Living Well With Alzheimer’s Thanks to a Village Square, a Garden and Autonomy

When she used to visit her mother in the nursing home, she found her once-loving and adventurous parent with her face messed up and her body rigid with tension. Her mother, who was in her 80s at the time, had been living with dementia for a long time.

She changed her demeanor when she moved to a facility that looked like a village. At the Care Village, a campus of white clapboard houses on the shores of New Zealand's Lake Rotorua, she spent hours in her shared cottage's living room listening to operas. Jeffs says that she would sit there and tap her feet while they played the music she liked. You knew she was happy when you looked at her and saw how happy she was.

Jeffs was interested in her mother's well-being. She has been involved in every aspect of the residence, which is designed to care for people suffering from various stages of dementia. A growing number of communities around the world are experimenting with models of care that encourage a sense of self-control. As societies grapple with aging populations, they are raising fundamental questions about what care for Alzheimer's disease and other diseases should look like.

Jannette Spiering, one of the founding members of the village concept, asked what they needed to change to become a home. How can we make a place where you can live?

The answers are coming soon. An estimated 53 million people will be living with Alzheimer's by the year 2050. Japan, a country where the elderly make up almost a third of the population, is working to ensure people can stay at home as long as possible by training social workers, as well as store employees and ordinary citizens.

The village concept re-creates the real world in a safe place. Six or seven people live in a house in New Zealand. They can shop for groceries, cook with others, and do their laundry with the help of staff who teach them to empower them. They can go for a stroll along the lakeshore or do some gardening.

Outside the old spa town of Dax in the South of France, there is a village conducting research into the effects of freedom on Alzheimer's. It could lead to a different approach for dementia care if scientists at Village Landais succeed in demonstrating that theholistic model can slow cognitive decline. Alzheimer's Disease International is an umbrella organization of dementia associations with no financial ties to any of the villages.

Proponents of the concept aren't without their critics. Residents are trapped in a make-believe environment According to the village creators, they had to come up with a way to replicate the freedom residents can no longer enjoy outside. Proponents say they are cheaper to operate than nursing homes.

$30 million was spent to build the French village. According to Mathilde Charon-Burnel, a spokeswoman for the local region, Les Landes, the cost of building a nursing home in the same region is $10 million less. The maximum monthly price for village residents is $2,000. It goes as low as $250 a month with subsidies. The Alzheimer's Association says a private room in a US nursing home costs about $9,000 a month.

The New Zealand village costs less to run because it is more flexible and there is less turnover. She says that they are able to be more responsive. If someone became unwell during the day and the house needed more care, we could bring in someone and people would do it. You run a roster that is very set if you are running an institution. Everybody gets breakfast at half past seven and you make every bed at 8 o'clock.

The pilot project started in the middle of the epidemic. People are milling about the town square, walking down walkways covered in vaulted arches, or chatting in front of the supermarket. Outside the cafe, others are playing Scrabble. Some people in the village ride bikes, but it is not known if they are patients, doctors or volunteers because staff don't wear uniforms. Locals are allowed to enter the village to have lunch at the restaurant or get a haircut.

On a sunny autumn day, a group of residents quietly flow through their exercise class on park benches, under the gaze of Jasmine and Junon, two resident donkeys. The villagers gather in the back room of the cafe to sing. Some of them need a wheelchair. A lot of them are free to move around the campus. Individual rooms in one of the houses on the campus are available to the residents. There are no dead end corridors, few mirrors and signs are depicted with simple images rather than words, and the architecture is intended to reduce frustration and confusion.

The life of the community depends on volunteers. Florence Laudouar, who is in charge of coordinating the volunteers, says the village is very calm. Some people have found creative ways to help out in other ways. There was a discussion of current events and astronomy.

The lead scientist on the project and her team meet with patients to evaluate indicators of cognitive function, depression, anxiety and social participation. Next year, the results of the research will be available. The effect of the village on families, staff and neighbors is being investigated by her. The work shows that the perception of dementia in Dax has changed. A control group in a town three hours to the north that is home to a traditional nursing home is less likely to see Alzheimer's as a problem.

Amieva theorizes that if the person is better adjusted to her environment, better supported, that there is a level of well-being that brings out less anxiety and behavioral disorders. The disease could be slowed by that.

The original Alzheimer's village in the Netherlands was built by Spiering and her team after tearing down a nursing home. Doctors, nurses and dementia specialists allow villagers to set their own schedule instead of being forced to follow one.

Spiering and her team were retained by Jeffs to help with her project. Similar communities have been introduced in Australia, Canada, Italy and Norway. One village in New Jersey is in the planning stages. There is a mix of furniture and architecture in the Hogeweyk. There are heavy curtains in the living room. They are airy and loft like. Families are involved in helping pick the house that best fits each resident's background and preferences, ranging from food to music.

Jeffs went to the Netherlands to look for a new model of care. Her mother was going through the early stages of dementia when Spiering and a colleague took Jeffs around the village.

The New Zealand village has been applying that approach. Some long- married couples are placed in different houses even though they have been together for decades. People with dementia tend to come back in time. If the pair experienced different economic levels as children, the one who became wealthy in adulthood is likely to feel more at ease. The husband walks from his house to his wife's for lunch every day.

A scientist studied the New Zealand village and found that people who moved there from a more traditional nursing home were generally less agitated and needed less medication. Kay Shannon is a senior lecturer in the nursing department at the University of Technology.

A Care Village resident who used to be an accountant and auditor regularly shows up at the reception desk to check their list. The staff created lists for him to look over, and thanked him for his work. The reality of the residents is not our reality. I don't think we're creating a false world. We are going into their world.