An insight into dementia villages

A dementia village in Berlin

A new report gives an encouraging insight into the benefits of residential villages specially designed for those with Alzheimer’s and other forms of dementia, benefits that outweigh those of traditional nursing homes.

The report follows the recent positive news about trials into a drug capable of slowing cognitive decline. Now comes information from the Bloomberg Media Company describing much better community environments for dementia patients. It’s all good news at a time when developing better ideas is imperative as the number of people suffering various types of cognitive disease are predicted to triple over the next 30 years. That would mean an increase to 150 thousand in Portugal and 150 million worldwide.

The residential villages are small, enclosed and safe with public spaces to allow those with dementia, their families and friends, professional workers and volunteers to mix freely and enjoy a relatively high quality of life. Such villages have been built in parts of Europe and as far afield as Japan and New Zealand.

“The concept is resonating as societies grapple with aging populations, with rising fundamental questions about what care for Alzheimer’s and other degenerative disorders should look like, and whether the traditional nursing home model is outdated,” according to the Bloomberg report.

It quotes Jannette Spiering, one of the founders of the village idea first convened in the Netherlands: “We said, what do we have to change to make this more of a home? How could we create a community where you can go on with your own life?”  

The Netherlands project, located in Amsterdam, has about 160 inhabitants divided into various groups housed in 23 personalised residences.

In Japan, elderly people already make up almost a third of the population, compared to almost a quarter in Portugal. Japan has been working to ensure those with dementia can stay at home for as long as possible by training more social workers and others to personally engage with those with the disease, but the village concept takes that further by recreating the real world within safely enclosed spaces.

Those living in small village communities may be able to join together in pairs or small groups in doing some everyday things. In New Zealand, for example, the six or seven residents sharing individual rooms in a house can, with help if necessary, make shopping lists, wash clothes, go for walks, do a little gardening or just sit quietly chatting in the village square.

Research is being conducted in a village in the south of France into which safe but open liberties can lessen some dementia symptoms and, if so, how. If researchers succeed in showing that the holistic approach can slow cognitive decline, it could lead to a different approach for dementia care at a time when much of the medical profession and many members of the public have pinned their hopes  - and financial investments – on new but so far moderately effective medication.

People in the French pilot project, launched in the middle of the COVID pandemic, can stroll or be pushed in wheelchairs down walkways and under vaulted arches, stopping to chat with other residents or welcome visitors outside a supermarket, play scrabble outside a cafe, engage in an exercise class on park benches or have a haircut in the local salon.

“Here you are making people better, not by giving them medication, but simply because the environment is nicer,” says Paola Barbarino, CEO of Alzheimer’s Disease International, an umbrella organisation with no financial ties to any of the villages. 

Not everyone is happy with the village concept. The main criticism is that residents are trapped in a make-believe environment. Nor are the villages cheap to build, but proponents say they are less expensive to operate than nursing homes.

A French village with 120 residents could cost nearly €30 million to construct.  Building a nursing home in the same region with a similar number of beds would cost €10 million less. The maximum amount for village residents without any state or regional aid is about €2,000 a month. With subsidies it can be as low as €250 a month. A private room in a nursing home meanwhile would be about €9,000 a month, according to the international Alzheimer’s association.