Living in the Past: Dementia Villages
By Lisa YuPublished November 18, 2018
Figuring out how to improve the lives of patients with dementia is no small challenge. Currently, 50 million people worldwide and their families deal with the difficulties of dementia every day, and this number is expected to increase to 152 million by 2050. Dementia, and its most common form, Alzheimer’s disease, are neurodegenerative disorders that decrease cognitive abilities and memory over time, to a point where someone may no longer be able to recognize their surroundings, communicate, or even swallow. While researchers and many pharmaceutical companies have been searching for treatments for this debilitating disease for years, a cure has yet to be found, so the question of care for patients is essential. Long-term care is especially important since dementia patients may experience a decline over many years or even decades, and at a certain point, it becomes dangerous for dementia patients to live independently.
A promising model of care that will meet many of these challenges could be the widespread implementation and funding of dementia, or memory, villages. These ‘villages’ are care facilities specifically designed for patients with dementia. They may be permanent residences for patients, providing around the clock medical care, or centers for patients to engage in activities during the day. The uniting feature of these facilities, however, is that they recreate the past for their residents. The first village of this kind is a residential nursing home in the Netherlands called Hogeweyk dementia village. It is a small enclosed community containing architecture from the past 70 years, shops from the same eras, and plenty of green spaces. Visiting Hogeweyk is like stepping back in time to periods when residents were likely in the prime of their lives. Residents are able to explore freely and safely, make choices about their days, and live a normal life that is lost for so many dementia patients. Not only is the idea intrinsically appealing, studies have shown that there are proven medical benefits of living in Hogeweyk as well. Residents need less medication, eat better, and live longer, even if most of the patients are in the very late stages of dementia. Reminiscence therapy has also been used successfully to improve cognition and happiness of patients in dementia village settings.
Another benefit of creating dementia villages is that families will benefit as well. Caring for family members with dementia is a huge burden placed upon the shoulders of many families, and the value of unpaid caregivers in America is estimated to $450 billion USD. Nursing homes, however, are considered a last resort and family members often don’t want to leave their loved ones to languish in traditional long-term care facilities. To combat these negative perceptions, research has shown that dementia villages have been able to improve relationships, lower stress for families, and allow families to provide essential emotional support rather than physical care for patients.
The most overlooked benefit, however, is that patients and their families are happier. The importance of happiness and mental well-being is often lost in our modern healthcare systems, and Atul Gawande explores this idea in his popular book, Being Mortal. We have metrics to measure a host of physical functions and can perform thousands of procedures to extend a person’s life, but we can still fail to care about a patient’s quality of life, even at the end of life. This is an issue we have begun to take notice of, but still struggle to address. Dementia villages are bringing the focus of improving well-being and quality of life to elderly care.
While there are currently very few villages that exist around the world, creating more of these facilities has the potential of greatly improving life for more patients and their families. Hogeweyk was created with the help of government funding and as a result, all residents pay no more to live there than the standard nursing home. A similar village was built near Vancouver, Canada, and several non-residential memory villages have been built across America, but patients using these facilities currently cannot receive government subsidies, while residents of most traditional nursing homes are eligible for these subsidies. This must change as we transition into a time where more and more of the elderly population will require specialized dementia care. It is only with government funding that more of the population can access such holistic care, and that the dementia village model can spread to meet the rising demand. Concerns of cost may arise, but an initial comparison shows that the cost of running these facilities are within the average national nursing home costs of $82,128 to $92,376 per year. Costs are likely to decrease as well when successful projects are scaled up.
After analyzing the benefits that dementia villages have on the health and well-being of dementia patients and their families, it is clear the best way forward is to look to the past.