Members Article: Visit to De Hogeweyk dementia specific village in the Nederlands

Submitted by: Erica Stevenson, Diversional Therapy Assistant, Royal Hobart Hospital, Student at CSU (Bachelor of Health Science-Leisure and Lifestyle)

 I have recently returned from a holiday in the Nederlands where I was lucky enough to visit a dementia specific village called “de Hogeweyk”. There has been much media publicity on this village and it has often been referred to in my university studies to acknowledge their approach to care of people with advanced dementia. I emailed the facility requesting to visit and their response was a friendly: “Yes, come, have a coffee, use the facilities and stay as long as you wish”. I was most grateful and excited by this opportunity.

The village is in the township of Weesp which is close to Amsterdam. I met with the Activities Co-ordinator, Jorgos Arvanitis, who was very happy to explain how the village is organised. Although Jorgos was not familiar with the profession of ‘Diversional Therapy’ during my interactions it appeared his role could be similar to that of an RAO. I appreciated his time, although brief as I noted that I was not the only foreigner visiting that day. As well as a large group who appeared to be on a tour, I met an Occupational Therapist and Social Worker from the United States, and a carer from the United Kingdom who, like me, had come to learn from a Hogeweyk experience.

The only locked door is the front entrance where the receptionist informs you of the necessary procedures. You are allowed anywhere in the facility apart from inside the homes. You can take photos but not of the residents. We were encouraged to walk, enjoy the gardens and village squares, meet the staff and talk with the residents if they so wished. Their philosophy is one that recognises residents cannot always access the outside world and therefore they invite the outside world in as much as possible.

The people living here are encouraged to wander throughout the village, to visit other homes and even to ride bikes. For those who may not have visited the Nederlands they have the largest population of bicycle users in the world. In fact they have more bikes than inhabitants! Bikes are an important part of the Dutch culture and many very fit, very elderly people can be seen riding their bikes to the local shops and restaurants. The country is flat, beautiful and everywhere you look is a photo opportunity. It is the perfect place to ride your bike. The bikes at Hogeweyk sit lower to the ground and are built for two (side by side), and WOW, they manage to ride them very quickly through the village square. It was wonderful to see.

It should be noted that many Dutch people migrated to Tasmania after WW2. Many of these migrants are now in their late 80’s and 90’s and are Tasmania’s oldest migrant cohort. Initially my interest in visiting Hogeweyk was to find out how they care for people from other cultures that have dementia. Jorgos indicated this was not an issue for the Nederlands because the Dutch already speak a few different languages from neighbouring European countries. However he noted with the increase of recent refugees this will be an issue for them in the future!

The Dutch are a warm, very helpful, extremely organised and safety conscious society and this is reflected in their nursing home. It was architecturally designed to look like a village and not a large facility. It is situated over 4 acres, has ‘streets’, trees and gardens designed to have a different view from whichever aspect you look. The seasons have been taken into consideration with cut flowers, fruit and mature trees. The garden is very accessible to all residents and they are encouraged every day to go outside, be it sunshine or rain. The residents are free to go wherever they wish and pathways lead to the gardens, village squares, shopping, restaurants and a bar. Large windows look out onto the neighbouring school where residents can watch the primary children play.

The concept for Hogeweyk originally came from Yvonne van Amerongen in 1992 while working as a nursing home manager. She is an Occupational Therapist and Social Worker. When her father suddenly passed away she expressed her happiness that he would never have to go into residential care. She understood she shouldn’t think this way so Yvonne and her colleagues set about plans for the ideal facility where those with dementia could live as normal life as possible. In 2009 de Hogeweyk was built. It has 152 residents, 23 homes each of only 6 or 7 people. The homes are designed into 7 different lifestyle areas. With help from families, residents are asked to complete a ‘lifestyle’ assessment. This enables residents to be placed with ‘like-minded’ people: people you would choose to have as friends, people who share similar values and ideas. The different lifestyle areas are urban, homely, cultural, Indonesian, well-to-do, traditional and cultural: each home is designed and decorated to reflect this style. For example in the Indonesian homes kitchen are large to allow for communal cooking. You can access this lifestyle assessment at

In each home there is a central staff member who acts like ‘a mother’ figure. That person organises the residents to do minor household tasks like making beds, washing clothes and shopping for food; staff take care of the difficult tasks. Every home cooks their own meals, every day. Hogeweyk has its own supermarket where residents come to buy food for their cooking. It is not a problem if they forget to pay as staff have training in dementia care. Every home has a front door and a door bell, hallway and corridors to the bedrooms. While I was unable to enter the resident’s homes it sounds like the design was as close as possible to replicating a normal home environment. In the Nederlands dogs and cats are allowed on public transport and you often find a cat sitting under your chair in the local restaurant. At Hogeweyk your pets are welcome and staff can provide assistance to help walk and care for them.

Hogeweyk has a hairdresser, beauty salon, physiotherapist, theatre, music recital hall, restaurant, café, art and craft centre, men’s workshop, and library to name a few facilities. But the difference is it is designed to feel as if you are living in your own home and you are going out into your local community to access services. Suburbs in the Nederlands are often situated around a town square where you have farmers markets, shopping, bars and restaurants. This is replicated at Hogeweyk round a market square.

Again night-time at Hogeweyk is designed to reflect ‘normal’ life. After 10.00pm staff numbers are reduced to five. If someone wishes to stay up late watching TV, staff will keep them company. Otherwise all lights are turned off, no-one is disturbed and a sophisticated audio system alerts staff to sounds out of the ordinary from those who may need assistance. Hogeweyk report their residents sleep very well and staff feel they have a greater understanding of what is happening during the night.

The facility is funded by the Government and has the same budget as all nursing homes. It has 240 volunteers and families are asked to contribute 4 hours of their time a month. Residents can also join activities clubs. To access these you can ‘pay as you go’ or pay a membership fee. This can be anywhere between 30 to 350 euros per month. This is paid for by family or by sponsors who donate money for residents who do not have family. The Social Worker is responsible for observing and documenting challenging behaviours and together with the Psychologist they work out a care plan and activity suggestions in order to modify the behaviour.

Reflecting on what I experienced at Hogeweyk.

I really appreciated the design of the facility. It really does reflect living at home, with people you want to be with, within a ‘village community’ that supports you. Hogeweyk provides that safe, ‘I belong here’ feeling. I liked the fact you could access free WIFI which makes the place visitor and family friendly, especially for teenagers. The staff and volunteers were very welcoming and friendly. Yvonne van Amerongen indicated that residents have less medication and live longer. If people with dementia are frightened by the things they don’t understand then Hogeweyk does a great job of making life feel normal and non-threatening. Hopefully this is positive step towards a future relationship with the Nederlands which DTA’s International Portfolio has been provided with a new contact to pursue.

Yvonne van Amerongen is presenting in Perth on the 4th September at the ACSA IAHSA “Global Communities coming together” Joint International Conference

You can access her TED Talk at: “Living with Dementia: To be or not to be/ Yvonne van Amerongen”

Or hear about Hogeweyk at CNN’s World Untold Stories: Dementia Village

NB: some of the information contained in this article has been extracted from the youtube clip

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