Dementia Villages

Maggie Albrecht '25

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The Netherlands is taking a new approach to supporting people with dementia.

In the United States, there were about five million adults over the age of 65 with dementia in 2014, and the CDC projects that there will be nearly 14 million by 2060. An increasing lifespan means an increasing proportion of elderly to the general population. So the question arises: how do we care for people who can’t independently care for themselves?

Today, families, friends, and home care are assisting dementia patients. However, taking care of people who have difficulties with memory, attention, communication, reasoning, and visual perception is not an easy task. As a result, traditional nursing homes have become the solution to the need for full-time care. This model has had issues for the past century, but they come down to lack of personalized care. These places generally lack an appreciation of individuality, as all residents are forced into programs presented by the institution.

But Hogeweyk, a village located outside of Amsterdam, wants to change this. This village houses 152 adults over the age of 65, all with dementia. Hogeweyk started as a traditional nursing facility in 1970, but switched to village-style living in 2008. The physical changes provide the groundwork to thinking about what each patient wants, how they live, and who they really are. There are 23 houses, with about six residents in each, emulating typical family homes in the Netherlands. Each patient has a private room, giving them privacy, but also the opportunity to form connections with others in a comforting setting, whether that’s the home, yard, or village. There are dozens of opportunities for choice, like club meetings, concerts, art exhibitions, markets, cafés, beauty salons, and more. It gives residents the ability to live a live similar to before they had dementia while also being surrounded by employees who can help at any moment. Hogeweyk encourages movement, socializing, and consistency. The intentional design of gardens, streets, and squares serve a dual purpose: to each be unique and not a carbon copy so as to help with navigation, as well as creating outdoor environments that promote time in the sun.

As teenagers, it’s hard to imagine our life looking like this. Especially now that we attend boarding school and are transitioning out of a heavy reliance on adults. Yet by the time we’re nearing the end of our lives, we’ll be regressing back into this reliance on others. Even though it’s far away, we all want the best for the people we care about, because one day we will be there too. But it is also a reminder that choice is a desire for people of all ages. Just as now, we want to choose our balance of solitude and social time. We want to go into town. We want to participate in our favorite activities. We are forming habits and finding our interests, which will last a lifetime. We can’t subscribe to the notion that the eldery are all the same, or that they can be treated without respect because they might not remember it.

It’s not just Hogeweyk. More dementia villages are popping up around the world, like in Denmark, Canada, France, Germany, and Ireland. They begin to raise the question: how do we want to be treated in old age? This idea also raises questions of accessibility. How do we design spaces that work for as many people as possible, not just able-bodied individuals? How can design in a more inclusive way, beyond the ideal of ‘normal people’? For people with dementia, having brightly colored doors and dishware can help with navigation and remembering to eat.

Hogeweyk is designed to support physical and mental limitations. But when looking at our campus, we greatly lack accessibility. Most dorms around campus are considered wheelchair accessible, but only to the entrance, as upper level floors can only be entered through stairwells. In CHLL, there is a bathroom stall and shower stall that are big enough to fit a wheelchair, but if the wheelchair cannot even get to that hallway, how are the accommodated stalls even helpful? This can exclude disabled family members who might visit their student but be unable to move around campus easily. Similarly, students who have used scooters because of injuries are familiar with the extra time it takes to get around campus. Having to take Chapel Road to get to Booth from CHW takes time out of your day, as does taking the science building ramp around to the day walk to cross campus.

Additionally, an important movement to put effort into community building has prompted the rule to not walk around campus with earbuds in. But, some have wondered if we can make room for students to use headphones without music when overstimulated to quiet noise that can be overwhelming. There is no easy solution. It would be a challenge to redesign campus to suddenly be more wheelchair accessible, and the overstimulation headphones exception could create a loophole that other students abuse. But it is still false to presume that all Cate students are able-bodied and neurotypical, let alone, have the same needs. Just looking around at the physical design of campus, we can see that it was intended for able-bodied people. But the range of students who attend Cate now has drastically changed since 1910, and the standards of accessibility need to be broadened as well.

Looking at Hogeweyk prompts us to consider the intention of design, especially who it excludes, and reminds us that general well-being for as many people as possible should always be the ultimate goal.