Dementia Villages USA

Is Dementia care heading for the Village?

Dementia villages are slowly popping up around the world as the place to be for dementia sufferers. The Netherlands, Canada, England are all experimenting with these villages.

When I first started working with elderly patients back in the early 2000s, my facility had a dementia unit. There was nothing spectacular about it. Yes, the patients suffering from Dementia were separated from the general populating, and they were kept on a locked unit. Behind those locked doors, they had a small dining room, on the doorway of each room was the patient’s name, accompanied by a photo of the patient occupying that room. The significant thing about the photo was, it was never a recent photo, it was a photo from the distant past. Everything else ran almost identical to the remainder of the facility. The most important thing then was the safety of the patient

From personal experience, the average dementia patient having problems with cognition and memory loss still had the ability to walk without difficulties. Back then, approximate 50% of that could be seen pacing in the hall at any given time. One reason the pacing/wandering appeared so very obvious was because of the limited space provided for it. The patients walked the length of the short hall, then turned around and walk back in the direction in which he or she just came. This process was repeated over, and over.

Gradual improvement

In recent years, dementia care, and dementia care facilities have consistently improved. Facilities are drifting away from the hospital like settings to a more home-like environment. Several organizations have gone into providing care for the elderly and dementia population. Because of the crowded field, organizations are spending countless hour working on providing the best care and the best facilities. With state-of-the-art equipment and care programs, the focus is beginning to shift to dignified care. The Alzheimer’s association believe that this can be improved through person-centered-focus.

Cost

In my opinion, home care provides the best chance of such care, but it comes with a staggering price tag. According to the CDC, informal or unpaid caregivers provided more than 230 billion dollars’ worth of care in 2018. The price tag, for care provided by professionals, for Alzheimer’s and other Dementias was estimated to be more than 250 billion dollars in 2017. As the search for a more dignified setting continues, the cost will continue to increase. Community programs linked to clinical services may help to ease the burden. REACH OUT is one such program. REACH OUT is a training intervention for caregivers of people with Alzheimer’s disease or dementia. The CDC believes that its future direction will be to work with partners in the community. With these partners, CDC plans to develop and share strategies that will help older adults suffering from cognitive impairment to remain active, independent, and involved in their community.

Will we go there?

Like I said before, Here in the US, Dementia care is drifting slowly towards a home-like setting, with restaurant-style dining, common spaces to encourage socialization, beauty Salon and barber shop, outdoor patio, smart TV, computer assess with interactive touch screen, customized music, the list goes on. The question is; will it make it all the way to dementia villages?
Form my research, Dementia villages, first seen in the Netherlands, is more like a combination of our indoor malls, and an all-inclusive resort. Almost everything related to the activities of daily living is in there. It is the closest thing to a home environment, with kitchen, sofas, dining tables, and TV. It resembles an indoor mall simply because it is equipped with barber shops, a beauty salon, a supermarket. The dementia patient gets to walk the streets and go to the supermarket in a secure environment. The residents live in a community that is closed off from the world. Despite this, it is a least restrictive environment.

Ties to what remains

The environment takes them back in time, to a more familiar time. Remember, a person suffering from dementia have problems recalling recent events but does much better with events from distant past. “This village of Hogewey create ties to what remains despite the dementia,” said Barbara Hans, the author that provided us the sneak peek into that Netherlands’ village.
How do they differ from Memory care?
Let’s admit, recently built dementia care units in the US have improved considerably but not to the extent to include such amenities a supermarket to shop for groceries and a kitchen for cooking. The homes are connected by streets. Furniture is selected to match the patient’s background.

The village-like setting does not stop or remove the need for the pacing/wandering activity. In my opinion, it encourages it by creating an even larger area for such an activity. Patients can wander out into the streets, to the supermarket, through the supermarket, and back up the street, without it looking like repetitive behavior.

Would this type of facility be built in the US?
Would it be cost effective?

Reference

Hans, B. (2019). Living in the Moment: Dutch Village Offers Dignified Care for Dementia Sufferers – SPIEGEL ONLINE – International. Retrieved from https://www.spiegel.de/international/europe/dutch-village-for-elderly-with-dementia-offers-alternative-care-a-824582.html