The Hogeweyk dementia village in the Netherlands has revolutionized care for individuals with dementia, combining freedom, community, and safety in a way that challenges traditional institutional care. Opened in 2009, Hogeweyk was conceived by the Vivium Care Group, led by Jannette Spiering, who began developing the concept in 1993. This innovative model has inspired projects around the world, from nearby Scotland to as far away as Australia and the United States. These initiatives showcase the global impact of Hogeweyk’s philosophy, even as they grapple with financial, cultural, and logistical challenges.
The Vivium Care Group is a not-for-profit organization that provides care funded through the Dutch healthcare system. The Hogeweyk project is supported by Be Advice, Vivium’s advisory department, which shares the knowledge and experience gained from the Hogeweyk model with a global audience. Be Advice offers educational programs, study visits, and consultancy services to care workers, architects, governments, and others interested in dementia care. While the Hogeweyk remains a key location within Vivium, Be Advice operates independently, charging fees for its services to cover operational costs, as it cannot access the healthcare budget allocated for resident care.
What Makes Hogeweyk Dementia Villages Unique?
Hogeweyk, located in Weesp, Netherlands, opened its doors in 2009 after more than 16 years of planning and development by the Vivium Care Group, spearheaded by Jannette Spiering. Dissatisfied with traditional care models focused solely on medical needs, Spiering and her team envisioned a “small-town” environment that normalizes life for individuals with severe dementia.
The village includes 27 homes, each accommodating seven residents grouped by shared lifestyles and interests. This small-scale living environment is embedded within a secure, open-layout neighborhood that features a grocery store, café, hair salon, theater, and outdoor gardens. Residents participate in daily activities, from shopping to gardening, replicating familiar routines and fostering a sense of purpose.
Crucially, the model emphasizes freedom and dignity. Residents can move freely within the village, with the environment designed to be safe yet unobtrusive. This approach reduces the anxiety often associated with institutional care and combats the stigma surrounding dementia. By integrating medical, social, and psychological care, Hogeweyk has shown that creating a life resembling normality leads to greater resident satisfaction and well-being.
Challenges in Implementing Dementia Villages Abroad
Replicating Hogeweyk’s model internationally has posed significant challenges, highlighting the complexity of adapting its principles to diverse settings.
Financial Challenges: Building dementia villages requires substantial investment in infrastructure, staff, and training. For example, Emmaus Village in Port Macquarie, Australia, faced cost overruns during its construction, which began in 2022 and concluded in 2024. The project relied on government funding, including $5 million from New South Wales and $6.5 million from the Federal Government. Despite these hurdles, the developers remained committed to Hogeweyk’s standards, proving the financial strain does not easily deter ambitious projects.
Cultural Adaptation: Different countries must tailor the Hogeweyk model to align with local customs and expectations. Scottish Borders Council’s upcoming dementia villages in Hawick and Tweedbank required input from the Dementia Services Development Centre at Stirling University to ensure compatibility with Scottish culture. Similarly, Lutheran Senior Services (LSS) in Missouri adapted the model to fit smaller-scale American settings, developing a memory care wing with 29 apartments rather than a full village.
Regulatory and Social Resistance: Zoning laws and community resistance have also slowed progress. For instance, United Methodist Communities in New Jersey, USA, has struggled with zoning approvals for its planned Avandell dementia village, which aims to include 15 houses for 105 residents. Local opposition often stems from misconceptions about dementia care or concerns over integrating such facilities into residential neighborhoods.
Staffing and Training: Ensuring that care staff are adequately trained in dementia-specific approaches remains an ongoing challenge. For example, LSS provided specialized training to staff across departments, from dining to marketing, to create an environment consistent with Hogeweyk’s person-centered philosophy.
Success Stories Inspired by Hogeweyk
Despite these challenges, numerous Hogeweyk-inspired projects have emerged as shining examples of what is possible when innovation meets determination.
In Australia, Emmaus Village officially opened in May 2024 after 16 years of planning. Located in Port Macquarie, it features 12 small homes with a capacity for 94 residents. Residents engage in daily activities in settings such as a café, corner store, and garden shed, mirroring Hogeweyk’s philosophy of a meaningful, community-oriented life. Despite construction delays and cost challenges, the project received enthusiastic community support, with over 700 visitors attending its open day in June 2024.
In Missouri, USA, Lutheran Senior Services launched Towne Plaza at Meramec Bluffs in July 2024. Adapting the Hogeweyk model to a smaller scale, the facility includes 29 apartments, sensory gardens, and interactive spaces like a general store and art studio. Independent living residents volunteer in the community, fostering intergenerational engagement. Future LSS projects, such as the Mason Pointe facility, are already incorporating elements of this approach.
In Scotland, plans for dementia villages in Hawick and Tweedbank are underway, inspired by Hogeweyk and adapted to the Scottish context. Expected to replace conventional care homes, these facilities aim to house up to 60 residents in Hawick with small-scale living environments and accessible communal areas. The project has drawn attention for its innovative design and its potential to normalize dementia care in the region.
These stories highlight the transformative potential of Hogeweyk’s model, proving that with persistence and creativity, its principles can improve lives worldwide.
by Erin Tallman
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