How Hogeweyk “normalizes” dementia

Last month, my column was about my recent visit to the Netherlands for a tour and workshop at Hogeweyk, famously known worldwide as the “Dementia Village.”
The first thing I learned was that no one ever refers to Hogeweyk as a “dementia village.”

This is the term Sanjay Gupta coined some five years ago in his visit and story for CNN. Gupta used that term so his American audience would quickly grasp what he was talking about. But not only do the managers not use the term; they really don’t like it!

Their choice to avoid the term “dementia village” reflects their essential commitment to an atmosphere and practice of “normalcy” in their environment and techniques of dementia care. They are not hiding what they do. They are not ashamed of it. They simply believe that NOT separating people living with dementia from the world in which they grew up is the key to better care and quality of life, and this belief permeates how they think and everything they do.

For example, the people at Hogeweyk actually laughed when one in our group used the term “pet therapy.” We could tell from the blank stares among our delegation that something was going on that we did not understand.
Then they gently explained, “Do you use the term ‘pet therapy’ when little children respond well to animals? No, they simply love animals! It is a natural human response. There is no ‘therapy’ to it. It is the same with people with dementia. Our need to think of their natural love of animals as some kind of ‘therapy’ that we discovered is an example of us setting them apart from the rest of the world, whether we realize it or not.”

This is why, as I mentioned in my column last month, their care staff do not wear scrubs, uniforms, or even name tags. They are just people living in the village with their friends with dementia. As I began to gasp this concept, I began to notice how hard they try at Hogeweyk to pursue normalcy in every little detail.
I also mentioned last month the Hogeweyk has an open gate, but very little trouble with wandering. This is because their residents are comfortable where they are. There is nothing unfamiliar to alienate or frighten them, so they feel little reason to “escape.” Hogeweyk actually encourages mobility, which is not the case in too many of our dementia care facilities in our own country.

Here in America, we certainly grasp this concept of “normalcy,” but we have not yet even begun to dip our toe into the water. For example, we place familiar objects in the rooms of our residents living with dementia, but the moment they leave their room they step into the hallways of a medical factory.

Yes, I use the term “factory!” Our medical care has evolved from the concepts of efficiency and replication spawned by the industrial revolution. This may work well for many kinds of physical illness, but it does not work well for diseases of the mind when change and unfamiliarity can be confusing and frightening.

I wonder if we harm our loved ones with dementia even more by toying with little tokens of nostalgia and familiarity in parts of their environment, then thrusting them into common areas that are similar to the emergency rooms of hospitals or the lobbies of hotels. Surely this must be confusing and jarring to minds that are already struggling to understand why, who, and where they are.

Here is the link to the video of Sanjay Gupta’s visit to Hogeweyk.

Until next time remember: “We all deserve the Best”

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