November 17, 2014

How a 'Truman Show'-style nursing home is changing dementia care

Daily Briefing

    A small village outside of Amsterdam that has been dubbed "Dementia Village" is changing how elderly care is delivered to patients with severe cases of Alzheimer's or dementia, Josh Planos writes in The Atlantic.

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    What sparked the idea for Hogewey?

    Yvonne van Amerongen developed the concept for the village, known as Hogewey, while working for a traditional nursing home. Van Amerongen "envisioned a setup as far away as possible from the nondescript buildings and polished floors of her workplace, where everything carried a scent of a dentist's medical cabinet," according to Planos.

    Over the next two decades, van Amerongen worked to secure funding to "make the idea a reality" and better the state of elderly care in the Netherlands.

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    Details of 'Dementia Village'

    Hogewey houses 152 elderly individuals with severe memory problems and is about the size of 10 football fields. It has "no wards, long hallways, or corridors."

    Instead, residents live in groups of six or seven in 23 homes outfitted with furnishings from the time that the residents' memories stopped properly functioning. The home styles range from the 1950s to the 2000s and are "accurate down to the tablecloths, because it helps residents feel as if they're home."

    Meanwhile, the village has a town square, theater, grocery store, post office, and more operated by 250 full- and part-time geriatric nurses and specialists. The nurses wear street clothes and "hold a myriad of occupations" within the town.

    Hogewey takes myriad safety precautions, including 24-hour surveillance from cameras that monitor residents at all hours of the day. There is only one door in and out of town.

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    The cost of living in the facility totals about $8,000 per month, but the Dutch government offers subsidies. While the amount each family actually pays varies, total payments never exceed $3,600 per month. By comparison, a typical private room at a U.S. nursing home costs about $90,500 per year.

    Hogewey residents more joyful, live longer

    Data suggests that residents at Hogeway have a better quality of life than those at traditional nursing homes. According to a CNN report last year, Hogewey residents require fewer medications, eat better, live longer, and appear happier than those residents of traditional senior care facilities.

    Paul Newhouse, director of Vanderbilt University's Center for Cognitive Medicine, says, "The environmental approaches to reducing both cognitive and behavioral problems associated with dementia are really the key to improving quality of life for these patients without excess medication."

    In addition, Planos writes that those with the most severe mental health issues—such as dementia and Alzheimer's—are often the loneliest and express feelings of isolation. However, "a place that looks and feels like home, even though it's not ... may help them to feel normal even in the midst of their disease."

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    What's next for the future of elderly care?

    According to Planos, dementia experts from numerous countries—including the United States, United Kingdom, Germany, and Japan—have studied Hogewey in the hopes of replicating its services and level of care for Alzheimer's patients.

    Last year, a nursing home in Fartown, England, built a 1950s village for its residents, and a similar project is in the works in Wiedlisbach, Switzerland. However, the design may be difficult to implement in the United States because of its costs.

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    Planos concludes, "Hogewey hasn't found a cure for dementia, but it's found a path that's changing ideas of how to treat those who can no longer take care of themselves," adding, "sometimes it truly does take a village" (Planos, The Atlantic, 11/14).

    How to better manage dementia patients

    Both acute and post-acute care settings are critical in dementia care—and they have to work together. We've seen many strategies for managing patients across both organizations, but there are a few development areas we think you should focus on.

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    More from today's Daily Briefing
    1. Current ArticleHow a 'Truman Show'-style nursing home is changing dementia care

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