A settlement for oblivion

Za "Time" from Vespa

In Vespa, I will build almost merged with Amsterdam, an elderly woman and her daughter push a cart to the supermarket. Not far away, a woman with a walker and a stuffed dog smiles at an old man. A child runs through. People are chatting in the cafe. Looks like a typical one Dutch quarter. But this is a completely different story.

Hogewijk is the world's first "village" for people with serious disabilities dementia. Unlike other nursing homes, this one was built as a residential area. The houses have numbers, there are gardens and sheds, shops, a cafe, a restaurant, a concert hall and a theater. Doctors and other staff don't wear monotonous blue or white suits, but sweaters and jeans. They act as if they too are part of the settlement in order to make the patients feel as normal as possible.

About 55 million people in the world live with dementia. World Health Organization believes that this number will increase to 139 million within a quarter of a century. The frequency of the disease has to do with the aging population. Dementia leads to a decline in cognitive abilities. It is progressive, so faster and faster. He forgets. They lose their memories. Everyday things become confusing, like getting dressed or preparing a simple meal. There is no cure, it can only get worse. In many countries, people with dementia spend their last years in closed institutions. Some are locked up to "protect" themselves - to keep them from wandering off or harming themselves. "We want to show that people with dementia can do much more than they think - if they are offered a good living environment and support," says Eloy van Hull, a consultant at Vivium, the care concern that runs Hogewijk. "In other countries, people are sometimes tied to wheelchairs, beds and chairs," he tells "Vreme" as he walks through this special neighborhood, which is somewhat his child.

photo: be advice de hogeweyk vivium yorggroep

ALMOST LIKE HOME

People go shopping and for beer. They become friends, some fall in love. "It's nice here," says Pete, as he shows us his house. It's not really his house, but he lives there with others. Some of these people do not know where they are and believe they are at home.

In Pete's home, two women chat with the caretaker while they prepare food. Tenants often help with simple things, cooking, setting the table, taking care of the garden. Another caregiver works at a computer hidden in a closet in the middle of the living room. The carer helps Pete put on his jacket because he wants to go for a walk.

Each of the houses has its own door, small garden or terrace. Six or seven people live in each. Each of them has its own bedroom. Van Hull does not recommend that people with severe dementia be cared for by the elderly family. He knows about this from personal experience - his mother is demented. "It can be too much of a burden for the family, and often leads to inadequate care for the patient - even though he may want to live in his own," he says.

BINGO IS PLAYED ON FRIDAYS

To get to Hogewijk, patients must have severe dementia, later stages of Alzheimer's or similar. They need twenty-four hour care. Anyone can apply for admission to this demented village. They spend up to two years on the waiting list.

The settlement covers an area comparable to two football fields and has 23 houses. There is room for 150 people. There is no visible fence, but the houses are lined up like a block, so there is no way out either. There is a receptionist at the entrance. Tenants move freely in the settlement. The staff organizes everyday life in one of the buildings on the "boulevard", a promenade where there is also a hairdressing and beauty salon. Bingo is played on Fridays. There are evenings for singing hits in the bar, painting classes, riding bicycles, buying tickets for concerts and plays that are performed in the neighborhood. Sometimes we go on trips to the famous Rijksmuseum in Amsterdam. Hogewijk is 99 percent financed from the state budget. The remaining money is provided by private donors.

The Dutch healthcare system is considered one of the best in the world. It is based on solidarity - rich, poor, young, old, healthy, sick, everyone has the right to affordable care. Health insurance is mandatory, similar to Serbia. The Dutch are interested in the quality of care for the elderly - hence the investment in Hogewijk. Here, people with dementia are allowed to keep sharp knives in the kitchen. No one would allow that in ordinary homes.

"People should be afforded simple pleasures. What makes them happy. To drink a cup of tea or coffee, go for a walk and meet friends. You do something at home, but then you go out and you're in a different space. It's the same here. People are active and meet other people. It's also about mental health," says this advisor.

Angelika Fodor, a nurse originally from Slovakia, has been working in Hogevejk for thirteen years.

"In the Netherlands, the relationship between doctors and patients strives for equality," he says. "In Slovakia, it's hierarchical - the doctor decides, he has a reputation, he studied and knows everything, so he proves it to everyone. Here, on the other hand, you have to take care of the patients' personal needs and keep an eye on the group dynamics. You need to know who comes from where, what their character is, in order to provide the right care."

photo: be advice de hogeweyk vivium yorggroep

REALITY OR ILLUSION?

Not everyone is enthusiastic about this model. Some compare it to a movie The Truman Show, in which the character played by Jim Carrey lives his whole life in a reality show he knows nothing about. All the others are actors. In Hogewijk, many patients do not know where they are. Is this actually a fantasy world where carers pretend to be good neighbours? Can such a play be moral?

Van Hull disagrees. As he walks through the supermarket in the neighborhood, he says: "People who haven't been here think that we are playing supermarket, that there are fake products on the shelves. But that's not the case. Here, people buy real food with real money in the store. And caregivers buy breakfast and dinner."

Neighbors who live near the settlement can also come and eat in the restaurant. The staff, they say, are not faking anything, but the restaurant's employees really earn a salary by selling food and drinks to visitors.

WORKERS LIKE POTATOES AND BEER

Criticism is also heard because the houses in the neighborhood should reflect different lifestyles. That is, different layers of society. Patients thus end up in houses that are "urban", "traditional", "formal" or "cosmopolitan". Each looks different.

Tenants who come from the working class will thus receive more "classic" meals, more potatoes, for example. They watch the local news on television. "Cosmopolitans", on the other hand, get some fine tea and wine, listen to classical music. "In a traditional house, for example, there might be a plastic fly on the table, but not in a formal one. There are linen tablecloths," says Van Hal. For him, it's a way to make different people feel at home. "You are you. If you belong to a certain lifestyle, if you see similar people around you - it provides refuge. We just recognize that identity, culture and habits play a role. Details matter."

LET'S TALK ABOUT DEATH

photo: be advice de hogeweyk vivium yorggroep

Small residential units, discreet care and freedom of movement - this is how this small town in the Amsterdam hinterland has become a global model. The model has been applied in Germany, France, Italy, Switzerland, Australia and New Zealand. Admittedly, not everyone accepted the model with more "lifestyles".

"They have to make their own decisions and develop a model that fits their culture and values. We are not on a mission to impose the Dutch model," says Van Hal

Elsewhere, the Dutch open approach to the topics of illness and death may also be poorly understood. In the Netherlands, the terminally ill receive care that focuses on relieving pain and providing comfort. Euthanasia laws allow a doctor to help bring death as soon as possible - under strict conditions. In Hogewijk, that rarely happens, says Van Hal. But no one hesitates to talk about death.

"Sometimes someone falls. But, in return, they have privacy and can live alone. There will always be accidents. Here we can almost promise people that they will fall at some point. And that also means freedom. What do you want in the last phase of life? If you're going to die in two years, what really matters? Treatment or going to a concert? I think it's just about quality of life," says Van Hal.

Elsewhere, he says, death is less discussed. "In Italy and Japan, for example, you can't just talk about death. It's hidden and people seem to feel a duty to go to a hospital and die there. We look at it differently." Van Hal is very progressive here, one would say beyond the limit of taste. Other nursing home managers, he says, brag when none of their residents die. "But here death is just a part of life."

Van Hal has big plans. "I dream that even a person without dementia can rent an apartment in a safe neighborhood in the middle of a care facility. If families live here. Intergenerational living, that would be great."

Translated by Nemanja Rujević