Washington, D.C., is pushing a senior care system modeled on Hogeweyk in the Netherlands, known as the world's first "dementia village." As dementia cases surge with an aging population, it is an attempt to shift from medical-centered care to community-based care that focuses on quality of life.
According to the Washington Post on the 10th, at the "Urban Aging Symposium" recently held in Washington, D.C., health authorities, developers and dementia experts gathered to discuss the direction of housing policy for older adults. The case that drew the most attention there was Hogeweyk. This village in the Netherlands is an innovative model that views dementia not as a disease but as "a stage of life," designed so that residents can continue daily routines and maintain social relationships.
About 188 people with severe dementia live in 27 dwellings in Hogeweyk. Each dwelling has live-in caregivers, nurses and an activities support team, and residents cook together, tend gardens and shop at a supermarket in the village. Medical intervention is minimized, and the core is to respect the patient's own daily life. Co-founder Eloy van Hal said, "Care is only 5% of the day, and the remaining 95% is about life and happiness."
The model has now spread to places such as Canada and Australia, and Serenbe in Georgia has adopted a similar structure in the United States. In Washington, D.C., a plan is under discussion to include a dementia village in the city-supported redevelopment of the Fletcher-Johnson Middle School site. Developer Osama Suaidi, who leads the project, said, "Facility-centered dementia care lacked human warmth," and noted, "If we provide quality meals, housing and social interaction, we can also reduce the burden on public health care costs."
The nonprofit Iona Senior Services also separately proposed to the council a hybrid-style dementia village for low-income older adults. Korean American head Jun Bang requested a budget of $3 million, explaining, "The goal is a structure where people live at an adult day health center during the day and receive care in a group home at night." The council approved only $850,000 of that, but Bang said, "Dementia is not something to fear but a reality everyone will face," and continues to push the project.
Experts said Washington, D.C., has little choice but to consider adopting the "dementia village" model because it has the highest dementia incidence rate in the United States. About 16% of all older adults have dementia caused by Alzheimer's disease, and the risk among Black older adults is twice that of whites. With isolated lives, chronic diseases and lack of access to medical care overlapping, there is a judgment that the existing medical- and facility-centered care has reached its limits.
Sharon Hines, Director General of the Washington, D.C., Department of Aging and Community Living, said, "Most families caring for people with dementia are facing psychological and financial limits," and noted, "A system in which the community cares for patients together is urgent." She added that Iona's "dementia navigator" program, which links caregivers and patients to local medical and welfare resources, is currently the most important mainstay.
Christina Prather, director of the Brain Health Institute at George Washington University, said, "Screenings alone are not enough," and emphasized, "We need to develop into an age-friendly community where health care, housing and the community are integrated." She pointed out, "With the existing system we have built, it will be difficult to handle the oncoming wave of aging."
Washington, D.C.'s attempt is still in its early stages, but the philosophy of "treating dementia not as something to isolate but as a subject to respect" could bring change to elderly care policy across the United States. Co-founder van Hal said, "If we cannot cure dementia, then at the very least it is society's role to help people live with dignity."