Hogeweyk, a village in the Netherlands, looks like any other village from outside. But the main thing that sets it apart from other villages are its residents: everyone has a form of dementia.
Hogeweyk is a nursing home designed to look like normal houses. It is a facility that helps the patients feel a bit more normal towards the end of their lives. As the manager of the facility, Eloy Van Hal, told Business Insider, this preserves people’s sense of autonomy.
This sense of autonomy is important, considering the way dementia patients have been treated for decades. In the mid-nineteenth century, scientists struggled to define dementia in biological or scientific terms; they came up with terms such as insanity. In the first decade of the twentieth century, the German psychiatrists Emil Kraepelin and Alois Alzheimer were interested in developing a clear pathological basis for dementia.
They presented a paper on the case of a 51 year old woman who developed progressive dementia, who despite her young age, seemed to be similar to senile dementia. This discovery led to the disease being more well known, but scientists still did not know how to define it in the psychiatric field.
At around the same time, doctors in the US began to feel like dementia patients were a growing problem, placing strain on their healthcare system. They had little financial incentive to take care of these patients because they could no longer live indecently within the community. They saw these patients as a financial and institutional burden.
Furthermore, during the 1930s-1950s, psychologists such as David Rothschild began to frame dementia as a psychosocial condition, rather than a brain disease. People began to see the disease as the interaction between a person and the context in which they live. These theories influenced the way dementia patients would be treated for decades, especially when it was seen as a major public issue in the 1970s. There was more strain on the caregivers, and it became extremely hard for mental institutions to house a large number of patients. Due to this, there was little effort to improve the quality of lives of these patients. The institutions were designed to contain these people, not care for them. Most of the funding by the government focussed on finding a cure, not improving their quality of life.
Hogeweyk started out in 1993 as a hospital / nursing home. But as the people in the facility began to spend more time with the patients, they seemed to realize that there are more humane ways to improve the remaining days they had left. In 2005, they tore down most of the original design and decided to build something new. Instead of a nursing home, it became a village.
Even though the patients are on their medication on a regular basis, the town is maintained like a regular town; there are grocery stores and houses. The creators of the facility said this was important because they wanted the patients to experience a normal day, or a day they would recognize.
There are approximately 50 million people worldwide who suffer from this disease, and each of them have their own unique needs. The nursing home tries to cater to each person’s moods and routines in order to make them feel like they are part of the ‘real world.’
These elements may sound mundane to us as we view it from the outside, but studies have shown that people with dementia benefit from being physically and mentally active. The Hogeweyk was built to accommodate these needs with its dementia friendly design. The patients receive constant and careful medical attention by medical workers who help out with whatever the patients need. They usually do not even wear scrubs; walking through the town feels like walking through a normal town in the Netherlands.
Furthermore, there are social activities designed to help people interact with more people. The people who live here continue to pursue their hobbies, make friends, play games, etc. The creators of the village even designed grocery stores; but they have no price tags or money exchanged. This ensures that the people can collect their groceries without worrying about whether they have money, etc.
According to most experts, patients with dementia are expected to double by the year 2050. Due to this, healthcare professionals are looking to new models like the Hogeweyk as an example for how to treat these people differently; it helps us realize that a person’s environment is just as important as their medical treatment. There are several of these small towns that are starting to emerge in places like Switzerland, Denmark, and even Canada.
But, according to me, the biggest innovation in Hogeweyk isn’t their construction or design, it is their autonomy. Their village allows their residents to envision a sense of normalcy; it allows them to try and remember a life before their prognosis. It gives them a chance to live a life like everybody else.