Alternative Planning: Home, Community And Alzheimer’s Disease

tree leaves memory loss illustration

Populations are getting older, and Alzheimer’s Disease is becoming more common in older people. How do we plan healthy and dignified communities for them?  How do we re-think what it means to be older and maintain independence despite physical and mental barriers to good health? How does community planning, design, and decor itself help to alleviate the effects of the disease?


As someone who’s as sharp as a straight-razor, to become diagnosed with Alzheimer’s was always a nightmare for me.

And why not? According to the latest statistics, a woman in her sixties has a 1-in-6 chance of developing Alzheimer’s, and nearly ⅔ of those afflicted are women. Every 67 seconds, another American is diagnosed with Alzheimer’s, and it’s the sixth leading cause of death today.

Worse is, by 2050, the number of those afflicted is expected to triple worldwide — that is, if the rate of diagnosis continues as-is and doesn’t escalate.

The good news is, people are now studying Alzheimer’s via a different perspective and coming at the disease with new approaches. Some of them are working.

Some believe it is possible for Alzheimer’s patients to enjoy a quality of life and manner of living familiar to them, and to that end, the Dutch “town” of Hogeweyk, or as it’s become known, “Dementia Village,” is creating a world where the patients can live under care without feeling trapped in a hospital.

A safe place

In Weesp, Netherlands, Dementia Village is a unique experiment in Alzheimer’s care that has made news around the world since it opened five years ago. The gist of it is simple. Instead of being hidden away in the sterile world of modern care facilities, the residents here are given a lifestyle reminiscent of that they grew up with.

As CNN explains, “’Dementia Village’… is a place where residents can live a seemingly normal life, but in reality are being watched all the time. Caretakers staff the restaurant, grocery store, hair salon and theater — although the residents don’t always realize they are carers — and are also watching in the residents’ living quarters.”

Comfort through design

With “public spaces” to wander through, stores to “shop” in, and apartments designed to reflect popular styles commonly found in Dutch homes of the patients’ earlier lives, there’s a real-world feel that keeps patients stimulated and comfortable. While the metric for measuring their joy is debatable, those involved in the care and lives of the patients, from families to administration to outside observers, all agree the patients do seem more joyful than those housed in more traditional spaces.

Interior design in Hogeweyk is a critical factor. When surroundings are unfamiliar to patients with Alzheimer’s, it can cause distress and tension for them. With that in mind, none of these apartments lack personal style. Gizmodo tells us more: “At Hogeweyk, apartments are designed to reach familiar cultural touchstones, categorized into six basic “genres” of design: “goois” or upperclass (the decor looks old-fashioned), homey, Christian, artisan, Indonesian, and cultural.”

(Indonesia, of course, was a significant colony for the Netherlands, and even today Indonesian food ingredients like sambal oelek play a role in Dutch cuisine, and its decor touches are still entwined in modern Dutch culture.)

Does it cost more?

Estimated at an approximate care cost of around $8,600 a month, families of patients staying in Hogeweyk pay around $3,600 monthly and the rest is subsidized by the Dutch government.

This is not expensive compared to American care costs, the Atlantic Monthly writes. “A private room at a U.S. nursing home cost an average of $248 per day in 2012, or more than $90,500 annually—a figure that’s even more staggering when applied to the rapid increase in dementia patients globally. By 2030, the number of people suffering from dementia around the world is expected to hit 76 million, which some estimate will cause an 85 percent increase in dementia-related healthcare costs worldwide. By 2050, the U.S. alone will pay a projected $1.2 trillion.”

The cost-effectiveness paired with the quality of life, care level, and dignity afforded Hogeweyk’s patients means other countries around the world have flocked to the Netherlands to study the effect of this groundbreaking care center.

A legacy is born

The critical part of the success in Hogeweyk is that touch of style and culture that harkens back to the golden era of its residents’ lives. As time progresses, those touches will have to change in order to reflect times gone by of new residents.

That’s why, in a trial program initiated in England in 2013, the cultural design touches in their nod to “Dementia Village” center around 1950s English life. Fartown’s Abbey Place Nursing Home features everything from a classic post office to hairdressers and a florist.

Similar plans are underway for another 1950s-style care village in Switzerland.

A brighter future for those living in the past

As a woman in my forties, I realize I have better than a 15% chance of being diagnosed with Alzheimer’s in the coming decades. The more I hear about places like this, where there’s a quality of life that’s still bringing joy to its residents, the more hope I have that such a diagnosis won’t necessarily be as traumatic as it might have been ten or twenty years ago.

If ever there was a story that communicated just how important interior design and public spaces are to our spiritual and emotional well-being, I think Dementia Village is the perfect example.

As demonstrated by the change in decor and mood found in England’s take on this innovative style of care, it’s critical that the culture and history of the patients in question plays a role in what space they’re housed in. For me, I would need a rustic American interior, with wood and antiques and books, because while I love a 1950s post-modern look, it’s not something that I identify with as part of my upbringing and formative years. It seems that emotional connection with the surroundings and the casual daily-life feel of these “villages” is the difference-maker for each of these patients.

Maybe, just maybe, we’re only something here.

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