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The De Hogeweyk Dementia Care Revolution

Dana Larsen
By Dana LarsenJune 14, 2013

A Place for Mom sat down to discuss the famous Dementiaville or De Hogeweyk — a pioneering dementia and Alzheimer’s care village, that began 20 years ago with the Hogewey organization — with Eloy Van Hal, a facility manager with De Hogeweyk. We discuss how Dementiaville has increased the quality of life for dementia sufferers by allowing them to do the “same things they loved before their illness took hold.”

De Hogeweky Village

The human brain works miracles. It is responsible for human innovation, progress and evolution. That’s why De Hogeweyk, a pioneering dementia care community located outside of Amsterdam, also known as “Dementiaville,” is a dichotomy between what the mind is capable of — the invention of an effective memory care facility that allows residents to live without locks and with minimal medication, in their own apartments, doing the things they love — and what can happen to the mind with age.

An Interview With Eloy Van Hal of “Dementiaville”

De Hogeweyk Seniors Riding a BikeEloy Van Hal, a Facility Manager for the Vivium Care Group, the parent company of several senior care facilities, including De Hogeweyk, spoke with us about the iconic “Dementiaville.” Van Hal’s experience with one of the most famous memory care communities is fascinating, to say the least.

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According to Van Hal, the idea for the small scale living environment, with only a small number of residents living per home, came from Yvonne Van Amerongen (who is now in charge of Quality and Innovation); Jannette Spiering (who is the current Director and former Facility Manager);  and the former Director — who wanted more for seniors than an institutional, white-walled environment filled with medication. Van Amerongen and her colleagues envisioned a more humane, engaging dementia care community where residents could experience life as they once had — making their own choices, performing everyday routine tasks as well as socializing with people who share similar interests, despite their disease.

“They wanted to make it a place where you want to be. Their vision and heart were in the right place,” noted Van Hal.

Along those lines, the founders decided that each resident would set their own schedule. De Hogeweyk residents choose their routines for breakfast, coffee, lunch and dinner, but each house plans its meals, shops and cooks together daily. Recreational and social events include going to concerts and films, visiting the barber and engaging with other seniors in their choice of 30 different social clubs, including The Classical Club, Baking Club, Walking Club, and so on. The social interaction and functions provide residents the opportunity to meet with others with similar interests as well as do the same things they did before the illness took hold.

The Dementia Care Community Model

De Hogeweyk Dementia CareWhile De Hogeweyk’s vision has not changed in 20 years, the logistics of how the community is run has changed.

For instance, the community was originally comprised of a traditional enclosed building, but it was discovered that smaller, separate and open buildings worked better, with 6-7 residents per building. The De Hogeweyk complex is set up like a village with an old-fashioned supermarket, town square, theater, pub and cafe restaurant, so that residents can live social lives, despite their conditions. After all, having fun and enjoying life is essential—and responsible for some of De Hogeweyk’s success and why other cultures are trying to replicate their care model.

In addition to the common areas of the dementia care village, each home is designed to match the class and culture of one of 7 different resident lifestyles:

  1. Stads — Urban, casual
  2. Goois — Upper class
  3. Ambachtelijke — Working, farmers class
  4. Indische  — Indonesian/Dutch East Indies
  5. Huiselijke — Homy
  6. Cultural — Arts and culture
  7. Christelijke — Christian

Senior Artist at De HogeweykWhile De Hogeweyk is a seemingly ordinary village at first glance, the environment is really a large-scale facility that caters to dementia patients’ individual treatment and therapy needs. What’s incredible is that residents live in realistically constructed environments that allow them to act out their memories in a calm, peaceful and safe ambiance that appeals to their illness delusions. Caregivers support the seniors and help make their worlds as real as possible by appealing to their senses through food, music, home decorations — and anything else that brings back fond memories of living life.

Van Hal notes, “They [residents] eat dinner at a table with normal plates and enjoy the smells of food cooking in the kitchens of their homes. And residents shop for their own food. When they [residents] step out in the rain, they are outside as cold is a part of normal life. While Dutch law states that you have to have 24-hour care, we do it differently as no one wants somebody following you 24 hours a day.” Eloy notes that the residents still get the care, but Hogewey invented “something different” by providing “something special in a normal way.” Basically, the doctors adjust to the daily rhythms of the residents.

Catering to the Different Stages of Alzheimer’s

De Hogewek Dementia Care VillageDe Hogeweyk has residents at advanced stages of dementia. It is ideal to have “your loved one stay at home as long as possible, but when people get to certain stages of Alzheimer’s disease; this is not always possible as severe dementia requires 24-hour care,” notes Van Hal.

It’s no surprise that Hogewey has a waiting list as the treatment is every family’s dream come true for a loved one who suffers from dementia. According to Van Hal, the wait list is from 5 months to 2 years, depending on different life styles and availability. But, not everyone adapts well to the environment. Eloy comments, “About once per year there’s not a good match,” usually a result of psychiatric problems or the fact that “not everyone is good in small-scale living.”

The Hogeweyk staff includes 240 people, with 170 full-time employees. The workers are all-inclusive, including care workers — doctors and nurses— as well as restaurant, supermarket and cinema workers. The 0.84 care ratio does not include the doctor and after time the soothing effects of the village help residents to be less aggressive and less restless. While there is no treatment for the disease, many residents do seem to get better as they are happy in these environments. “It’s all part of the methods,” according to Eloy. Residents are in a place that is recognizable, normal, safe and secure.

The Future of Alzheimer’s Disease

De Hogeweyk Dementia Care VillageSince De Hogeweyk has been so successful, the current De Hogeweyk team is beginning to think about how to share their approach with more dementia care facilities around the world. Van Hal notes that the “search for a dementia pill,” or a medical treatment or cure, is on everyone’s mind. But in parallel, Eloy’s team hopes to help change the way we care for loved ones that have the disease, while one day wishing that there will be no more diagnoses and a dementia-free world without need for their compassionate approach to care.

Eloy reminds us that it comes down to humanity. While the disease changes people, those people still live within their bodies: “It is important to let others experience the method of De Hogeweyk, and hopefully apply.” There are also ideal approaches through tactics, such as appealing to their memories, senses, as well as, approaches for effective communication. iPad apps and some of the other more recent Alzheimer’s innovations are interesting, but in his mind, providing a safe, normal environment that allows for a lifestyle you enjoy, including art, music and stimulation, is the most important.

How do you feel about Dementiaville? If you or a loved one was diagnosed with dementia or Alzheimer’s would you prefer this type of dementia care model over the traditional care? We’d love to hear your thoughts in the comments below.

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