Most people would prefer to be able to age in their own home or apartment as opposed to an assisted living facility. Being able to remain in one's home provides a sense of independence and satisfaction. But what about those elderly people who suffer from dementia? A model concept from the Netherlands is providing ideas for those who wish to age in place here in North America.
What are dementia villages?
A dementia village is exactly what it sounds like: a group of people with dementia living together in a community. These villages are essentially gated communities. Within these communities are shops, grocery stores, apartments, parks, and anything else you would expect to find in a normal community.
The difference is that the residents in these communities all have one thing in common: dementia. Although they may be in different stages of the condition, all of the residents have it. All of them wish to live out their final days in a setting as close to "normal" as they can get, and all of them have chosen to live in a dementia village.
Most residents of a dementia village live in a residential unit housing 6-8 people. Essentially, it is a shared apartment. They go about their daily lives, even going to see a movie in the movie theater if they so choose. In the background of the daily hustle and bustle, trained geriatric nurses and caregivers dressed in street clothes provide care and assistance when necessary. Even the employees who staff the various shops and businesses in the village are trained to assist people with dementia.
While some people argue that a dementia village is something of a cruel joke--making the residents feel that they are living a "normal" life when in fact they are essentially in a huge Alzheimer's ward--the fact is that the homey feel and the laid back atmosphere is something that the majority of the residents prefer. When you cannot change the fact that you have dementia, you can at least exercise some control over the way in which you live out your remaining days, and these residents have chosen a life that resembles--as much as possible, anyway--life in a normal, everyday village.
The model for this idea is located in the Netherlands. The village, Hogewey, has 152 residents and 240 "villagers" (caregivers dressed in street clothes). The residents of Hogeway have chosen to live there and there is always a waiting list to get in.
Although--for their own safety--the village gates are locked, residents are free to venture through the streets, spend time at one of the parks, go shopping in the "business district" and even visit one another in their respective homes. If they do happen to get lost or need assistance, one of the "villagers" is always nearby.
The concept has been hugely successful, and residents of the Netherlands who choose to make Hogeway their home seem to be happier: behaviorial issues--often a major problem with Alzheimer's patients--are fairly low due to the freedom they enjoy, the sense of purpose they have in their lives, and reminiscence therapy.
Can a dementia village work in North America?
Considering the success of Hogeway, the question becomes whether such an arrangement is feasible in North America. Certainly, there would be an enthusiastic response from potential residents, but a significant consideration is cost.
A month at Hogewey is approximately $7,000. While that sum is not completely out of reach for many North Americans, the fact is that it does represent a higher cost than some other options. Further, because of North Americans' heavy reliance on insurance--and because of the reluctance of insurance companies to pay any more than the bare minimum for treatment--it is not clear whether a dementia village in North America would have a perpetual waiting list as does Hogeway.
Nevertheless, the fact is that at least some North Americans could afford such an arrangement. Given the popularity of the arrangement in the Netherlands, it is probably an option that is at least worth looking into.
Napoletan, Ann. Dementia Care: What in the World is a Dementia Village? August 7, 2013. Available at http://www.alzheimers.net/2013-08-07/dementia-village/
www.bccare.ca (website). Dealing with Dementia: Can the Dementia Village Model Work in Canada? Available at http://www.bccare.ca/dealing-dementia-can-dementia-village-model-work-canada/.