[100-Year Brain Health⑧] An Entire Village of Dementia Patients... Hogbeck as a 'Small Society'

The World's First Dementia Village Established in 2008
Shopping and Cooking Desired Foods Directly
Respecting Choices and Preferences... 25 Club Activities

Residents of the dementia village shop for groceries and cook meals themselves within their accommodations before eating. At Hogbek, they sit around the dining table and eat just like in a regular household. Photo by Hogbek Dementia Village.

Visiting the Netherlands, a Leading Country in Dementia Care

The Netherlands is the country that holds the most titles as the ‘first’ among advanced dementia care nations. In 2008, it established the world’s first dementia village where dementia patients are treated as ‘residents,’ and in 1997, the ‘Alzheimer’s Caf?,’ a meeting place for dementia patients to interact with others, was first started in the Netherlands. To directly observe advanced cases of dementia care, a crucial challenge for brain health at 100 years old, Asia Economy visited the Netherlands from the 23rd to 24th of last month.

[Asia Economy VISP (Netherlands) = Reporter Kim Young-won] "Goede morgen (Good morning)."

Two women dressed in jeans and comfortable T-shirts and dresses were pulling carts and cheerfully greeting with a morning hello. At 10 a.m., approaching lunchtime, it is common to see groups heading to the supermarket tucked away in the alleys of Hogeweyk, the dementia village in the Netherlands. It looks no different from an ordinary village, but among the two women pushing carts in casual clothes, one suffers from severe dementia. Eloy van Hal, the manager and founder of Hogeweyk village, said, "Even I don’t know who the caregivers or dementia elderly people were among those who just passed by," adding, "That’s how normal daily life is here."

The World’s First Dementia Village, 'Hogeweyk'

Hogeweyk village, established in 2008, is the world’s first dementia village. It was built on a 15,310㎡ site where a nursing home had stood since 1970. Co-founder Jannette Spiering, while working at the nursing home on the Hogeweyk site in 1993, felt that "this place could not even be recommended to families," which led her to conceive a new system and break ground for the dementia village in 2002. Currently, 187 elderly residents with severe dementia live in Hogeweyk village. Seven residents, averaging 85 years old, live in one two-story building. One fixed caregiver is assigned per household. These caregivers, dressed as freely as the dementia residents, use computers inside the house in places that do not look like offices or living rooms. Eloy explained, "Because dementia patients have difficulty adapting when the people they frequently meet change, we assign staff to each house."

Eloy described the dementia village as a ‘small society.’ It respects individual life rhythms and allows residents to live their daily lives naturally. The internal buildings resemble everyday scenes. Although it is a dementia care facility, the roads are not artificially smoothed but kept uneven like regular streets. The management office, responsible for repairing various equipment in Hogeweyk village, is decorated like a camera shop to avoid disrupting the village’s identity. Various types of cameras were displayed in glass showcases.

Two women are coming out after shopping at the entrance of the supermarket inside the dementia village. The supermarket is an important space in the dementia village where daily life interactions can take place. Photo by Hogbeck Dementia Village.

The supermarket plays the most complex role in this small society. Unlike nursing homes that prepare and serve meals in bulk, Hogeweyk residents decide what they want to eat and head to the supermarket to cook. Eloy said, "Going to the supermarket allows interaction with society," adding, "It is common to see people sitting at tables placed in front of the supermarket, watching others as if in a familiar scene." Hogeweyk dementia village prioritizes residents’ choices and preferences. Residents can select not only the food they want to eat but also activities they want to do and their living and resting spaces according to their tastes. The large fountain located in the center of the village is a lively spot that everyone passes through on their way to the supermarket, while the lake park surrounded by buildings offers a calm and quiet atmosphere where residents can rest according to their preferences. Those who want active engagement can apply for 25 club activities. Music clubs are so diverse that they are divided by genres such as classical, folk, and jazz.

Housing facilities are divided into four types based on preferences identified through pre-admission interviews and home visits. The urban-style accommodations mainly house residents who lived in the capital, Amsterdam, and have outgoing personalities. The interior follows Amsterdam trends with purple sofas and red floral wallpaper. In contrast, residents in the traditional-style accommodations across the street mostly lived their lives in their hometowns and read hometown newspapers. There are also formal and international types, each with different preferred foods and interior designs.

Autonomy as a Foundation... Including Health and Care

The process of maximizing daily life for dementia residents also helps their physical health. Eloy pointed to Mr. H, a ‘gentleman in blue’ chatting under a parasol. He said, "Mr. H voluntarily manages the fountain and picks up fallen leaves, walking around 100 to 200 times a day," adding, "He has lived here for seven years and is in good physical condition."

Elderly people are talking in the theater square (Theaterplein) located in the center of Hogeweyk Dementia Village. Photo by Hogeweyk Dementia Village.

There is also a physical therapy room for dementia patients whose bodies stiffen due to reduced activity, but it is used more for sports club activities than for treatment. Eloy said, "Usually, dementia patients sit a lot and receive physical or manual therapy frequently," but "here, residents walk around and do dishes themselves, so therapists mainly give simple instructions to staff working inside the accommodations rather than providing direct treatment."

While emphasizing residents’ daily life and choices, Eloy stressed that appropriate care support is essential. For example, multiple activities are not conducted simultaneously in one club activity space. He explained, "In nursing homes, multiple activities happen in one space, but for people with brain problems like dementia, this can cause confusion," and introduced, "In Hogeweyk, the music club space is clearly designated only for music."

Inspired by Hogeweyk’s model, dementia villages have been established in various countries. Despite the COVID-19 pandemic last year, France opened its first dementia village, Village Landais. A French university is conducting research on this village. Milton Village, created in South Bend, USA, in 2019, adapted Hogeweyk’s idea into a day care center format. In Korea, Yangju City in Gyeonggi Province is promoting the construction of a ‘public dementia-specialized elderly care facility’ in the form of a pension, aiming to emulate Hogeweyk village. Yongsan District in Seoul had planned to build a dementia-safe village in Baekseok-eup, Yangju City, but recently lost a lawsuit to cancel the refusal of building consultations with Yangju City and will discuss future directions through a policy review committee.

/VISP (Netherlands) = Reporter Kim Young-won forever@