Dementia Villages – the Future of Dementia Care?
Aging doesn’t automatically lead to dementia, but as more people live longer, more will develop it
In the 1980s, I worked with a nurse from another province whose dad back home had developed dementia. As his dementia progressed and his wife could no longer care for him, the nurse’s dad was admitted to a unique “dementia floor” at a local hospital. The staff, from janitorial to medical professionals, were matched with residents to help them maintain their interests for as long as possible.
A janitor took my colleague’s father under his wing because her dad was a tinkerer who was always fixing things. So Janitor and Dad would go about their day working on what needed to be repaired or adjusted. Dad was busy and happy; my colleague was relieved that her father was in a good place.
I remember thinking that this was such a great idea – and I wondered, why don’t we do that? Why don’t more facilities and organizations take this kind of approach?
Some people equate aging with forgetfulness, leading to dementia. That’s not the case though.
We often had patients on our medical floor who were in various stages of dementia. That wasn’t the place for them. We did our best, but they needed more than just the physical care we provided. I remember one patient in particular, Mrs. J. One day, as I was coming in to work an evening shift, I found her in her hospital gown on a busy street corner. Mrs. J was always trying to get out because she needed to catch a bus, the 105 to be specific.
One nurse came up with an idea. She made a bus sign and stuck it on a wall in the hallway. She set up a chair below the sign and whenever Mrs. J showed signs of bolting, she was encouraged to sit at the “stop” and wait for the bus. Sometimes she would do so on her own. We would pass her and greet her, asking how she was. She’d tell us she was waiting for the bus. She was happy and would eventually get up and wander back to her room. Interestingly, some people – including visitors – didn’t agree with this approach. They said we were “feeding into her delusions.” We said we were keeping her happy and safe.
Another thing Mrs. J liked to do was help with housekeeping tasks. We’d find her in the utility room handling stuff she shouldn’t – like dirty laundry. So we devised a system to keep her distracted. We’d take a pile of clean facecloths and towels, mess them up, and then tell her we were too busy to fold them – would she be able to do us a favor and fold them for us? Oh, she was so happy to be asked!
Dementia is not inevitable
A study published in 2022 found that one in 10 U.S. adults have dementia (10%) and another 22% have mild cognitive impairment. This is the early stage of memory loss, or language or visual/spatial perception but people with MCI can often continue to live reasonably independently.
Dementia rates are also affected by factors other than age. “The data show a disproportionate burden of dementia among older adults who self-identified as Black or African American, of mild cognitive impairment among older adults who identify as Hispanic, and both categories of cognitive impairment among people who had fewer opportunities to obtain education,” wrote the author of an article published by Columbia University.
Some people equate aging with forgetfulness, leading to dementia. That’s not the case though. Getting older doesn’t mean you will get confused, forget your loved ones, or forget how to care for yourself. If this is the case though, why is the number of people in the U.S. who develop dementia rising? The actual prevalence (proportion of people who develop dementia) is dropping, but more people are getting older. This is why.
In 1920, only one in 20 people in the U.S. were 65 or older. In 2020, this was one in six – almost 56 million people. And the growth continues. The aging U.S. population will double between 2000 and 2040. How are we going to care for them all?
Retirement villages
I first read about the concept of retirement villages several years ago. Being of Dutch heritage, I felt a small tingle of pride that the Netherlands came up with the concept and ran with it.
(I gifted this New York Times article so you can read it if you don’t have a subscription: As Cases Soar, ‘Dementia Villages’ Look Like the Future of Home Care.)
The 4-acre town is designed so people with dementia can go about their lives, drinking at a café, getting haircuts, grocery shopping, or going to a movie before returning to their private homes. The staff, including medical professionals and social coaches, outnumber the residents and ensure that everyone is safe and cared for.
The idea has spread somewhat. Norway now has a dementia village and Australia has a “microtown” dementia community. The U.S. doesn’t have a similar setup yet, but one is in development, set to open in a few years in Holmdel, N.J.
I would love to see this concept become more common. There could be villages or smaller projects, like gated groups of homes clustered together in a city or suburb. High-rise buildings with courtyards or an atrium could also work. The possibilities are endless. The goal is to keep the residents safe and secure while allowing them to live doing what they enjoy for as long before they become immobile and need more involved care.
The aging U.S. population will double between 2000 and 2040. How are we going to care for them all?
What do you think?
Are dementia villages, towns, or communities the answer to the growing number of people needing dementia care? Are there better options? Let me know in the comment section below what you think or your own experiences with dementia care. Let’s get a conversation going.
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I like to think that just because I am getting older doesn’t mean I have to become forgetful. I also have read some scientific journals that attribute some of the dementia to lose of hormones, and begins for many women during peri menopause. It is a whole other topic for how do we care for the ones who need it most. As our ancestors did in their homes, today it is thought of as a burden, and many pay dearly to have their aging parents taken care of properly. I’ve been reading The Nordic Theory of Everything by Anu Partanen and she describes when she moved to America she had great anxiety about how there was no support from the government to care for aging family members and how alone she felt. This is still true in America and is a big problem that hasn’t been addressed. It is a sad reality. I had some neighbors when I lived in the city who paid $80K just to get on a list of an assisted living apartment and the cost was absolutely incredible. Not everyone is as lucky as they were because they have the funding required. Once again the gap between the wealthy and the poor is widening.