There's a 20,000-square-foot (1,858-square-meter) warehouse in California, USA adorned floor-to-ceiling with 1950s decor, from photos of Elvis Presley to a working Ford Thunderbird. Despite the decor, the US$3 million Glenner Town Square that opened last year in Chula Vista is intended for comfort—not kitsch.
The project is part of a growing trend of so-called Alzheimer's villages, which aim to redefine care for people with dementia by placing them in surroundings that feel like normal, everyday life. Until recently, patients of these degenerative brain diseases often lived out their final years in hospital-like environments—a potentially unsettling context for a population that might not remember where they are in the first place.
The new approach has project teams designing and building facilities to mimic patients’ lives, either by drawing on past visual cues from when their memories were sharper or in mirroring nearby building and landscape designs. The largely publicly funded €28.8 million Village Landais Alzheimer in Dax, France will feature familiar everyday amenities—like a supermarket and library—but will be designed in a medieval style similar to Dax's architecture. The five-year project is due for completion later this year. Glenview Community Services is building an AU$25 million village called Korongee in Glenorchy, Tasmania, Australia, also due for completion later this year. The organization is partnering with HESTA, a health sector superannuation fund, which is providing AU$19 million in funding. The 96-person facility will feature homes that are organized in cul-de-sacs similar to nearby suburbia and will contain amenities such as a café and beauty salon.
“Korongee's design will make it possible for residents living with dementia to walk around the village and participate in everyday life decisions that are presently not available to those in dementia care—activities such as going to the café to buy a coffee or simply heading to the supermarket to buy groceries for dinner,” says Lucy O'Flaherty, CEO of Glenview Community Services, Glenorchy, Tasmania, Australia.
Rendering of the Village Landais Alzheimer project in Dax, France
The desire to provide better care coincides with an increase in dementia rates. The number of people with dementia is projected to more than triple from 50 million in 2018 to 152 million by 2050, according to the World Alzheimer Report 2018. As project teams build these new facilities, they're drawing on lessons learned while also having to contend with newfound safety risks.
Learning From the Past
Today's Alzheimer's village projects are modeled after the Hogeweyk village outside Amsterdam, the Netherlands. The village, the first such facility, opened in 2009 after more than a decade in the making. Hogeweyk's founders say they've seen both a decrease in reliance on medication and an improvement in the quality of life among patients.
To create the Korongee village in Tasmania, Ms. O'Flaherty traveled the world to understand how other institutions are best serving people with dementia. Her search for lessons learned brought her, naturally, to Hogeweyk.
“The Korongee village concept draws on a range of international best practice models, including the dementia village of Hogeweyk and many smaller living models in the U.K. while contextualizing this into a uniquely Tasmanian experience,” Ms. O'Flaherty says. One of the lessons learned the Hogeweyk project team passed along is that they wished they would've consulted more with the local community to better integrate the village with the surrounding community.
A Sense of Place
An additional risk these projects share comes from allowing patients to roam freely in environments where they could get hurt. “The issue here is the frontier between medical care and individual care,” says Francis Lacoste, director of solidarity for the Landes Department Council, which is overseeing the Village Landais Alzheimer project.
—Francis Lacoste, Landes Department Council, Mont-de-Marsan, France
The village consists of distinct “neighborhoods” whose colors, vegetation and smells are designed to match the country's various regions where many patients come from. One area has a beach, another a forest, and a third hills and valleys. Patients will be assigned to the neighborhood that best matches their home environment.
Technology is helping the project team mitigate some of the risk that comes with giving residents so much freedom. Bedroom floors are embedded with sensors that communicate with GPS chips worn by residents. If a resident falls and can't get up, the sensor triggers an alarm.
Still, the risk of injury can only be managed, not eliminated, says Mr. Lacoste. Part of the plan also requires that the village clearly communicate with stakeholders about these risks.
“We have to explain to the families that their parent or husband or wife will be in a place that is better and that they will be well taken care of, but it comes with the risk of someone falling or getting hurt,” he says. “When you give someone freedom, it comes with a certain measure of risk.”—Ambreen Ali
People who live with dementia in 2018
Projected number of people with dementia by 2030
Projected number of people with dementia by 2050
Total estimated global cost* of dementia in 2018
Total estimated global cost* of dementia by 2030
*Societal and economic costs
Source: World Alzheimer Report 2018, Alzheimer's Disease International