Nursing homes are depressing places — depressing to employees, residents, and visitors alike in most cases. With this in mind, Yvonne van Amerongen set out to make a new kind of nursing home in her native Netherlands.
Motivated by the recent death of her mother, van Amerongen imagined a nursing home where the new life wasn’t such a difficult departure for residents. She worked for 20 years to make her vision of the ideal nursing home into an unlikely reality.
The result of her efforts resembles, as Josh Planos of the Atlantic calls it, a “more benevolent version of The Truman Show.” Her nursing home is an isolated village, called Hogewey, part of the small Amsterdam-suburb of Wheesp. Once called “Dementia Village” by CNN, the semi-miniature town encompasses the area of about ten football fields, complete with all the typical fixings of a Dutch town — a town square, a theater, a garden, a post office.
The residents, all of whom have some form of dementia or Alzheimer’s disease, are constantly being watched by their caretakers, some of whom are posing as residents in street clothes. The town has only one door in and out, to keep residents from wandering away. Friends and family are free to visit their loved ones.
The unique setup, while surreal, yields clear results. CNN reports that Hogewey residents need fewer medications, eat better, live longer, and appear happier than their counterparts in conventional nursing homes. Hogewey residents are encouraged to lead active lives.
Residents live six to seven people to a house. Even the facility’s 23 unique homes are meticulously designed to suit the needs of its residents. The architecture of each home corresponds to the time period when its residents’ short-term memories stopped properly functioning. Some have a contemporary feeling while others adopt a 1950s or 70s atmosphere.
The 250 workers at Hogeway don identities within the village, acting as cashiers, gardeners, and post office-clerks. Within Hogewey, there is no exchange of currency, since dementia patients frequently have trouble with financial matters.
Hogewey demonstrates the usefulness of community in treating disease, physical and mental, and improving the overall quality of life for the ill. In many extreme cases of mental illness, the patients are isolated from others, which reduces production of the nerve-cell-maintaining fiber myelin. The results of Hogewey suggests that the severity of dementia is less a result of the individual case than it is the way we treat it.
All residents have particularly advanced cases of dementia, and space for newcomers is generally limited as the village has operated at full capacity since its 2009 opening. It was funded primarily through government funding, and most families never pay more than $3,600 a month for elderly care, thanks to subsidies.
To compare those numbers to dementia care in the US:
A private room at a U.S. nursing home cost an average of $248 per day in 2012, or more than $90,500 annually—a figure that’s even more staggering when applied to the rapid increase in dementia patients globally. By 2030, the number of people suffering from dementia around the world is expected to hit 76 million, which some estimate will cause an 85 percent increase in dementia-related healthcare costs worldwide. By 2050, the U.S. alone will pay a projected $1.2 trillion.