How dementia villages work

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At first glance,

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the Hogeveig looks a lot like any other neighborhood in the Netherlands.

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It's got a restaurant,

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barbershop,

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theater, grocery store,

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and open green space.

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You can see people walking around,

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getting groceries and having coffee.

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The difference is that this neighborhood is a facility

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for people with severe dementia.

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And everyone else in it,

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from grocery store cashiers to barbers to waiters,

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are trained in dementia care.

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This model of care has been dubbed a dementia village.

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As people continue to live longer around the world,

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the proportion of older people in the population will continue to rise,

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and that means a steep increase in the number of people with dementia.

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Caring for that population will require designing environments

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that help people feel safe and free,

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even as they lose the ability to recognize the world around them.

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And the architects behind dementia villages think they might have figured out the formula to

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do it.

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So, and this is the Hogeweg.

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Social life is happening there,

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so you can see it now.

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That's Eloy van Hal,

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one of the Hogeweg's founders.

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Dementia,

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it's of course a brain disease.

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If you look at your life as a photo album,

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you forget the last pictures.

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The last pictures,

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they fall out of the album,

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and so you remember the past better when you were younger.

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And that's a daily challenge for the individuals.

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How to live with memory loss.

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In early stages,

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people with dementia can live at home,

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looked after by family,

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friends,

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or home care,

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but they eventually need full -time care.

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Often, that care comes from traditional nursing homes,

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but those settings can be sterile and clinical.

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You all dine together in a big dining area.

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You all have to listen to the same music at the same time,

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where you're forced as a person into a program of the

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institution.

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There's not that much attention towards who

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are you really,

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what is my life story,

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who am I,

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what do I prefer to do during the whole day.

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In any setting,

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the goal of good dementia care should be to preserve quality of life as dementia progresses.

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In traditional settings like nursing homes,

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surface level changes are a good place to start.

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Since people with dementia might perceive dark tiles as holes,

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floors should be visually consistent without contrasting patterns.

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Brightly colored doors and handrails help residents navigate around,

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and bright dishware has been shown to help people with Alzheimer's eat more food.

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Acoustic ceiling tiles,

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carpeted floors,

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and soft furniture can absorb noises that trigger disorientation.

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Glass -fronted cabinets help residents have a clear line of sight to what's stored inside,

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and lighting fixtures that mimic natural light strengthen residents' circadian rhythms,

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which helps mitigate sundowning,

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where people with dementia become confused in the evening and night.

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Some of the advisers about lighting,

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clear lines,

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surface patterns,

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and so are based on institutions.

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Instead of normalizing the environment,

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all those elements are essential.

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But sometimes they are the solution for an institution.

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But the Hogevig's design solution is different.

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Instead of changing surface -level design to preserve quality of life for people with

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dementia, they took a structural approach and designed their facility to

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look as much like the outside world as possible.

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Our guiding principle here is normalcy.

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It's their vision and normal life for people living with dementia.

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That starts with lodging.

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Traditional nursing homes keep all of their residents under one roof.

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But real households don't typically consist of dozens of people.

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So the Hogeveik split its residents up into small groups of six or seven,

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recreating the scale of a single -family home.

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Inside,

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each resident has a private room,

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furnished with personal belongings.

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The units are split up into different neighborhoods to mimic Dutch cities

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that residents are used to.

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The public space,

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the gardens,

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the streets,

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the squares.

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They are equally important if you want to build a community where people

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live.

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Each neighborhood's public space was given distinct landscapes and unique landmarks

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so people could easily find their way around.

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And destinations like the theater,

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barbershop and grocery store were put in separate buildings,

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encouraging intentional movement and intermingling in that public space.

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These different areas provide multiple scales of experience.

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And residents are given the autonomy to safely wander along that spectrum,

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from very private to very public space.

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That autonomy helps further preserve quality of life.

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People stay in their own bedroom.

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Many people socialize in the living room.

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But you can also decide to leave the house because the front door is open and

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to walk to your own private outdoor space,

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your terrace or balcony or your own garden.

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or you walk further into the neighbor where you can mingle so

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it's about choice choice choice where you want to be during

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the whole day and with whom

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Crucially, the Hogevegs design allows for a balance of safe design and

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controlled risk.

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Walkways,

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for example, don't have super high walls to guarantee that no one falls over.

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You see handrails everywhere in institutions.

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The question is,

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do you need a handrail everywhere?

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Or do you want to provide a walker where you can walk with two

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hands on the walker?

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and make it accessible for the walker.

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Since the Hogeveik opened in 2009,

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dozens of other dementia villages have opened across the globe.

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But without ample government funding,

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they can be prohibitively expensive.

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And there isn't enough evidence yet to say whether the dementia village model is better than

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traditional models of care.

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The Hogeveik claims that since they transitioned from a traditional model to the

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village, the number of residents on antipsychotic medication decreased from

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50 % in 1993 to just 8 to 10 % today.

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And there have been studies backing up different features that dementia villages use.

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One review of the evidence found that uncrowded small -scale living resulted in

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fewer psychiatric symptoms and behavioral issues among residents with dementia,

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and that increased daylight lighting reduced their behavioral issues and improved

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spatial orientation.

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Another review found that outdoor gardens can reduce agitation and improve

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quality of life for people with dementia.

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But by creating an environment specifically for people with cognitive and physical impairments,

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dementia villages are a fascinating practice in universal design.

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Design that works for as many people as possible,

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regardless of their ability.

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And they can teach us something about where the outside world falls short.

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If you design well for normal people without

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dementia, you design also well for people with dementia.

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We forgot that people with dementia are human

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beings with a lot of aspirations.

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And we forgot that people with dementia are not patients where you can

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put them in a chair and wait until they die.

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They are people who want to do certain things during the day.

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They know and they are happy to have this freedom.

How dementia villages work

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