When Dodd Kattman first heard about the De Hogeweyk dementia village in the Netherlands, he knew he had to check it out.
Kattman, an architect with MKM Architecture + Design, shared his review of De Hogeweyk and other European dementia villages at a presentation titled "Acclaimed European Dementia Care Buildings" on Monday at the Environments for Aging Conference in Baltimore.
"A lot of prevalent diseases have decreased in the United States, except Alzheimer's," Kattman said. "There is very little money dedicated to finding a cure for dementia, say compared to what was set aside in the 80s to do HIV research."
Before he began his reviews, Kattman shared statistics about the percentage of people in European countries who are receiving long-term care: In Austria it's 24 percent; the Netherlands 19 percent; Switzerland 18 percent; and the United States it's 6.5 percent.
"We have a lot of people working up to age 80, and other nations just don't," Kattman said. "The bad thing is that the longer they work, the more their children reach the peak of their careers and won't be able to provide long-term care when they need it. That makes our jobs (as architects) that much more important. We have to provide the facilities where children can take their parents."
Below is Kattman's review of five dementia care communities in three European countries.
Heavers Court Care Home, Croydon, United Kingdom
Layout: This neighborhood is set up in neighborhoods of 10 residents. Heavers primarily provides dementia care. It has a very large, protected courtyard, and is very residential. The building is a square, and all parts of the building can be accessed by a single "race track" that goes around the perimeter. All "neighborhoods" open to the courtyard. It's a 30 minute train ride from downtown London.
Review: "Of all the facilities I saw, this one was the most Americanized in terms of building design," Kattman said. "Each neighborhood had a balcony, but it was never used because staff couldn't see out. There was nothing special about this building. It was a nice simple design with lots of daylight. It was a pleasant space, but it appeared a little dated. There were also very narrow 4-foot hallways. So in an emergency, it's obvious that they couldn't wheel beds out anywhere. Another thing is that if there was an emergency, they evacuated everyone to the courtyard in the center of the building."
Dedei, Amsterdam, the Netherlands
Layout: This is a large campus with four floors each serving six residents. Each floor has a manager plus two additional nurses that help serve the four floors during the day. The nurses are universal caregivers. On the first floor there is a restaurant and store. There are no utility rooms because all supplies are kept in built-in cabinets.
Review: This is a very successful building, but it scared the people I traveled with," Kattman said. "There is one nurse per floor for six residents and two additional people during the daytime to help cover two floors. At night, there is one nurse caring for all people on all four floors. There are tiny patios on the living areas where the staff can see out, and they are used all the time."
De Hogeweyk, Weesp, the Netherlands
Layout: This dementia village is totally secure, and there is no way to get out without an administrator badge. It includes a restaurant, theatre, bar and more, all on a campus plan. In every household there are six residents with a capacity of about 150 residents. Each household has a specific lifestyle: traditional, homey, upper class, Christian, Indonesian, urban and cultural. Before a resident can move in, they have to be interviewed by a family to determine which home they belong in. Residents are able to cook, do their own laundry and shop.
Review: "The whole idea of the interview is that you'll be happier living with like-minded people," Kattman said. "The strength isn't in the buildings, it's really in the courtyard. The residents can go anywhere they want. We weren't able to talk to anyone while we were there and we had to pay about $1,000 just for a tour. I think we were given the sterilized version of the tour, too. We noticed things going on that were contrary to what we were being told. They tell you residents can leave and do their own shopping, but they don't. They don't have that ability. The building staff comes down, shops and stocks up the homes. It isn't quite like you see in the pictures. They told us the restaurant and bar were packed all the time, but when we were there, I asked how many reservations they had and it was only four. Can you imagine expending that kind of capital to build this and it only serves maybe four people a night?
"In the households, there are no bathrooms in the bedrooms. There is one large bathroom that serves three residents. Also, the residents were only able to attend one group activity a week unless they had the money to pay to join more."
Sonnweid, Wetzikon, Switzerland
Layout: In this culture, silence is valued. The community has a room of silence for residents to sit, wind down or think. There is a central ramp that connects all floors with a water feature in the middle that can be heard throughout the building. The community believes in the power of silence and soothing water sounds equally. Along the ramps, in the little alcoves that were created, designers created cozy conversation corners where residents can chat with friends or family. All rooms are shared, but each resident has a private bathroom right outside their door.
Review: Most of long-term care buildings we visited are owned by husband and wife partners," Kattman said. "This is what they do for a living. They don't own six or seven facilities. One thing that scared the CEO I traveled with was the concept of a Care Oasis. These are becoming more popular, and the thought is that people don't want to be alone during end-of-life care. So the Care Oasis in this facility was a round room with private beds separated by curtains. It was a therapeutic space with access to the outdoors. And the nurses here said they've seen several improvements in residents in terms of nutrition, alertness and interaction.
Seniorenheim Bad Santisblick, Waldstat, Switzerland
Layout: This facility has the adaptive reuse of a 200-year-old historic hotel. There's a community restaurant, and it has a traditional nursing home that is integrated with dementia care. It's nestled in a walkable village in the mountains. The whole building was made of wood because that village is known for it's craftsmanship in woodwork.
Review: Kattman's session time ran out before we could get to this segment.
To see more pictures from Kattman's session, log on to the EFAcon app. Search EFAcon in your app store. Login in with the email you used to register and the password is efa2015. Search for session E19 and check out the Collateral section to see the slides. The slides will only be visible to EFAcon attendees.
