageously expensive, note that private rooms in American nursing homes average about $8,350 per month, and that’s without these kinds of amenities.
Due to the success of Hogewey, other countries have started to follow this blueprint and create their own Dementia Villages of sorts. England is currently building a 1950s styled community like this in Kent, and both Germany and Switzerland have plans for something similar.
The number of people suffering from degenerative dementia globally is expected to hit 76 million in the coming decade, so perhaps this innovative care model should be studied and implemented more in the coming years. What do you think?