'Dementia village' Inspires New Care
By B. Tinker; CNN; 12/27/2013

Theo Visser was thirsty. He got up from his seat during the half-time break in a soccer match to purchase a drink through the concession stand.

"There she was, standing behind the bar," he recounts, 58 years later. "It was love at first sight." Theo asked the young woman to a movie -- and the rest, they are saying, is history.

It's a significant shame, then, that Corrie Visser doesn't remember any of this. Or if she does, she can't say so. Corrie is just one of 152 residents at Hogewey, a cutting-edge elder care facility on the outskirts of Weesp, the Netherlands, just minutes from downtown Amsterdam.

'Dementia Village' - mainly because it has become known -- is really a place where residents can live an individual you believe normal life, but actually are being watched all the time. Caretakers staff the restaurant, market, hair salon and theater -- although the residents don't always realize these are carers -- and are generally watching within the residents' living quarters.

Residents may roam freely across the courtyard-like grounds using its landscaped trees, fountains and benches -- but they can't leave the premises. Dementia care gets a makevover Dementia care receives a makevover Gupta: Residents say they're happier Residents shops as caretakers watch Music is an important therapy

Their two-story dormitory-style homes form a perimeter wall for that village, meaning there is no way a resident can accidentally wander out.

And when they do approach the one exit door, a staffer will politely suggest the door is locked and propose another route.

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Placing a maturing family member the following is far less expensive than round -the-clock, in-home care. It also takes an enormous amount of stress off members of the family who don't have many time or training to care for their loved ones.

Corrie has received a diagnosis of severe dementia, meaning she requires attention and support around the clock. That clinical indication is necessary to gain admittance into Hogewey.

The burden of taking care of Corrie eventually became unmanageable for Theo and the daughters, so together, they made careful analysis place her here.

He says: "It's perfect. I wouldn't know a greater place for her. It's 100% good."

Nearly every day of the week, Theo drives 15 kilometers (10 miles) each method to spend a few hours with his 80-year-old wife.

"I do it for myself," he says. "I need it for myself. She (still) recognizes everyone... so it is important I be here every single day."

Although they cannot chat with one another, Theo and Corrie will usually sit for hours, holding hands and lovingly look into the other person's eyes. Every so often, Corrie supplies a smile, amusing, a squeeze of the hand. At least part of her memory, this indicates, is still intact, though she can't verbalize much today.

Like other residents of Hogewey, Corrie may well not know exactly where she is, but she always feels right in the home. That's exactly the idea.

For Yvonne van Amerongen, considered one of Hogewey's founders, the necessity to create the small village was deeply personal.

"It was the minute my mother called me and informed me my father had passed on suddenly," she recalls. "Nothing was wrong with him. He just had a heart attack and he died. One with the first things I thought was, 'Thank God he never had to be in a nursing home.' That's crazy that I must think that! I'm in the management of a elderly care facility and I don't want my pops to come here."

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Van Amerongen sat down with her colleagues in November 1992 to debate how they could transform the typical nursing home into more worthwhile living.

They designed a 1.5 hectare (four-acre) complex, carried out 2009, that is home to 23 housing units and seven different "lifestyle themes," for example crafts, culture, religious and urban.

Art lovers get paintings for the walls and music is obviously playing while the religious have more conservative décor and Christian crosses about the walls.

The simple goal: provide you with the most normal possible life, similar to each individual's childhood.

From the furnishing of her unit on the decorations and the type of food served, Corrie is led to believe that nothing in their own life has changed. It's this sense of normalcy that they strive for day in and trip to Hogewey.

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In many ways, this can be similar to the manufactured reality depicted within the movie "The Truman Show," the place where a man played by Jim Carrey discovers his entire every day life is actually a TV program. Everything he thinks is real is certainly a mirage, created by television producers for your viewing public's entertainment.

Van Amerongen dismisses any accusations that she and her staff are duping their residents. "We have a real society here," she says. "I don't even think people feel fooled. They feel fooled whenever we just inform them a story that is not true and so they know it. We're not telling stories."

But telling stories is really what some of the residents do, the entire day, including Corrie's housemate, Jo Verhoef. Like all of Hogewey's residents, Jo's dementia is rapidly progressing. Her "loop" gets shorter; the conversations she carries and the questions she asks are getting to be more repetitive inside a shorter timeframe.

"Do you know Steve Matthew?" she asks, several times over the course of an hour. Of course, no-one does, but each time she seems surprised we haven't met. *

Steve is often a relic of Jo's past, a distant, foggy memory of a baseball player she says lived along with her for a short period of time when she was younger. Or, he is often a figment of her imagination. Sadly, we'll don't know.

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Worldwide, 35.6 000 0000 people have dementia, according for the World Health Organization, with 7.7 million new cases being diagnosed each year. At that rate, the amount of people with dementia is predicted to double by 2030 and triple by 2050. This will be an additional burden for governments already struggling to support the runaway costs of medical.

In Holland, everyone pays into the state health care system throughout their working years, with the money then disbursed to fund later-in-life expenses - and that means moving into Hogewey doesn't cost any more than a traditional nursing home.

Could this innovative model are employed in other countries? Health care industry leaders in Germany, England, Switzerland and Japan are all beginning to take notice. At Hogewey, says van Amerongen, "We have Dutch design, Dutch cultures, Dutch lifestyles, though the concept is usually to value the person, the average person... to support the crooks to live their life as usual, and you may do that anywhere."

On an actual level, residents at Hogewey require fewer medications; they eat better, and yes, they live longer. On a mental level, in addition they seem to have more joy. It's a difficult thing to measure, but that is certainly the most important thing at Hogewey.

So could this be employed in other parts in the world? That's the next question.




“Under the care of Leo J. Borrell, M.D. since December 2001, I have seen a remarkable improvement in my mother’s condition. She is responding dramatically to the new regiment Dr. Borrell has prescribed”

- Beth Rose


Feb 3, 2008

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by Dr. Leo J. Borrell, featured in Assisted Living Consult for November/December 2006. A HealthCom Media Publication