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In the village of Hogevey, everyday life flows peacefully: sedate walks, calm conversations, smiles when meeting on the street. Nothing betrays the nursing home: except that there are a lot of elderly people. But in fact, friendly shop assistants are specially trained doctors. And the villagers suffer from dementia or Alzheimer’s disease.
The village of Hogevey near Amsterdam is a quiet, almost idyllic place. A couple dozen nice houses with well-groomed front gardens, a cozy square, a toy central square with its own post office and even a theater. The inhabitants of the village, very elderly people, walk sedately through the streets, wander home with packages from the supermarket, slowly talk over a cup of tea or coffee in a cafe. Sellers and cashiers, bartenders and even janitors have long known all the residents by face and name, smiling affably and waving from a distance.
But it’s not real. Every inhabitant of the Hogevey village is monitored by video cameras around the clock. From the outside, nothing betrays the nursing home, but the smiling salesmen and bartenders are not at all what they seem. All this makes life here a bit like the famous movie “The Truman Show”. With the difference that all those who work in the village are not actors, but doctors or junior medical personnel with special training in the field of geriatrics. And everyone who lives here suffers from severe forms of dementia or Alzheimer’s disease.
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Hogevey is a closed medical institution, the only nursing home of its kind in the world. The idea to create such an institution came to the mind of Yvonne van Amerongen, who worked for many years in “ordinary” nursing homes in Holland. And every day she became more and more convinced that she would not want her parents to be in one such nursing home for anything in the world. Van Amerongen took a decade and a half to interest scientists and doctors, find investors, and then reach out to government officials. But she got her way: in 2009 Hogevey was opened.
Its construction cost about $25 million. The unique nursing home is funded by the Dutch government and costs $8000 a month per patient. But the families of all those who live here receive various subsidies from the state, and not one pays more than $3600. That’s $43 a year. For comparison, a typical American nursing home costs twice as much: for a relative to live in a separate room, his family pays more than 200 a year.
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152 people live in Hogevey, 6-7 in a house, and each one is always in a separate room. The interior of the houses is designed in strict accordance with the era, the memories of which are more or less clearly preserved in the memory of patients – be it the mid-50s or early 2000s. Furniture, tablecloths, napkins, wallpaper pattern. What for? Then why do nurses pretend to be cashiers and salesmen. So that the inhabitants of Hogevey feel that they are living a normal life.
The modern approach to dementia patients who find themselves in a “regular” nursing home is perhaps more honest – but completely ruthless. “You’re sick, you can’t take care of yourself, you can’t go out, you’ll forget who you are and never come back.” A recent report from the Dutch Association for the Study of Alzheimer’s shows that patients with this diagnosis who are admitted to a nursing home leave their rooms for an average of 96 seconds a day.1 Moreover, medicine tends to isolate patients with severe cognitive impairment. Of course, for their own good: this way it is easier to observe them and be sure that everything is in order. But, for example, a 2012 study published in Nature Neuroscience found that isolation leads to a decrease in the production of myelin in the body, one of the main “building materials” for nerve cells.2 And that means that in isolated “for their own good” patients, dementia will only develop even faster.
Hogevey’s patients don’t know that they are patients and that there is a nursing home around them. They live in their village in full confidence that they are at home. They are free to go wherever they want at any time (naturally, within the fenced area, but everything is arranged so that they do not stumble upon fences in bewilderment). They communicate with each other, go to the post office and to the store, to the theater and cafes. They are constantly visited by relatives – many come here almost every day. Doctors from all over the world constantly come to the unique nursing home. The dementia care model here seems to be the most successful in the world today. And similar settlements are already being built in Britain and Switzerland.
Because if a person cannot be cured, this does not mean that he cannot be helped. Hogevey has not found a way to treat dementia – it has not yet been found anywhere. But here they found a way to make people suffering from an incurable disease live normally and with dignity. They felt like full-fledged people and enjoyed life. And if for this you need to play along with them, is that bad?
The full text of the article about the village of Hogevey in English is available at magazine The Atlantic. You can watch the CNN report from the village of Hogevey .
1 Published on the American Hospital Association website hhnmag.com
2 Learn more at nature.com