As an elder care law firm which places a great emphasis in health care advocacy, our goal is not to work within the existing long-term care system. Our goal is to work towards changing the long-term care system in this country for the better. We as society should be doing much more for an increasingly aging population.
With these goals in mind, in November 2016, I had the privilege traveling to the Netherlands as a member of the National Academy of Elder Law Attorneys (NAELA) delegation. The goal of the trip was to learn about how health care and legal services are provided to seniors in the Netherlands compared to the US model.
My main purpose of participating in the delegation and the highlight of the trip (visiting the Anne Frank house and the old Jewish Quarter in Amsterdam was also memorable) was the opportunity to visit the renowned “dementia village” outside of Amsterdam called Hogeweyk.
Hogeweyk is a specially designed village with 23 houses for 152 dementia-suffering seniors. There is no similar type of specialty designed dementia housing in the United States. Unlike dementia facilities in the US where all residents reside in the same type of housing, at Hogeweyk, seniors who need nursing home dementia care live in houses differentiated by lifestyle. The residents opinion on life, housing, values and standards determine their “lifestyle”. Hogeweyk offers 7 different lifestyles: upper class, rural, Christian, artisan, Indonesian, cultural, and traditional.
Every Hogeweyk home houses six to eight people with the same lifestyle. People live together with other people sharing the same ideas and values in life. This makes the place where one lives a home. This lifestyle can be seen in the decor and layout of the house, the interaction in the group and with the members of staff, day to day activities and the way these activities are carried out. The residents manage their own households together with a constant team of staff members. Washing, cooking and so on is done every day in all of the houses. Daily groceries are done in the Hogeweyk supermarket. The village has streets, squares, gardens and a park where the residents can safely roam free. Hogeweyk also offers a restaurant, a bar and a theatre.
In Hogeweyk, the residents live in a place that looks and feels like home, even though it’s not. What others know to be a façade, the residents see as reality, which may help them to feel normal in the midst of dementia. The question a place like Hogeweyk confronts is how much of dementia is a result of disease, and how much is a result of how we treat it? Hogeweyk has not found a cure for dementia, but it’s found a path that’s changing ideas of how to treat those who can no longer take care of themselves.
In the years since Hogewyk’s founding, dementia experts from the United States and many other countries have flocked to the small Dutch town outside Amsterdam in the hopes of finding a blueprint for similar dementia care. While dementia-only living facilities are plentiful in the United States, none of them have offered the amenities or level of care Hogeweyk provides.
There are significant barriers, such as costs, to building a similar community in a non-socialized healthcare system, such as the U.S. However, we should do better. We must do better. Such a concept needs to be brought to the United States to reshape the face of senior care. It will take significant time, money, effort, and advocacy. We can start with the refrain, Let’s Go Dutch.