Article in Journal of Dementia Care
Hogeweyk: a 'home from home' in the Netherlands
Beatrice Godwin is impressed by Hogewey, an award-winning development with an innovative approach to residential and nursing care for people with advanced dementia.
When it comes to learning from international developments in dementia care, there are few better places to look than the Netherlands. Hogewey, located 20 miles south of Amsterdam in the small town of Weesp, is an award-winning development that pioneers an excitingly different kind of provision of residential and nursing care for people with advanced dementia. And its novel approach is much needed when, in spite of the many good examples, there is still too much sub-standard care. Before spending an afternoon there to see it for myself, I read published literature about Hogewey and emailed some questions to Yvonne van Amerongen, co-founder and now director for quality and innovation. The full conducted tour was rather costly, so I could not visit the houses or speak to the residents at home in this dementia village. But, over delicious meals in Hogewey’s restaurant, I met two very informative residents’ relatives who sang Hogewey’s praises, one commenting “It’s brilliant, it couldn’t be better!” The inspiration for Hogewey arose when two members of staff working in the previous home on the site each lost a parent. Both felt that this traditional nursing home would have been anathema to their relatives: “It wasn’t living. It was a kind of dying,” as one of them put it. The idea for something different was born and the site was completely redeveloped. Similar schemes are being planned in several countries. Care in this dementia-friendly community is based on two principles (Henley 2012). Firstly, as its official literature says, “it aims to relieve the anxiety, confusion and often considerable anger that people with dementia can feel, by providing an environment that is safe, familiar and human. Secondly, it focuses on “maximising the quality of people’s lives. Keeping everyone active. Focusing on everything they can still do, rather than everything they can’t.”
Helping new people settle
The novelty of its approach starts before admission. In Britain, potential home residents and their relatives are often asked to provide details of family history and lifestyle (Godwin 2002). In Hogewey, this goes one stage further. Family, staff and the new resident choose which lifestyle will suit them. Before Hogewey opened, an analysis of the most common Dutch home environments identified these options: traditional, city, ‘Het Gooi’ (upper-class), cultural, Christian, Indonesian and homely. ‘Het Gooi’ has lace tablecloths and chandeliers, unlike the traditional Dutch accommodation. The Indonesian house is decorated with tropical plants and statuettes of Buddha. It has ‘very tasty’ cuisine and the temperature is several degrees warmer than everywhere else. Hogewey’s philosophy sees lifestyle (including culture and class) as an element in a person’s life that tends to remain relatively constant. People develop lifelong daily habits and generally like to mix with like-minded people. If these are maintained after a person with dementia moves into a home, it will seem more familiar and acceptable to them. Each of the 23 homes accommodates six or seven residents, who bring in their own belongings, even their pets. Their visitors are welcome, involved and given facilities. Yvonne hopes that, one day, partners may be able to move in too.