As part of a series of case studies on best practices in elder care, Sofia Widén, program manager of ACCESS Health Sweden, visited De Hogeweyk, the dementia village in Weesp, the Netherlands. De Hogeweyk was established in 2008 (Phase 1) and 2009 (Phase 2). The village provides high quality elder care services for individuals diagnosed with advanced or severe stage dementia. De Hogeweyk is the only dementia village in the Netherlands. The village in Weesp houses one hundred fifty two residents in twenty three small houses.
Sofia Widén (SW): Could you tell us a bit about your background?
Eloy van Hal (EVH): I completed my studies in household and consumer sciences at the University of Wageningen and also studied facility management at Academy South in the southern part of Holland. I was an assistant manager for a cleaning company and worked at another Dutch nursing home before starting De Hogeweyk. I started De Hogeweyk and the dementia village in 2002 with some colleagues. I was initially the facility manager for the village and specifically studied the surrounding environment of the nursing home. Since 2015, I have worked as a consultant at the Vivium Care Group. I have always been interested in elder care improvements.
SW: How do you measure the outcomes, results, and improvements in the quality of life at the dementia village?
EVH: Outcomes and results are an interesting discussion. Our point of departure from the standard way of measuring is to use common sense. We observed that working as a traditional nursing home did not improve the residents’ quality of life. So, my colleagues and I asked ourselves several questions: How would we like to live? Would we rather live in a larger group or smaller group? Would we like to eat home cooked meals or outside food? Would we like to have a daily routine?
My colleagues and I started our new model with a focus on lifestyle. We all agreed it was important that the residents could walk outside and make their own choices. Almost all of the methods we used to provide care were later proven to produce better outcomes than traditional care models. For example, six years ago we found published research that showed people eat better in smaller groups of about six people. We considered a similar approach twenty years earlier.
Daily life challenges individuals who suffer from severe dementia. A traditional nursing home environment or hospital is confusing and stressful. The world seems dangerous. We made people more comfortable by making their world recognizable and safer. Research later supported our idea that smaller groups and a normal routine help individuals by creating a comfortable, familiar environment.
Exercise also has a positive impact on an individual’s quality of life. We encouraged residents to walk around the village every day. We also prioritized social contact with others. Here in the village, residents walk around, meet each other, and talk with visitors from the outside. Research later proved that exercise and social interaction improve the quality of life. All these aspects are part of our philosophy.
There has been no research project which has proven the entire concept of De Hogeweyk model. However, individual components of our care philosophy prove to produce satisfaction, to reduce anxiety, and to positively improve quality of life. I encourage you to walk around the village and see what is going on here. I want you to observe the individuals in the village. This way, you will understand better what I mean.
Research and proof are important. Politicians normally change policies based on evidence. We continue to work to produce evidence in support of our care philosophy. However, intuition and common sense are important, as well. I urge people not to wait until research endorses a care concept. Start with common sense. Ask questions and think about what you would like to have as you age. Many people from around the world show interest in the care concept at De Hogeweyk. I think that shows that we are developing something worthwhile. We cannot guarantee success in all areas of the De Hogeweyk care concept. However, we can examine individual aspects and measure their outcomes.