by Sherone Rogers
There is a very unique neighborhood in the Netherlands. It is called the village of Hogewey in Weesp, but you might have heard it referred to as the “Dementia Village,” for that is what it is. Every resident of Hogeway suffers from advanced dementia and is sympathetically cared for by village workers, who are specifically trained to deal with people with dementia and outnumber residents two to one. Residents don’t necessarily know they are being looked after: caretakers work as shop assistants, hair stylists and groundskeepers, to name a few positions.
There has been a lot of care and thought put into every detail of Hogewey. The grounds and buildings are designed to reflect the general style of most neighborhoods in the Netherlands. Six or seven residents share each house, which is furnished and decorated according to the time period when the residents’ short-term memories stopped functioning properly. Whether it was the 1950s or the 2000s, wallpaper, dishes, and even tablecloths are meant to increase comfort for residents and make it easier for them to adapt.
While this is indeed a manufactured reality, it seems to be just what this population needs. Hogewey co-founder Yvonne Van Amerongen explains that, in hospitalized surroundings, dementia patients often go to look for home. In the village, residents feel at home and don’t wander off as much.
Dr. Sanjay Gupta, reporting for CNN, stressed some of the other benefits of Hogewey, where there is an intentional openness, residents are free to roam about, and there is access to shops, the theater, and other amenities that increase residents’ sense of independence. There are special modifications to keep everyone safe, such as a single locked entrance to the village, sensor-operated elevators, and side-by-side bicycles which enable residents to go for a bike ride with a nurse, volunteer or visiting family member.
Money is never exchanged: groceries and other purchases are included in the cost of living in Hogewey. Products do not even have prices.
There are twenty-five clubs focusing on different interests that help to stimulate the mind and slow the brain’s deterioration. Residents are encouraged to exercise, keep active, and maintain social contacts and are found to eat better, get off of medications, and live longer than their counterparts in traditional nursing homes. They also seem to have more joy, which is like at least partly attributed to enjoying life and feeling welcome.
Music is also a big part of residents’ lives. Music connects with the part of the brain that functions the longest, so residents and caretakers make music and sing together. It has been found that people who can no longer speak and would ordinarily be robbed of a means of communicating are still able to sing. Caretakers believe they have learned to somewhat understand what these non-verbal residents are trying to communicate based on the songs they sing. This is important partly because aggressive behavior in those with dementia is often triggered by confusion or frustration. The ability to communicate needs and feelings, as well as the ability to recognize their surroundings and have feelings validated, cut down on these potentially harmful emotions.
Some believe it is unfair to dupe those with dementia by presenting villages like Hogewey as “real” but experts generally agree that complete honesty can be disorienting and upsetting to dementia patients. Van Amerongen says, "We protect our residents from the unsafe world. They do not understand the world outside this because the outside world doesn't understand them."
Hogewey is government-funded, receiving the same funding as traditional nursing homes. The cost per resident is about $8,000 per month, as compared with an average cost of $7,698 for a private room in a traditional nursing home in the United States. With such a comparable cost and so much more to be gained by dementia patients, I wonder why the Hogewey model isn’t being adopted more frequently here in America.
The number of Americans living with dementia is four to five million and in 2016, Alzheimer’s and other dementias cost our nation $236 billion. I believe that putting some of this money into improving the quality of life for those of us affected by dementia would be a sound investment, not only for patients, but for caregivers and healthcare providers, as well. The success of Hogewey has spawned “copycat” villages as close as Canada, and Miami Jewish Health Systems has announced plans to transform some of its existing campus “to give dementia patients more freedom by creating a safe space where they're not confined to their rooms,” according to Aleksandra Sagan of Canada’s CBC News. I think that being safe, happy and not confined to a room are reasonable expectations and what we would all like for ourselves and our loved ones. With that in mind, I would like to see more spaces where those with dementia can be cared for while roaming freely here in the land of the free.
Blog posts are written by Shore House members and staff.