It takes a village: caring for Alzheimer’s with community
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05-01-15 Category: Behavioral Health, Mental Health

caring for alzheimers with community

Taking care of people with Alzheimer’s disease is a big challenge for caregivers. The very nature of the disease causes patients to be confused and have no regard for their own safety. People with severe Alzheimer’s can wander off if not carefully monitored and put themselves and others in danger. Many such patients are in standard nursing homes or facilities specializing in the care of AD patients.

It can be an upsetting experience to see the progression of Alzheimer’s. It is as though a curtain has come down on the part of the brain responsible for memory. Alzheimer’s patients need full time care in every aspect of their lives. Family members typically take on the role of caregiver until the disease progresses and care at home becomes unmanageable.

Fairly recently, observations have noted that music (from the era in which Alzheimer’s patients were in their prime) has an almost immediate effect on the patient, causing many of them to become alert, change facial expression and even sing along. Likewise, exposure to pets often causes a similar response as the patient recalls beloved pets from his or her past life. Occurrences like this bring up the possibility that past memories help Alzheimer’s patients live a more fulfilling life.

There are other approaches to help Alzheimer’s patients that utilize this idea of the remembrance of the past helping these individuals lead more fulfilling lives. One example of this is the “village” of Hogeweyk.

Hogeweyk: the dementia village

Hogeweyk is a village on four acres of land in Weesp, Netherlands built for patients with Alzheimer’s and dementia. The village consists of two-story brick buildings plus amenities such as a supermarket, cafe and theater. Hogeweyk was funded primarily by the Dutch government, sponsors and local organizations. The café/restaurant is open to the public and the theater is hired by local businesses. These establishments contribute to the village’s running costs. The cost to residents of Hogeweyk is similar to more traditional nursing homes.

The Hogeweyk complex is constructed to mirror a village with a town square, supermarket, hairdressing salon, theater, pub, café and restaurant. Additionally, the village features 23 houses, each a different style that accommodate six or seven residents and includes 30 different social clubs including the Classical Club, Baking Club and Walking Club.

The village includes seven lifestyle settings which are common and familiar to the residents in each house. The theory is that living in a familiar setting and ambiance evokes the familiarity of an earlier time in a patient’s life. The settings are as follows:

  • Urban city
  • Aristocratic Dutch
  • Trades/craftspeople
  • Indonesian (former Dutch East Indies)
  • Homemakers
  • Cultural (theater and cinema)
  • Christian for Christians and other religions

Doctors and nurses make the experience as real as possible for their Alzheimer’s patients. Residents do the necessary shopping at the supermarket and assist with food prep cooking. The care providers wear normal daytime clothing rather than clinical clothing and fit into a role that the dementia sufferers are likely to understand. In working class households, the caretakers are perceived as neighbors. In the aristocratic setting, the nurses act akin to servants.

The different living styles have different types of music playing and significantly varied interior design, food and methods of table setting. Residents within each house have their own large bedroom and mingle with other residents sharing the living room, kitchen and dining room. The doors are unlocked and residents are free to walk around within the village or visit the supermarket or café, just as they would in the real world. There are around 250 staff. In order to maintain the “fake reality,” the staff does not seek to correct the residents as they talk about memories, background and history. If a patient inquires about their whereabouts, staff truthfully state that the residents are in a place where they can receive required care for their condition. Due to the nature of Alzheimer’s and dementia, the patients remember the distant past rather than the present, so even truthful answers are quickly forgotten.

Hogeweyk is a humane, engaging community in which residents experience life as they once did, making their own choices, performing routine tasks and socializing. The team is beginning to share their approach with more dementia care facilities around the world. Eloy Van Hal, facility manager, says: “We can still do more. But in general, I think we get pretty close to normal. You don’t see people lying in their beds here. They’re up and about, doing things. They’re fitter. And they take less medication. I think maybe we’ve shown that even if it is cheaper to build the kind of care home neither you or I would ever want to live in, the kind of place where we’ve looked after people with dementia for the past 30 years or more, we perhaps shouldn’t be doing that anymore.”

A happier lifestyle with minimal medication is a gift for Alzheimer’s patients. Hogeweyk is a blueprint for Alzheimer’s care everywhere.

Sovereign Health Group treats addictions, mental health disorders and behavioral problems. If you would like further information on our programs, please call 886-629-0442.

Written by Veronica McNamara Sovereign Health Group writer

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