A pioneering approach to dementia care, originating in the Netherlands with the Hogeweyk 'Dementia Village,' is gaining traction in the United States, aiming to enhance the quality of life for individuals living with cognitive decline. This model shifts the focus from institutionalized care to fostering autonomy and a sense of community, transforming the daily experiences of residents.
Eloy van Hal, a key figure in the development of the Hogeweyk model, observed that early pilot programs focused on empowering residents with more autonomy led to significant improvements. "We immediately saw improvement in how people reacted and responded," van Hal stated. "They became more active, less stressed and less agitated."
This insight became the foundation for Hogeweyk, which was rebuilt with resident autonomy as a central design principle. Instead of a high-rise institutional building, it features homes designed for small groups of six to seven individuals with shared backgrounds and interests. The surrounding neighborhood is designed to resemble a real-world environment, blurring the lines between residents, visitors, and staff. The core philosophy is to treat individuals as residents, not solely as patients, emphasizing the person over the disease. "With the word ‘patient,’ the focus is on the disease instead of the human being in front of you," van Hal explained. "If you look outside, it’s difficult to see the difference between a visitor, a resident, a volunteer or a staff member. You just see people meeting, smiling and walking around."
Studies indicate that residents at Hogeweyk experience greater happiness and require less medication compared to those in traditional nursing homes. This success has inspired care providers globally, including Agrace in Wisconsin. Agrace is currently constructing the first U.S. facility based on the Hogeweyk model, with an anticipated opening in 2027.
Lynne Sexten, president and CEO of Agrace, noted the stark contrast between Hogeweyk and typical U.S. memory care facilities during her visits. She observed fewer residents who were bed-bound or required oxygen, and a less regimented daily structure. "It’s monumentally different from what we see in memory care in the US," Sexten remarked.
Van Hal continues to advocate for this paradigm shift through his consulting work, encouraging more facilities to adopt the Hogeweyk model. "It’s about changing our perspective on people with dementia from thinking of them as patients with dementia to thinking of them as persons living with dementia," he said. "That’s my mission now."