Imagine a world where people who have dementia have the right type of support to be able to could continue to live the lives they are used to within their communities. Although we are not there yet, there is a village in the Netherlands that allows people to continue living independently in a way they are familiar with.
De Hogeweyk is a pioneering care facility for older people with dementia. Hogewey’s view on care is founded in day to day life in society. In normal society living means having your own space to live and managing your own household. People live together with other people sharing the same ideas and values in life. This makes the place where one lives a home. Hogeweyk residents have already lived a life where they shaped their own life, where they made choices about their own household and standards. 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. The residents opinion on life, housing, values and standards determine their “lifestyle”.
The Hogewey complex is set out like a village with a town square, supermarket, hairdressing salon, theatre, pub, café-restaurant—as well as the twenty-three houses themselves. Each house reflects a style that is common to, and familiar for, the six or seven people who live in that house. The seven lifestyles provided are:
- Stedelijk, for those used to living in an urban area
- Goois, with an aristocratic Dutch feel
- Ambachtelijk for those used to working as trades people or craftsmen/women
- Indisch for those with an association with Indonesia and the former Dutch East Indies
- Huiselijk for homemakers
- Cultureel for those brought up with theatre and cinema
- Christelijk for those with a central religious aspect to life, whether Christian or another religion.
Every Hogeweyk home houses six to eight people with the same lifestyle. This lifestyle can be seen in the decor and layout of the house, the interaction in the group and with the members of staff, day to day activity and the way these activities are carried out. The village employs 250 staff who all aim to make the experience for residents as real as possible. Residents shop at the supermarket and assist with preparing and cooking as they would at home. The carers wear normal daytime clothing rather than clinical clothing and fit into a role that the dementia sufferers are likely to be comfortable with. There are no locks on the doors, and residents are free to walk or cycle around the village, including choosing to visit the supermarket or cafe.
Hogeweyk was designed by Dutch architects Molenaar&Bol&VanDillen, but it was the brainchild of Yvonne van Amerongen, a caregiver who has worked with memory patients for decades. Starting in the early 1990s, van Amerongen and a group of like-minded caregivers began researching and designing a type of home where residents would participate in life, the same way they did before they entered a dementia care unit.
Some critics oppose the idea of creating this environment, arguing that residents are being misled. However, proponents tout the dementia village as being the most compassionate, kind type of dementia care offered anywhere. Many experts agree the homelike setting at Hogewey allows residents to live as normal a life as possible, eating dinner family style, visiting with friends, stopping by the barbershop, or going for a walk whenever they wish.
By treating residents as normal people, Hogeweyk seems to suggest that there isn’t such a huge difference between those who do and do not suffer from dementia — just differing needs. By designing a village tailored to those unique needs, residents avoid the dehumanisation that long-term medical care can unintentionally cause.