Care Center Hogewey in Weesp (near Amsterdam) is the first dementia village in the world. This weyk or wijk (being a group of houses, similar to a neigborhood or small village), Hogeweyk, which is operational since 2009, is a little community, where seniors with dementia can move freely among the streets, past the little parks and onto the boulevard, with the theater and the doctor’s practice. Safely and independently, they find their way to the supermarket, to the restaurant, the pub or the hairdresser. Even so, the success of dementia village Hogeweyk cannot be solely ascribed to the lovely architecture, but also to its specific concept of care. Within care center Hogewey (part of the Vivium Zorggroep), the professionals do not think from ‘care’ but from the daily life of the residents.

Normal daily life
According to the CEO of the care center Jannette Spiering, dementia cannot be treated at all. Which is why she stopped focussing the care of seniors with dementia on medical issues. Far more important is that these people live a daily life as normally as possible, the way they were used to befor they moved into dementia village Hogeweyk. Especially for people with dementia, it is vital that they feel at home and that things are the way they normally are. Of course, medical care is still important, but it shares the priority with living and well being.

Their own way
And thus, the residents choose when they get up in the morning, what they eat and at what time they go to bed.  With professional support if needed, they are responsible for their own household. They do their own  laundry, get their own groceries and cook their own meals. They participate in social activities just like they did before at home, and at a small financial compensation, they can go for a ride on on a dual bike outside the village.

Cultural lifestyle interior

Lifestyles
This concept has far-reaching implications for the daily practice in this organziation. First of all, the grouping of residents. Whereas in the past residents were grouped based on medical indication,  since a few years, the care center uses a natural grouping based on lifestyles. Dementia village Hogeweyk distinguishes several lifestyles, such as urban, Indonesian, family style, cultural, traditional and christian. In the units with a cultural lifestyle, classical music is played and you’ll find a piano and a large selection of films, and wine is served at dinnertime. In the urban style units you’ll heara popular Dutch singer on the radio and residents are served a Dutch stew with a beer.

Traditional lifestyle interior

Thinking from the unique resident
Another implication of the new concept is that the professionals need to refocus. Their work is not so much about treatment and care as it is about creating a confortable living environment. Instead of taloing about ‘residents with problem behaviour’ they reflect on their own problems with residents’ behaviour. They also learn to listen better and to understand the unique background of each resident. Apart from this, every employee in the care center, whether it is a cleaner or receptionist, is being taught about dementia and the way of thinking in this particular care center.

And sometimes you fall
Offering a daily life that is as normal as possible, cannot be done without accompanying risks. Residents of dementia village Hogeweyk are more mobile and move much more than those in other care centers. This allows them more freedom, more contacts with other residents, and they feel more healthy and happy. At the same time these residents have an increased risk of falling. Doctors in Hogeweyk are not solet focussed on preventing such incidents, more and more they weigh this risk against a higher quality of life.

Oh yes we can!
There are 23 small living units on the care center grounds, which are 15.000 m2. That the residents are very satisfied, is illustrated by the client satisfactions, which scores 8,9. The use of medication and adult diapers is remarkably low and the residents do not pay more than in other care centers. Regarding quality assessment CEO Jannette Spiering feels that there is more need for dialogue with assessors instead of stand criteria. More important than compliance is to be able to explain why certain procedures and rules are not being used, as they are contrary to the new concept of ‘living as normally as possible’.

Source: Duurzaam Nieuw Organiseren. Article by  Wouter Hart, 27 March 2014.