Dutch 'dementia village' Hogewey recreates life in the real world

Aug 2, 2017, 9:04 PM GMT+2

Residents of Hogeweyk, a village located in Weesp, Netherlands, lead a normal life. They go to the grocery store, complain about the weather, and enjoy a weekly game of bingo.

But there's one thing that sets the 152 residents apart from the general public: Everyone has an advanced form of dementia.

Hogeweyk is a nursing home disguised to look like the outside world. It helps people with mild to severe dementia suffer a little bit less in their remaining years, facility manager Eloy van Hal told Business Insider. He said it preserves people's sense of autonomy.

The village is comprised of 23 houses, each with six to seven residents and a caregiver who cooks, takes people to social events, helps them go grocery shopping at the village market, and watches over them to ensure their safety.

Here's what life is like inside Hogeweyk's walls.

Hogeweyk started in 1993 as your typical hospital-style nursing home. But the staff soon realized there was a better, more humane, way to offer care.

"We said to each other 'What do we want for ourselves and our moms and dads?" van Hal said.

The consensus was that people wanted normalcy, at least to the extent caregivers could provide it. Gradually, Hogeweyk began folding in elements of the outside world. It started by creating 23 houses in four different "lifestyle" categories — cosmopolitan, nature-oriented, well-to-do, and traditional Dutch.

"You have to choose," van Hal said. "Which is the lifestyle according to your preferences?"

Staff at Hogeweyk are trained to focus on highlighting what residents can do, not what they can't.

Hogeweyk places a great deal of importance on word choice, van Hal said. The staff members don't treat patients — they care for residents.

"All the residents living here need medical treatment, yes. They all have medication. They all have [an] advanced stage of dementia," van Hal said. "But they are first a person. That's why there are people living here with dementia, and not demented people."

Hogeweyk caregivers and house attendants use an in-house currency to help their residents buy groceries at a fully-functional supermarket.

The residents can also use real money if they want to, Hal said. Only a handful are lucid enough to do so, and typically they spend it on small items like toothpaste and candy bars.

As part of the facility's normal budgeting process, a chunk of money (not real currency) is doled out to each of the 23 houses. With some help from the caregivers, it's up to the houses to budget the money how they see fit over the course of the month.

"For us it's important that we support them to experience a normal day, a day they like and a day they recognize," van Hal said.

As a matter of policy, Hogeweyk rejects the idea that people with dementia ought to miss out on the finer things, such as beer or wine — even if they don't follow the social norms that most other people do.

"They have really bad manners and habits, in food and behavior," he said. "We are not going to change that."

Residents can use real money at the facility's pub. If people display signs of alcohol abuse, however, the facility will not serve them.

The staff of medical professionals tries to cater to each resident based on their unique needs, van Hal said.

That's important for a sensitive disease like dementia, he added. There are roughly 50 million people worldwide living with dementia, which means there are an equivalent number of stages at which the disease has advanced.

It's up to the Hogeweyk staff to know which residents are more lucid than others, and to treat them accordingly if they slip up with a name or date. According to van Hal, there is no single policy for bringing residents back into "the real world" or letting them live in their bubble.

It's also important for residents to go outside, research has found. Hogewey tries to encourage residents to take walks or enjoy one of the several gardens.

Alzheimer's and dementia sufferers are widely encouraged to stay physically active to keep their minds and bodies engaged.

Residents at Hogewey can stroll through the open courtyard or help caregivers tend to one of the many gardens. Even just sitting on a bench in the outdoors can help improve their mood and overall well-being, research has found.

The efforts may only yield benefits for a few years. But van Hal said the small details can mean the most, even if it's just pouring a resident the perfect cup of coffee.

"If we know that you have sugar in your coffee, we will still ask you every day, 'Do you want sugar in your coffee?' so you can make that choice every day," van Hal said. "That you can still decide what you put in your coffee is important."