Where are there dementia villages? A global guide to innovative memory care

The number of people living with dementia is projected to more than double by 2060, fueling a global search for more humane and effective care models. This growing need has led to the development of dementia villages, a revolutionary approach that moves beyond institutional settings to create a more familiar and engaging environment. But where are there dementia villages, and what do they offer?

Quick Summary

Dementia villages exist in several countries, including the Netherlands, Canada, the UK, and the US, providing a non-traditional memory care option. These communities are designed to resemble small towns, offering residents with dementia a sense of autonomy and normalcy within a safe, secure setting.

Key Points

• Global Examples: Dementia villages can be found worldwide, with the most famous being The Hogeweyk in the Netherlands, which inspired many others.

• Normalizing Life: The core concept involves recreating a small, familiar town environment to give residents a sense of normalcy and freedom.

• Person-Centered Care: Staff focus on each individual's remaining abilities and preferences, not their disabilities, supporting them to live an autonomous life.

• Reduced Medication: The calming, community-focused environment has been shown to reduce the need for psychotropic medication in residents.

• Not Just for the Elite: While expensive to build, funding models and adapted versions are expanding access. Some facilities integrate village elements into smaller settings.

• Challenges Remain: High construction costs and staffing needs are major barriers to wider implementation, requiring ongoing research into sustainability and efficacy.

Pioneers in dementia village care

The Netherlands: The Hogeweyk

The Hogeweyk in Weesp, Netherlands, is the world's first and most famous dementia village, serving as the blueprint for similar communities globally since its opening in 2009. It is a gated, 4-acre community designed to mimic a regular village, complete with a town square, supermarket, hair salon, and restaurant. Residents live in small, shared houses with trained staff who act as neighbors and friends rather than clinicians in scrubs. The village focuses on maintaining normalcy and personal autonomy, which has been shown to reduce residents' stress and reliance on medication.

Other dementia village locations

Following the success of Hogeweyk, similar models have been developed and implemented in numerous countries, each adapting the core philosophy to local culture and needs. Key examples include:

• Canada: The Village in Langley, British Columbia, opened in 2019, providing a similar village-like environment. Its design emphasizes walkability and community engagement within a secure, home-like setting.
• United States: While full-scale dementia villages are less common due to high costs and different healthcare funding models, innovative dementia care is growing. Inspired by Hogeweyk, Glenner Town Square in San Diego uses reminiscence therapy by creating a 1950s-style town square. Other US facilities, like Lutheran Senior Services' Towne Plaza in Missouri, have incorporated elements of the model.
• United Kingdom: The Grove Care Home in Bristol has incorporated a village-like design with a cafe and small shops. There are also plans underway for new dementia villages in Scotland.
• Italy: Villagio Emanuele in Rome is a project inspired by the Dutch model, aiming to provide a similar sense of freedom and community for its residents.
• India: NKISA in Bangalore is another example of a village designed on the principles of De Hogeweyk, adapting the model to the local context.
• Switzerland: A village was in the works near Bern, adapting the concept for Swiss residents.

How dementia villages work

The fundamental philosophy of a dementia village revolves around person-centered care, emphasizing a resident's remaining abilities rather than their disabilities. Key operational aspects include:

1. Normalization of life: The environment is structured to mimic normal life, with residents participating in daily activities like cooking, shopping, and social events. This approach can reduce agitation and improve mood.
2. Specialized staff: Staff are highly trained to care for individuals with dementia but wear normal clothes and integrate seamlessly into the community. They are present to assist when needed but do not interfere with residents' independence.
3. Secure but open environment: The village is a secure, gated community, but residents are free to wander and explore within its confines, reducing the sense of confinement often felt in traditional institutions.
4. Lifestyle-based living: Residents are often housed with others of a similar cultural or social background. The Hogeweyk, for example, has different living styles, including urban, aristocratic, and homemaker-focused houses.

Comparison: Dementia Villages vs. Traditional Memory Care

Feature	Dementia Village	Traditional Memory Care Unit
Environment	Resembles a small, familiar town with streets, parks, and shops. Non-institutional and home-like.	Often clinical, with a main hallway and institutional features. Can feel impersonal.
Resident Autonomy	High degree of freedom within a secure perimeter. Residents can shop, stroll, and socialize independently.	Often restrictive, with more limited movement due to safety concerns. Strict schedules are common.
Staff Role	Staff act as neighbors, friends, and subtle guides. They wear regular clothing to reduce the institutional feel.	Staff wear uniforms (scrubs) and their role is clearly defined as a caregiver. Schedules are medically-driven.
Activities	Emphasis on normal, everyday activities like cooking, gardening, and shopping. Activities are based on resident interest.	Structured, scheduled activities organized by staff. Less emphasis on recreating 'normal life'.
Medication	Often results in reduced need for psychotropic medications due to a calmer, less stressful environment.	Higher reliance on medication to manage symptoms like agitation and anxiety.

The future of dementia care

Despite the significant benefits, the dementia village model faces challenges, including high initial construction costs and ensuring a sustainable, equitable funding model. However, the concept has spurred a global conversation and represents a hopeful paradigm shift in how society approaches dementia care. While a full-scale village may not be feasible everywhere, incorporating elements of person-centered care and normalization can improve the quality of life for individuals with dementia in any setting.

More research is needed to fully understand the long-term outcomes and cost-effectiveness of this model. Nevertheless, the commitment to providing a life of dignity, meaning, and freedom is a valuable lesson for the future of senior care. As the population ages, innovative and compassionate solutions like dementia villages will become increasingly important. For more information on this innovative model of care and others, visit the website of the National Institute on Aging.

Conclusion

Dementia villages represent a powerful evolution in memory care, with real-world examples in countries like the Netherlands, Canada, and the UK demonstrating the potential for more humane and dignified living. By creating environments that normalize daily life and prioritize personal autonomy, these communities offer a stark contrast to traditional institutional care. While challenges exist, the model's success in improving residents' well-being and reducing agitation offers a promising glimpse into the future of care for individuals with dementia.

Frequently Asked Questions

What is the most famous dementia village?

The most famous dementia village is The Hogeweyk, located in Weesp, Netherlands. Opened in 2009, it is widely recognized as the first of its kind and has inspired the development of similar innovative care models around the globe.

Are there dementia villages in the United States?

Yes, while fewer and often on a smaller scale, dementia villages and facilities inspired by the model exist in the US. Examples include Glenner Town Square in San Diego, which uses reminiscence therapy, and facilities incorporating village-like elements, such as Lutheran Senior Services in Missouri.

How do dementia villages differ from traditional nursing homes?

Dementia villages differ by creating a normalized, community-based environment with features like streets, shops, and cafes. Unlike the more clinical and restrictive feel of traditional nursing homes, they prioritize a resident's autonomy and freedom within a secure perimeter.

How much does it cost to live in a dementia village?

The cost can vary significantly depending on location and amenities. While some villages, like Hogeweyk, receive government subsidies, others can be very expensive. For example, some Canadian models have costs ranging from C$7,000–9,000 per month. Costs often remain comparable to, or higher than, traditional memory care units.

Do residents of dementia villages know they are in a care facility?

In some villages, like Hogeweyk, staff will not deceive residents if directly asked but know that due to the nature of dementia, the answer will likely be quickly forgotten. The environment is designed to create a sense of normalcy rather than a fantasy, with the goal of reducing stress and anxiety.

Is the dementia village model considered better than traditional care?

The model is considered more humane and potentially more effective for improving quality of life for individuals with dementia, leading to reduced agitation and medication use. However, more long-term research is needed to fully compare its efficacy and sustainability against traditional care options.

What kind of staff work in a dementia village?

Dementia villages employ highly trained geriatric nurses, caregivers, and other medical professionals. However, they often wear regular clothing to blend into the community, acting more like neighbors or friends to promote a less institutionalized feel.