Alzheimer’s disease and dementia treatment in Europe influencing North America

Hogeweyk_boulevardRGBAs Ontario’s population ages, dementia and Alzheimer’s disease, a degenerative disease that affects the brain, will affect a growing number of people. According to the Alzheimer’s Society, approximately 747,000 Canadians currently live either with Alzheimer’s disease or another form of dementia. That number is expected to increase to 1.4 million in the next 15 years. Right now, one in 20 Canadians over 65 has Alzheimer’s Disease and, among Canadians over 85, that figure jumps to one in four.

Several months ago, the Alzheimer Society of Ontario distributed a “Dementia Strategies Priorities” survey that was filled out by thousands of people around the province. The society hopes to use the results of the survey, and the over 1,140 responses they received, to drive their continued relationship with the province’s ministry of Health and Long-Term Care. Some of the survey’s findings include that service providers highly favour “strengthening the dementia workforce,” and that educating people “to overcome the stigma” of dementia is now somewhat of a lower priority for responders, perhaps indicating that public awareness campaigns and education have already helped to reduce the stigma. The top five priorities identified in the survey included increasing access to respite and home care services, providing financial assistance to caregivers, increasing flexibility in how services are delivered, promotion of early diagnosis, and increasing public education encouraging brain healthy lifestyles.

Hogeweyk_interieur_002RGBIn a November 2014 letter to his parliamentary assistant, Halton MPP Indira Naidoo Harris, Minister of Health and Long-Term Care Dr. Eric Hoskins identified issues the province would have to address in order to meet the health care needs of a growing senior community. “We must put in place a comprehensive strategy to provide quality care to patients and appropriate supports to caregivers at home and in the community,” Hoskins wrote. Naidoo Harris’ responsibilities, he said, include “using research and innovation to explore ways in which we can improve supports for these diseases throughout the sector,” as well as helping to develop “a comprehensive strategy to care for patients with Dementia and Alzheimer’s disease.”

In Europe, some very innovative and unique treatments for Alzheimer’s and dementia have made headlines in recent years that certainly bear consideration here in Canada. The most famous of which is the so-called “Dementia Village” of Hogewey, located on the outskirts of Amsterdam in the Netherlands, founded by Yvonne van Amerongen in 2007.

Hogewey is similar to a typical Dutch village in many respects; it has a town square, parks, a theatre, cafes and a post office. What’s different about it is that its 152 full-time inhabitants are under constant surveillance by the other inhabitants, who are caretakers dressed up in street clothes. Posing as cashiers, gardeners, postmen, these nurses and attendants oversee the residents of Hogewey, who are all dementia and Alzheimer’s patients. There’s only one door in and out of town, and the patients’ friends and families are encouraged to visit. Six or seven residents share homes, which are decorated to resemble the era when their memories began failing, to help them feel more at home. All their costs around the village are covered under Hogewey’s payment plan, which is partially subsidized by the Dutch government.

Some might view the lifestyle at Hogewey as dishonest to the patients, however experts have found that Hogewey residents require fewer medications, eat better, live longer, and appear happier than residents of traditional long-term care facilities. While residents of these facilities may only go outside for several minutes a day, at Hogewey an active lifestyle is encouraged, with employees organizing day trips to nearby shopping centres, and special two-seater bikes allowing residents to cycle alongside health-care workers, volunteers or family members.

Since Hogewey was opened, it has attracted the attention of experts in the field of dementia from the USA, United Kingdom, Germany, and elsewhere, with many booking trips to come see the village in person. Smaller-scale Hogewey-style projects have been introduced in England, where the Abbey Place Nursing Home opened a 1950s-themed dementia village, as well as in Switzerland, Rome, Miami and Penetanguishene, Ontario.

A section of the Georgian Bay Retirement home was converted to the look and feel of the 1950s and 1960s back in August 2014 to “promote the feeling of comfort in surroundings familiar” to patients.

Still, these steps are not always enough to curb the feelings of some dementia patients who feel sure they have something important to do, or somewhere important to be. In Germany, retirement home operators have taken to building fake bus stops outside the homes. There, the patients may sit for hours, waiting for a bus that never comes until they decide they’ve missed their ride or someone from the home drives by to “pick them up.” Some homes may even include vintage advertisements or bus schedules on their phony bus stops to enhance that sense of familiarity with patients.

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