By Janet Coulter, MSN, MS, RN, CCM
Is this an episode of The Twilight Zone? Imagine, if you will, a village for people with dementia. Have we crossed over to another dimension, a dimension not only of sight and sound but of mind…a journey into a wondrous land of imagination called The Twilight Zone? Is this the future of dementia care– a village just for people with dementia?
Twenty-five years ago in Amsterdam, The Netherlands, two nurses who were afraid to put their parents in traditional nursing homes came up with a better idea - “Dementia Village”. From this idea, The Hogeweyk®, a Dutch village where everyone has dementia, was developed. It was a risky break with tradition that reimagined nursing homes. Today, The Hogeweyk® is the home for over 150 people with dementia where the residents can live a seemingly normal life with freedom, a safe environment, and social life. At The Hogeweyk®, there are twice as many caregivers as residents. The caregivers watch the residents at all times and staff the grocery store, hair salon, library, pub, restaurants, and other areas. Many activities are available for resident participation and they are free to roam around increasing physical activity. All this has psychological benefits as well as general physical health benefits. The staff have reported that the residents take fewer medications, eat better and live longer. The village has been at full capacity since it opened in 2009. This is cutting-edge stuff, a real paradigm shift from traditional nursing home care.
It is estimated that by 2030, 1.5 of Americans will be 65 years old or older. According to the Alzheimer’s Association in 2018, 10% of people 65 years old or older have Alzheimer’s dementia. The incidence of dementia increases with age. It is estimated that by 2050, there will be 13.8 million people with dementia in the United States. Where are they going to reside? Who is going to care for them? Perhaps we can implement The Hogeweyk® concept. It is predicted that 10% of the enclosed malls will close by 2022. What about transforming abandoned malls, medical center complexes and hotels into dementia “villages”? These sites have a lot of promise! They are usually easy to access and have large parking lots that could be re-purposed for outdoor activities. What would the economic impact be? This concept could provide a more normal life for people with dementia. The focus could be on wellness instead of illness, possibilities instead of disabilities. This environment could allow the residents to live in a therapeutic environment that supports their unique needs, lifestyle and personal preferences. Loneliness and boredom could be replaced with physical activity and social interactions. This new environment would become their home and community where they can build relationships, participate in activities of their choice, walk around freely, tend a garden, socialize, and lead reasonably normal lives.
Alzheimer patients are living longer. Dementia Villages may be futuristic but what a great way to re-think Alzheimer’s care! This innovative idea could be life-changing for so many people. A new dimension in dementia care.
The possibilities are endless…imagine what could be…
Can you see the concept being implemented in the US?
This was an amazing idea, what an incredible way to make a safe space for these individuals.
Thanks for bringing this project forward. I remember hearing about it and think it’s important to bring these ideas back into view. How awesome is this innovative solution!
I believe here in the Us we need to seriously start building these villages. Notice I did not say consider building these villages but said build them.
Folks with a form of dementia need to have purpose and feel included. Going about their daily business in a respectful and dignified manner is the kindest care, where they can move about freely and safely. Fresh air is free and being outside with mother nature and a change of scenery is vital to our seniors’ health.
There’s an assistant professor of interior design at Oklahoma State University who is looking to repurpose abandoned shopping malls for similar types of villages.
How does one contact the professor looking at mall conversions for dementia towns?
This is such a remarkable idea and a much-needed innovation! As I write this, we are dealing with dementia of my father-in-law and getting to the point where assisted living is not enough. How I would love to have the option of a Hogeweyk-type environment!
Can you imagine if the mega-billionaires who are now financing leisure travel to space got behind this idea and financed development of dementia villages? Seems to me this would be such a gift to humanity and benefit so many more people.
I love this idea! And perhaps it could be expanded beyond dementia to other cognitive or behavioral conditions that require safety, supervision, and condition-specific care. And it’s not just specialty care ‘villages’ that are needed. Environments that support healthy aging are needed. It would be comforting to know that individuals could age-in-place, where they would be safe but can continue participating in chosen activities, enjoying an acceptable quality of life.