More than 6 million Americans over the age of 65 suffer from dementia. Alzheimer’s disease is most prevalent cause of dementia. About one in ten older Americans have developed Alzheimer’s disease.
The National Institute on Aging defines dementia as “the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.” In most cases, the disease is progressive. Changes in the brain that cause dementia may begin to occur years before symptoms appear. After early signs of dementia appear, brain function may deteriorate for several years before the disease reaches its final stage.
Family members typically provide dementia care in the disease’s early stages. Caregiving becomes a more demanding task as Alzheimer’s disease reaches its middle stages. Keeping patients safe and comfortable generally requires a full-time effort. Caring for an Alzheimer’s patient at home isn’t a feasible option for every family.
Housing Alternatives for Dementia Patients
Seniors suffering from early-stage dementia are often capable of living independently, although they may need assistance with paying bills, managing medications, and accomplishing other tasks that require an intact memory. If they do not live at home, they might be comfortable in a retirement community, particularly one that offers a meal plan. Even in that environment, they will likely need help at some point from family members or a professional caregiver.
Dementia patients who live with family members might also benefit from regular visits to an adult day care center. Some facilities provide activities (such as games, music, and discussion groups) that could help slow the progress of Alzheimer’s disease. Adult day care also gives caregiving family members a respite that allows them to work away from home.
As the disease progresses, dementia patients may need assistance from a fulltime caregiver. If they need help with their activities of daily living, they might be comfortable in an assisted-living facility. An assisted-living facility may be a short-term housing solution. While some assisted-living facilities provide memory care, most do not.
Memory care facilities are often specialized units in hospitals and nursing homes. They are locked units that prevent patients from wandering off the premises. Some group homes also provide caregivers for seniors suffering from dementia. Since many states do not license or inspect group homes, a senior’s family should conduct appropriate research before choosing a group home.
The New York Times recently spotlighted a future housing alternative for seniors who suffer from dementia. A community named Hogeweyk occupies four acres in an Amsterdam suburb. Its residents all suffer from severe dementia, yet they move about the village without the restraints on freedom that are common to memory care facilities.
Each home in Hogeweyk is occupied by six or seven dementia patients. They live in private bedrooms while sharing a kitchen and living room. Patients are free to leave the home and to interact with their neighbors. Several courtyards, each with a unique design, encourage residents to gather and engage in conversations. Residents can plant gardens, get a haircut, purchase a cup of coffee, or shop at the village supermarket. They don’t pay with real money; cashiers are trained to help them complete their transactions.
This extraordinary freedom eases the minds of patients who would otherwise be frustrated and confused about their inability to travel beyond a locked door. While locking doors is a common strategy to protect dementia patients from the danger of wandering away from a facility, Hogeweyk uses staff members to assure the safety of residents. Trained caregivers outnumber patients. They blend into the community, always keeping a watchful eye on patients, guiding them back to their homes when they stray too far and offering any other assistance they need.
Staff members are trained to calm patients who become agitated. Having the ability to explore the village helps residents maintain physical health and reduces confrontational behavior. Microphones alert staff members when residents leave their homes at night.
Hogeweyk has operated successfully since 2009. It houses 188 dementia patients in its 27 homes. The commitment of resources to Hogeweyk assures that its services are always in demand. Placements only become available when a resident dies.
The Future of Dementia Villages
Offering care that allows dementia patients to live a familiar life is a humane approach to dementia care, but it is also expensive. The Dutch government funds Hogeweyk as part of the universal healthcare it makes available to citizens of the Netherlands.
Dementia villages are operating in Italy, India, and British Columbia. The New Zealand Ministry of Health recently funded a pilot program. Private and publicly funded villages have been developed in England.
While it does not offer housing, Glenner Town Square in Chula Vista, California borrowed parts of the village concept for a dementia day care center. Located inside a 9,000 square foot warehouse, the center recreates a 1950s town, complete with a diner and movie theater.
Unfortunately, the number of patients with dementia is growing faster than the development of dementia villages. In the US, where Medicare does not generally pay for residential care, the cost of joining a village would be prohibitively expensive for many. The private facilities in England cost at least £1,100 (or nearly $1,500) per week. Home care remains the most realistic (and most burdensome) option for many American families. Still, dementia villages offer an extraordinarily caring way to meet the unique needs of patients who suffer from Alzheimer’s disease.