Centuries after Shakespeare wrote about King Lear’s symptoms, there’s still no perfect way to care for sufferers of dementia and Alzheimer’s. In the Netherlands, however, a radical idea is being tested: Self-contained “villages” where people with dementia shop, cook, and live together—safely.
We, as a population, are aging rapidly. According to the Alzheimer’s Association, one in three seniors today dies with dementia. The process of finding—and paying for—long-term care can be very confusing, unfortunately, and difficult for both loved ones and patients. Most caretakers are underpaid, overworked, and must drive far distances to their jobs—giving away some 17 billion unpaid hours of care a year. And it’s just going to get worse: Alzheimer’s has increased by an incredible 68 percent since 2000, and the cost of caring for sufferers will increase from $203 billion last year to $1.2 trillion by 2050.
In short, we’re not prepared for the future that awaits us—financially, infrastructurally, or even socially. But in the small town of Weesp, in Holland—that bastion of social progressivism—at a dementia-focused living center called De Hogeweyk, aka Dementiavillage, the relationship between patients and their care is serving as a model for the rest of the world.
Hogeweyk, from a certain perspective, seems like a fortress: A solid podium of apartments and buildings, closed to the outside world with gates and security fences. But, inside, it is its own self-contained world: Restaurants, cafes, a supermarket, gardens, a pedestrian boulevard, and more.
The idea, explains Hogeweyk’s creators, is to design a world that maintains as much a resemblance to normal life as possible—without endangering the patients.
For example, one common symptom is the urge to roam, often without warning, which had led most “memory units” and dementia care centers to institute a strict lock-down policy. In one German town, an Alzheimer’s care center event set up a fake bus stop to foil wandering residents. At Hogeweyk, the interior of the security perimeter is its own little village—which means that patients can move about as they wish without being in danger.
Each apartment hosts six to eight people, including caretakers—who wear street clothes—and the relationship between the two is unique. Residents help with everything from cooking to cleaning. They can buy whatever they want from the grocery. They can get their hair done or go to a restaurant. It’s those basic routines and rituals that can help residents maintain a better quality of living.
“The fact that a resident cannot function ‘normally’ in certain areas, being handicapped by dementia, does not mean that they no longer have a valid opinion on their day to day life and surroundings,” say administrators.