What is are dementia villages? And why don’t we have them?

Read the excerpts from this article, or for a fuller explanation, click its link to go to the full article.

The most important paragraph may be this: The effort could be more difficult in the United States (than in the Netherlands and other euro nations), where the costs will fall primarily on individuals rather than governments.

People had been reticent to do it in the U.S. because it’s a private-paying market, as opposed to Europe, which is all socialized medicine.

But the U.S. government is Monetarily Sovereign. It has the infinite ability to pay for anything, and without levying taxes.

By comparison, the euro nations are monetarily non-sovereign. Unlike America, they cannot create money at will. Their taxpayers pay for everything.

So, again, why will this great idea be “more difficult in the United States“?

As Cases Soar, ‘Dementia Villages’ Look Like the Future of Home Care

By Joann Plockova, New York Times, Reporting from Weesp, the Netherlands, July 3, 2023

On a recent morning in this quiet village outside Amsterdam, an older woman stocked shelves inside the local supermarket.

In the plaza just outside the store, a group of men sat around a table, chatting the hours away. Over in the town square, a woman in a hijab sipped coffee outside the cafe.

If it looked like a typical Dutch town — with a restaurant (which is open to the public), a theater, a pub, and a cluster of quaint two-story brick townhomes on a gridded street map — well, that’s the point.

Many people here don’t realize that they are living in the world’s first so-called “dementia village,” and it can be difficult for visitors to tell the difference between the residents and the plainclothes staff.

Since 2009, the Hogeweyk, which sits on four acres in the Amsterdam suburb of Weesp, has aimed to “emancipate people living with dementia and include them in society,” according to its website.

The community, funded by the Dutch government and currently serves 188 residents in 27 houses, marked an evolution from traditional nursing homes by offering residents (and their families) humanized care that feels more like home.

Residents at the Hogeweyk, all suffering from severe dementia, move about the village freely and interact with fellow patients.

They also interact with the trained staff — nurses, doctors, psychologists, physiotherapists, and social coaches — who far outnumber the residents and blend into the community’s daily life.

At the supermarket, for instance, residents can buy food, shampoo, or a postcard, but no real money is exchanged, and the cashier is trained to care for people with dementia.

The homes, which house six or seven residents, come with a living room, kitchen, private bedrooms, a laundry room, and outdoor space, and professional support is available day and night. New residences become available only when a resident passes away.

Over the past decade, as the number of dementia cases has exploded worldwide, more “dementia villages” and senior “microtowns” have opened across the globe.

But experts worry that if the senior-care community is going to keep pace with diagnoses, there will have to be another major paradigm shift, and quickly.

In essence, they want the Hogeweyks of the future to resemble real towns and be real towns.

When the Hogeweyk opened its doors, about 35 million people lived with dementia worldwide. Today, that number is more than 55 million, and the World Health Organization expects it to reach 78 million by 2030. 

“The numbers are increasing because the population size is increasing, and the population is aging,” said Dr. Tarun Dua, who heads the Brain Health unit at the W.H.O.’s Department of Mental Health and Substance Use. “This is not something that is going to go away.”

To meet the moment, several facilities around the world — many inspired by Hogeweyk’s “dementia village” — are working to push the model forward by further integrating dementia villages with their surrounding neighborhoods.

In Baerum, Norway, a municipality in the suburbs of Oslo, the Carpe Diem dementia village opened in 2020.

It was conceived as a pilot project to handle the anticipated strain on the senior-care community in Norway, where the number of people living with dementia, roughly 100,000, is expected to double by 2050.

Like the Hogeweyk, Carpe Diem uses its 4.4-acre built environment — two- and three-story buildings in varying shades of brick and wood — to create a contained civic space where residents can roam freely, with supervision.

There is an urban square, landscaped spaces, a looping path, and a “street” with a pub, a salon, and a boutique. The complex, designed by the Nordic Office of Architecture, comprises 136 communal housing units and 22 high-care dementia units.

“The biggest difference, maybe, between Carpe Diem and other nursing homes is that we bring and invite the local society into our village,” said Anne Grete Normann, village manager at Carpe Diem, in a video about the project.

Local neighborhood residents can participate in activities, dine at the restaurant, get a haircut, or walk the manicured grounds.

“Having an open village means a lot, both to those who live there and those who visit,” Ms. Normann said in an email. “The fact that more than just relatives come into the community means that more people become familiar with dementia and life with dementia.

We hope to achieve less stigmatization of this group in society.”

The local municipality is now planning a new nursing facility that further blends into everyday life in the nearby town of Rykkin — set to include a children’s nursery on the same site.

Half a world away in the town of Bellmere, Australia, NewDirection Care at Bellmere describes itself as the world’s first “microtown” dementia community.

Residents live in what resemble typical single-story homes — there are 17 in four different styles, with seven residents per home. The town center includes a corner store, cafes, a salon, and a cinema.

“It’s very much like a suburb in Australia,” said Natasha Chadwick, the facility’s founder and chief executive.

This “microtown” is fully inclusive, mixing dementia patients, including younger ones suffering from early onset dementia, with senior residents who haven’t been diagnosed with dementia.

“The fact that residents lived in houses with just six other residents was a huge plus for me,” said Elsie Marion Scott, 93, who has lived at NewDirection for just over five years and is not diagnosed with dementia.

“I also have a GOPHA,” she said, referring to a three-wheeled electric scooter, “and I can go up to 7 11 and soon Woolworths when I choose.”

The next step is to mix in more residents at a planned high-rise community that will house younger residents and “someone who might be living with severe dementia as well as someone who might have a physical disability.

There are no dementia villages in the United States, apart from a Hogeweyk-inspired dementia-care day center in South Bend, Ind.

But one is in development in Holmdel, N.J., with plans to open its doors in the next two to three years.

Designed by Perkins Eastman, an architecture firm based in New York, Avandell will comprise 15 homes in a farmhouse aesthetic to reflect the rural surroundings. The suburban-style community is set to include a town center with a grocery store, bistro, and community center.

The effort could be more difficult in the United States, where the costs will fall primarily on individuals rather than governments. People had been reticent to do it in the U.S. because it’s a private-paying market as opposed to Europe, which is all socialized medicine.

In low- and middle-income countries where there may not be resources to build these stand-alone facilities, the community-based approach could be the way of the future.

For those with severe dementia who need extra support, the traditional dementia village will continue to have its place, said Paola Barbarino, chief executive of Alzheimer’s Disease International and a member of the World Dementia Council.

“But not at the cost of shutting people living with dementia outside of the community,” said Ms. Barbarino, who lamented the “huge amounts of stigma” still attached to the condition.

“Because we still think that having people in the community, with a community informed about their condition and what they are experiencing, can help them live a better life.”

Ms. Spiering, the Hogeweyk founder, agrees, but the real challenge, she said, is a major cultural shift. “It is not a challenge to create something like this,” she said.

“The more challenging thing is to create a society where people are really included, whatever label or diagnosis they have.”

No, the real challenges are to convince America’s voters and political leaders that:

1. Our Monetarily Sovereign nation already has all the financial resources it needs for such projects.
2. No additional tax dollars are needed.
3. It isn’t the dreaded “socialism”; it’s just normal funding and supervision of private initiatives.
4. And people with dementia are well worth helping.

Both parties, but particularly the GOP, have no interest in helping the not-wealthy sick, as witnessed by their preoccupation with ending ACA (Obamacare) and limiting Medicare and Social Security.

We need intelligence and compassion from our voters and leadership from our political leaders, all of which are in especially short supply in America’s right wing.

Rodger Malcolm Mitchell
Monetary Sovereignty

Twitter: @rodgermitchell Search #monetarysovereignty
Facebook: Rodger Malcolm Mitchell

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Government’s Sole Purpose is to Improve and Protect People’s Lives.

MONETARY SOVEREIGNTY