An Aging Society #5: Opportunities in Dementia Care
What is exciting about the development of dementia care?
Have you worked in a long-term care (LTC) facility or nursing home? If not, have you ever visited one? Do you think LTC is the most suitable setting for providing care to people living with dementia (PwD)? The majority of people with dementia prefer to stay at home. Though practical problems exist, there are helpful tactics that can make aging in place possible (3). Early detection is key so that innovative tools and technologies can be applied to assist daily living activities such as furniture adaptation, medication dispensers, GPS tracking, special lighting, and fall detection devices (4).
Is there an alternative to the traditional nursing home for PwD if they can no longer age in place? An alternative solution requires one to thinking differently about the problem. Thinking differently ignited a revolution spearheaded by a social worker/occupational therapist Yvonne van Amerongen 30 years ago. Yvonne was the care manager in a traditional care home in Amsterdam. At the time, she would not recommend her parents to stay in the nursing home that she worked in because she believed that people need to feel respected for who they are even if they are suffering from illnesses. She did not believe the traditional nursing home model was meeting the needs of people with dementia. Instead of feeling embarrassed about this dilemma, she started to think differently and acted toward a solution that aligned with what PwD needed.
In 1993, Yvonne became a full-time project manager for the development of a village-style care home designed for a group of psycho-geriatric clients. Today, the groundbreaking HogeweyK dementia care center awakens us with possibilities and reimagined a nursing home that is grounded on freedom, meaning, and social life. You can watch Yvonne’s story here.
Following up on the concept of “dementia village” vs. a traditional nursing home, we can now see many “dementia villages” are opening up or underway in different parts of the world including Denmark, Switzerland, Ireland, Germany, France, UK, Australia, Scotland, Japan, Norway, Italy, USA, and Canada. The Canadian Agency for Drugs and Technologies in Health (1) encourages further research and evaluation on dementia villages based on the HogeweyK concept to inform policy makers in future development work. In Canada, we have the first Dementia Village, located in Langley, British Columbia. This special care home is called “The Village”. This is truly an active movement since a few more projects in Canada are underway. You can watch the news clip on Canada’s first dementia village here.
The Village is a private facility where residents live in cottage-style houses in a small community. A second dementia village community with a capacity for 116 residents is planned for Vancouver Island, Comox, British Columbia. This facility will be publicly-funded, serving people with dementia. Though much work awaits to overcome the considerable capital (construction) and operational cost (staffing and training) in this new care concept (1), this can be a step toward a grand vision.
When more people start to think differently and refuse to do something just because “we always do it this way,” transformation is possible. Hats off to Yvonne for her courage, attitude, openness, and lifelong learning inspire us all.
What can happen as you start thinking differently about dementia care?
What are you doing today that you think does not fill the needs of the people you are serving?
References:
(1) CADTH (2020). Dementia Villages: Innovative Residential Care for People With Dementia. Retrieved December 01, 2020, from https://www.cadth.ca/sites/default/files/pdf/in_brief_dementia_villages_innovative_residential_care_for_people_with_dementia.pdf
(2) Raak ICT BV, W. (n.d.). Home. Retrieved December 01, 2020, from https://hogeweyk.dementiavillage.com/en/
(3) Thoma-Lürken, T., Bleijlevens, M. H., Lexis, M. A., Witte, L. P., & Hamers, J. P. (2018). Facilitating aging in place: A qualitative study of practical problems preventing people with dementia from living at home. Geriatric Nursing, 39(1), 29-38. doi:10.1016/j.gerinurse.2017.05.003
(4) Vinick, D. (2019). Dementia-friendly design: Hogeweyk and beyond. British Journal of General Practice, 69(683), 300–300. https://doi.org/10.3399/bjgp19X703949
