Like autism among children, Alzheimer’s among seniors has reached epidemic proportions, with no slowdown in sight. On the contrary, evidence suggests the trend is worsening. At present, Alzheimer’s affects about 5.4 million Americans and is the sixth leading cause of death in the U.S.1 The World Health Organization predicts that by 2050, 1 in 6 adults will be living with dementia, which means elderly dementia care facilities will soon be in critical demand.
More than 80 percent of current care home residents have significant memory problems or full dementia.2 More than 15 million Americans also provide unpaid care for family members with dementia, and 35 percent of caregivers say their personal health has declined as a result of the strain, compared to 19 percent of those who care for elderly without dementia.
With younger family members footing the bill, the cost of a good residential home is out of reach for many, causing some families to consider options outside of their own national borders. The 16x9 News Online documentary special, “Dementia: The Unspooling Mind,” explores innovative models of dementia care in Thailand and the Netherlands — unique residential complexes designed to keep this vulnerable population safe, happy and well-cared for.
Netherland’s Dementia Village
On the outskirts of Amsterdam in a small town called Weesp, is Hogeweyk, also known as Dementia Village.3As this is typically a person’s last residence, the goal at Hogeweyk is to provide the most normal life possible, reminiscent of each individual's formative years. It has the sort of manufactured reality depicted in the movie “The Truman Show,” where Jim Carrey portrays a man who discovers his entire life is actually a reality TV show.
There is only one way into the village and one way out. All doors open automatically, except those to the outside world. This four-acre village was built with the specific needs of dementia patients in mind, designed around common and familiar social and cultural building blocks.
For example, residents with shared interests and backgrounds live together in “lifestyle groups,” with the design and decoration of the 23 homes tailored to each type. Together, the residents manage their own households in most respects, with staff members helping out as needed.
The cost is nearly $8,000 per month, but the government provides subsidies so that each resident’s rent will never exceed $3,600. The entire complex is geared toward giving residents a high quality of life; to provide them with a sense that their life is still worth living — they can have fun and have a purpose.
There are all sorts of amenities, including a cafe and parks with gardens and fountains along streets where the residents can freely roam.4 Village staff are everywhere, cleverly blending in as ordinary town folk. Caretakers staff the restaurant, the grocery store, the hair salon and the movie theatre. They also have the ability to surveil the resident’s living quarters without being intrusive.
Care From the Heart
Thailand, “the land of smiles,” has two “dementia resorts,” both of which are a stark contrast to your typical nursing home. At the Baan Kamlangchay center,5 which translates to “care from the heart,” there are no locks, gates or fences at all. The center, which houses a dozen residents in a small village of eight homes, was established by Martin Woodtli, a Swiss psychologist who previously worked for Doctors Without Borders.
According to Woodtli, patients at his center generally don’t require drugs to stay calm. Nor do they need locked doors to keep residents safe. Instead, they’re never without an attendant, so they have the benefit of continuous human interaction and supervision, and have freedom to move about. He says his guests “feel part of a family, a community, and that’s very important.”6 Patients are accompanied to local markets, temples and restaurants, and receive personal around-the-clock care — all for $3,800 per month.
When considering whether or not to place a loved one in a care center far from home, the most challenging part is leaving their loved one behind, not knowing if he or she is aware of what’s happening or feels abandoned. This is, of course, a very personal decision with multiple factors weighing differently in every situation, and each patient is different.
The majority of dementia patients placed far away from home are in the most advanced stages of the disease. Experts report that while many with early dementia would find it difficult to adjust to life in a foreign place, separated from their families, many in advanced stages adjust surprisingly well to a place with good care, because they “live in a world of earlier memories.”