There is a paradise village called Hogeweyk and it is situated just a few kilometres from Amsterdam in Holland. What is so special about this village? It caters for 150 residents who are suffering from severe dementia and/or Alzheimer’s disease. It is usually referred to as dementia village although paradise may be a more apt description. Here the residents are encouraged to lead as normal a life as possible and take part in lots of activities in a protected environment.
This is in stark contrast to the gloomy nursing homes in most countries. Those are sometimes be staffed by disgruntled and cruel staff in white coats. Patients are kept quiet with medication and follow a boring routine where they are rarely allowed out.
An ideal environment.
Living in Hogeweyk is the perfect solution because each resident can choose his/her accommodation and is assisted by two specially trained carers. It is the perfect replica of any neighborhood in that there are supermarkets, barbers and hairdressers, clubs, and gyms. Residents are encouraged to go out and about, do shopping, go for walks, meet socially and generally lead an as normal life as possible with dignity and grace.
The village was co-founded by Yvonne van Amerongen in 1992. She and some other carers sat down and worked out what would be the best possible environment for people with severe dementia. The results have been gratifying as the residents now generally live longer, calmer and happier lives. They also eat better and need less medication. When interviewed they usually say they are happy in this environment.
The problem of how best to treat dementia patients is an urgent one as the World Health Organisation is convinced that the numbers of people suffering from this debilitating disorder is likely to double by the year 2030.
Living in Hogeweyk.
Every day, the residents go shopping in the supermarkets and shops which have been designed in the 1960s style to provide them with a familiar setting. As most severe dementia sufferers can remember their past perfectly well, this is a comforting ambience. The food is free as this expense is covered by the monthly fee of $5,000. All the staff running the hair salons and shops are fully trained and no money is ever exchanged.
They then have to go back to their apartments and start to cook and prepare food, under the supervision of their carers as they often need round the clock care. They usually live in units which cater for 6 to 8 people although each person has their private accommodation. Carers never wear white coats. Spouses and partners are encouraged to visit the residents. It is hoped that they will be able to live together with them eventually, although the Dutch government does not provide funding for this at the moment.
Music is a very popular activity and there are sing alongs and music practice, together with theatres and other club activities. It is a fact that many people who suffer mental decline lose the power of speech but they still manage to sing and appreciate music. Apparently, the area of the brain which governs our musical capacity is the last to decline when dementia strikes.
Social workers are on hand to deal with emergencies as sometimes newly arrived residents become aggressive or may barricade themselves inside their units.
How dementia needs to be treated.
Hogeweyk has led the way and some countries and institutions are ready to follow suit. It has provided a lesson in how to treat elderly people in mental health care. The following points should be borne in mind when we have to deal with mental health patients.
- Dementia patients will suffer much less if they are kept active.
- They should be allowed to live in a home like environment which is gated.
- Pharmacological treatment needs to be combined with providing them with normal activities as far as possible.
- Patients should never be kept in bed but encouraged to move about and be engaged with their surroundings.
- The care environment needs to be upgraded to reduce the possibility of patients feeling distressed.
- People need to be put before profits so that dementia sufferers do not lose their freedom and independence.
- Nurses need to be reminded to be people first, rather than mere trained specialists.
- People with dementia should still be allowed to make limited choices about what they want to eat and not be bossed around all the time.
- Carers need to adhere less and less to being a model custodian. Dementia demands much more tolerance and empathy.
- Denmark is leading the way in providing preventive home visits for people over the age of 75 to assess whether they are at risk of dementia. They aim to provide personal assistance wherever possible rather than admit these patients to nursing homes.
As we can see, there is much to be done to revolutionize elderly mental health care. But at least the paradise village and other similar ventures are blazing the trail.
Featured photo credit: IMG 0213/Hans Erkelens via flickr.com