How “dementia villages” work

Summary

The Hogeweyk in the Netherlands is a 'dementia village' designed to provide a normal life experience for residents with severe dementia. Unlike traditional nursing homes, it features small group living, personal belongings, and public spaces like a theater and grocery store to foster a sense of community. The village's design prioritizes autonomy, safe movement, and a reduction in antipsychotic medication use, highlighting the importance of universal design for both dementia patients and the general population.

Takeaways

• 🏘️ The Hogeweyk is a 'dementia village' designed to provide a normal life experience for people with severe dementia.
• 🌐 It resembles a typical Dutch neighborhood with amenities like a restaurant, barber shop, and grocery store, but with a focus on dementia care.
• 🧠 Dementia is a brain disease that affects memory, causing individuals to forget recent events and rely more on memories from their past.
• 🏠 In traditional nursing homes, residents often live in a sterile, clinical environment that lacks personalization and autonomy.
• 🔑 The Hogeweyk emphasizes 'normalcy' by creating a living environment that closely resembles the outside world, with private rooms and personal belongings.
• 👥 Residents are grouped into small units of 6 or 7 to mimic the scale of a single family home, fostering a sense of community and belonging.
• 🏡 Each neighborhood within The Hogeweyk has distinct landscapes and landmarks, helping residents navigate and feel at home.
• 🚶‍♂️ The design allows for a balance of safety and controlled risk, providing residents with the freedom to move between private and public spaces.
• 🌞 Features like bright dishware, acoustic ceilings, and natural light fixtures are implemented to improve residents' well-being and orientation.
• 💊 Since adopting the village model, The Hogeweyk has reported a significant decrease in the use of antipsychotic medication among residents.
• 🌟 Dementia villages are an example of universal design, creating environments that work well for both people with and without dementia, and can inform broader design practices.

Q & A

What is The Hogeweyk and how does it differ from a typical neighborhood?

The Hogeweyk is a 'dementia village' in the Netherlands designed for people with severe dementia. Unlike a typical neighborhood, everyone in it, including grocery store cashiers, barbers, and waiters, are trained in dementia care, providing a specialized environment that still resembles a normal neighborhood with amenities like a restaurant, barber shop, and theater.

Why is the concept of a 'dementia village' significant in the context of aging populations worldwide?

The 'dementia village' concept is significant as the proportion of older people in the population is rising globally, leading to an increase in the number of people with dementia. Such environments are designed to help these individuals feel safe and free, even as they lose the ability to recognize the world around them, addressing the growing need for specialized care.

How does The Hogeweyk's approach to dementia care differ from traditional nursing homes?

Traditional nursing homes often provide care in a sterile and clinical setting with a one-size-fits-all approach to daily activities. In contrast, The Hogeweyk focuses on preserving the quality of life by offering a more personalized and autonomous living experience, with small group living, private rooms, and a variety of public spaces that encourage social interaction and movement.

What are some of the design elements in traditional nursing homes that can be improved to better cater to people with dementia?

Design improvements in traditional nursing homes include visually consistent flooring without contrasting patterns, brightly colored doors and handrails for better navigation, bright dishware to encourage eating, acoustic ceiling tiles and carpeted floors for noise reduction, glass-fronted cabinets for clear sightlines, and lighting fixtures that mimic natural light to strengthen circadian rhythms.

How does The Hogeweyk's structural design contribute to the well-being of its residents?

The Hogeweyk's structural design contributes to well-being by creating an environment that closely resembles the outside world. It includes small group living arrangements, private rooms with personal belongings, distinct neighborhoods with unique landmarks, and separate buildings for public services like theaters and grocery stores, all of which encourage intentional movement and a sense of community.

What is the guiding principle behind The Hogeweyk's design for people with dementia?

The guiding principle behind The Hogeweyk's design is 'normalcy'. It aims to provide a vision of a normal life for people living with dementia, allowing them to maintain a sense of autonomy and a connection to familiar surroundings and activities.

How does The Hogeweyk ensure a balance between safety and autonomy for its residents?

The Hogeweyk ensures a balance by providing a design that allows for controlled risk. For example, walkways do not have overly high walls to prevent falls, and instead of handrails everywhere, walkers can be used to provide mobility support, allowing residents to move safely while maintaining a sense of independence.

What evidence supports the effectiveness of The Hogeweyk's approach compared to traditional care models?

Since transitioning from a traditional model, The Hogeweyk has reported a decrease in residents on antipsychotic medication from 50 percent in 1993 to just 8-10 percent today. Additionally, studies have found that features of dementia villages, such as small-scale living, increased daylight, and outdoor gardens, can reduce psychiatric symptoms, behavioral issues, and agitation, while improving spatial orientation and quality of life.

What challenges does the dementia village model face in terms of widespread adoption?

The dementia village model faces challenges such as high costs, which can be prohibitive without ample government funding. Furthermore, there is a need for more evidence to conclusively determine whether this model is superior to traditional care models.

How does The Hogeweyk's approach to dementia care reflect the principles of universal design?

The Hogeweyk's approach reflects universal design by creating an environment that works for as many people as possible, regardless of their ability. It emphasizes the importance of designing spaces that are inclusive and accommodating to everyone, including those with cognitive and physical impairments.

What message does The Hogeweyk convey about the humanity and aspirations of people with dementia?

The Hogeweyk conveys the message that people with dementia are human beings with aspirations and desires, not just patients to be cared for. It emphasizes the importance of providing them with freedom, choice, and the opportunity to engage in meaningful activities throughout the day.