The Netherlands they have come up with an alternative to conventional aged care for residents with dementia. Called a ‘dementia village,’ this type of relaxed community living has proven to greatly reduce aggression and anxiety for the residents, and thus the need for psychotropic drugs.
One such village is Hogewey in the municipality of Weesp – not far from Amsterdam. Largely because of the comforting, home-like design of this village, it has been very successful with over 150 residents according to one of its employees and concept developers, Yvonne Van Amerongen.
Amazingly, none of the Hogewey residents are bedridden and the use of psychotropic drugs to handle the resident’s aggression and anxiety is at an all time low.
Yvonne Van Amerongen told us the story behind Hogewey at the ACSA IAHSA conference in Perth last week. She said in The Netherlands a lot of people with dementia are looked after at home but around 15 per cent of people can’t cope with this so Hogewey was designed as a place to house them.
“When home is not possible, this can be their place – so they can have a normal life,” she said.
“This is all based on scientific research which has found small-scale living helps people live a normal life. When they live this type of life, their social contact increases and this is important for their brain,” said Van Amerongen. The decrease in anxiety and aggression is also a big plus factor for this way of living.
Higher quality of life
The concept behind Hogewey is to develop a place for people with quite severe dementia are still be able to enjoy a high quality of life. Van Amerongen said before they built the
23-unit village, they researched what people wanted by talking to families and carers. Their main priority was to design a place where there are favourable surroundings and far less confusion.
“We found people get confused when they live in an institution with large kitchens and eating areas. So we have 23 houses with six to seven people living in their own home, within Hogewey. We found that eight was too many.
“So they have their own team and a high quality of life. Lifestyle is everything – we pay a lot of attention to the environment, interior design, social behaviour, daily routines and preparations of meals. We have worked out everything so the place is de-institutionalised and normalised,” she said.
“They have a house with a front door, a kitchen and a terrace. They have their own bedroom in a normal style. It is so homey,” she added.
Village supermarket and theatre
Hogewey even has its own supermarket so all the residents can do their daily shopping if they like. They can help cook meals at night if they want to, with the trained nurses and caregivers who stay in the houses with them, dressed in ordinary street clothes.
“We have our own pub so they can go to the pub or the theatre,” said Van Amerongen. “With this set up, they can live a normal life. Fifty per cent of the property is outdoors so they can take a walk in the garden or on the terrace.”
While the residents are free to walk around the village, they are also safe because the village is securely gated. If they ever get lost or confused there is always a caregiver close by who can give them assistance.
Are ‘dementia villages’ the future?
The cost of a self-contained village like Hogewey is probably the greatest barrier to this type of community becoming the standard in dementia care. The cost to build Hogewey was over $35 million and most of this was funded by the Dutch government. Residents pay approximately $10,000 per month and yet, there is a perpetual waiting list.
Some countries such as Germany and Switzerland have studied Hogewey and are looking at following suit. However, here in Australia there don’t seem to be any plans yet for facilities such as Hogewey. This is disturbing given we know the incidence of dementia is on the increase. As Van Amerongen said:
“Worldwide we now have 46.8 million people with dementia and by 2050 this figure will be 115 million.”
