One of the biggest fears or worries people have are of having to move into a nursing home. Stereotypically nursing homes are seen as sterile and cold. Nobody likes the idea of being forced into the decision to leave the home they’ve made for themselves and their families to live in a place they don’t recognize and feels more like a hospital than a home. Of course, the stereotypes associated with nursing homes aren’t accurate. Nursing home staff go above and beyond to make sure their residents are happy and comfortable as they adjust to new living conditions. The atmosphere and living conditions are constantly changing and innovations are always being made to make transition easier and more seamless for people.
Over the last twenty or so years Yvonne van Amerongen, an occupational therapist and social worker in Amsterdam, has been working creating a living environment that would be less of a departure from reality for residents, specifically those living with cognitive impairments like Alzheimer’s and dementia. Located on the outskirts of Amsterdam, the village of Hogewey, is roughly the size of ten football fields and houses 152 residents. In a way, the village is sort of like a more well intentioned version of The Truman Show. The village creates a different version of reality for its residents with it’s own town square, a theater, and a post office as well as cameras scattered across the village to monitor the residents and their caregivers around the clock to make sure everyone is safe. There are no wards or long hallways or rooms set up like those you might find in a hotel or a hospital. The caregivers dress in street clothes and family and friends can visit their loved ones in their homes.
The most unique part of this facility is their take on housing. The village of Hogeway has 23 homes that are furnished and decorated to resemble the time period in which the resident’s memory stopped properly functioning. There are homes that resemble those from the 1950s or the 1970s and the 2000s. The tablecloths and the window treatments and furniture resemble those time periods in efforts to make the residents feel more at home. In addition to the caregivers that stay in the homes with the residents, Hogeway has about 250 part and full time geriatric nurses and specialists who monitor the village posing as cashiers, post office clerks or grocery store attendees. What’s even better is that the issue of finances has been sorted out for the residents as well which is why everything the residents want and need is taken care of via the family’s payment plan so no form of currency is exchanged within the confines of the village.
Finances are one of the obstacles many families face when it comes to finding the right place for their loved ones. Funded by the Dutch government, Hogeway cost just over $25 million to build with the cost of care totalling about $8,000 a month. However, that jaw-dropping cost of care isn’t what the families are paying for their loved ones. Since the government subsidizes the residents the amount each family pays is based off of their income and never exceeds $3,600, a number that isn’t too far off from the average cost paid in the United States.
Facilities, such as this one, just might be the future of Alzheimer’s and dementia care. Oftentimes nursing homes are associated with poor quality of life and issues of patient mistreatment and low levels or morale. In studies on nursing homes in the Netherlands that were done around the time Hogeway opened in 2009, it was discovered that residents only go outside for an average of 96 seconds a day. In contrast, Hogeway residents are able to live an active lifestyle and run their own errands and go to the theater. While the negative associations with nursing homes aren’t entirely accurate, the environmental approach to reducing the cognitive and behavioral issues caused by dementia that Hogeway is taking really could be the way of the future. Instead of reminding their residents of their disease, Hogeway leans into it. If a resident believes they’re living in the summer of 1963, then they are. Their residents live in a palace that looks and feels like the home they remember even though it’s not. Their friends, family, and caregivers know that it’s a facade, but they see it as a reality which, in turn, helps them to feel normal in the midst of their disease.
Since Hogeway was founded a little over eleven years ago, experts from all over the world have gone to visit the town in the hopes of finding an example of how to better handle the ever growing problem of degenerative cognitive diseases like Alzheimer’s and dementia. In 2013, a 1950s styled village was created in Fartown, England and a similar project was started in Switzerland. The small, quiet town of Hogeway may have set the new standard of dementia care for future generation and solidified the truth in the saying “it takes a village.”