A new way of caring for the vulnerable old

ANJA, who is in her 80s, says she has lived here for one hour. In fact, it has been almost a year. Like all of her neighbours, she has severe dementia. But if she is feeling particularly perky, she can buy lagers at the local supermarket, get coiffed at the hair salon and play bingo as night falls. She can dip her feet into the local fountain, or even cycle into it. She lives in Hogeweyk, thought to be the world’s first “dementia village”, near Amsterdam.

Dementia villages are gated communities designed for people who suffer from dementia, a term used to describe a set of symptoms (such as memory loss and confusion) that are caused by a variety of brain diseases. Hogeweyk’s 150 residents live in six-room houses, each designed around one of four “lifestyles”. These are selected for patients after tests and interviews alongside their families. Anja (not her real name) and her housemates live in a “traditional” home. They eat starchy stamppot stews and have a sewing machine that says it is “Made in West Germany”. “You won’t find Danish [modern or minimalist] design here,” says Eloy van Hal, who founded the village in 2008. The neighbouring house is furnished with pink floral wallpaper and kitschy plastic chandeliers; all part of the “urban” style.

Hogeweyk’s allowance of small freedoms gives peace of mind to people who have lost a part of theirs. Grouping residents by lifestyles is meant to establish continuity between their former lives and the nursing facility. The idea is based on reminiscence therapy, which holds that anxiety in dementia patients can be reduced by creating a familiar environment. It is catching on. A dementia home in Rotterdam has built a “remembrance museum” in its basement where residents can ogle over childhood artefacts. In Dresden, one nursing home has a room set up to recall the former East Germany. A poster of Erich Honecker, a former leader of the East German communist party, looms over communist paraphernalia and bulky cassette tapes playing 1960s hits. Sometimes fakery keeps residents safe. One home in Düsseldorf has a fake bus stop. Residents who decide, in their confusion, that they want to go somewhere else tend to line up patiently there. After they have waited for a bus that will never come, a carer lures them back to their homes.

Hogeweyk received over 1,400 visitors in 2017, keen to copy the concept in their own countries. It is not hard to see why. In 1993, when it was still a regular nursing home, 50% of patients were being given antipsychotic drugs. In 2015, only 8% were. In a client satisfaction survey from 2010, the home scored 9.1 out of 10, compared with 7.5 countrywide.

Hogeweyk exists because the Netherlands can pay for it. Like all care homes in the country, it is primarily state-funded. A national insurance system covers the hefty €6,000 ($7,160) monthly cost for each patient, with the richest people paying up to €2,400 into the scheme each month. In all, the Netherlands spends 4.3% of its GDP on long-term care, the highest in the OECD. It may take a village to help dementia patients. But it takes a country to pay up.