Most of us think of nursing homes as places of safety and care, but also of limits. Long hallways, shared dining rooms, set schedules, and routines dictated more by staff than by residents. For people living with dementia, this institutional model often prioritizes medical care and safety at the cost of autonomy and dignity.
There’s another way.
The Dementia Village Concept
In the Netherlands, a groundbreaking community called De Hogeweyk has pioneered a new approach. Known as the “dementia village,” it resembles a small, enclosed village with homes, a supermarket, a café, a theater, and outdoor spaces. Residents live in small households of about six or seven people, each styled according to a familiar lifestyle—urban, cultural, artisan, and more. Meals are prepared in household kitchens, and staff blend in as neighbors or shopkeepers while still providing 24/7 care.[1]
How It Differs from Traditional Care
Built on the simple philosophy that people with dementia should live as normal a life as possible, the dementia village model contrasts sharply with traditional settings:
| Feature | Dementia Village (Hogeweyk Model) | Traditional Nursing Homes/Assisted Living |
|---|---|---|
| Environment & Design | Designed as a safe, enclosed village with homes, shops, café, theater, and park-like outdoor areas[1:1] | Institutional layout with corridors, clinical décor, and limited shared space |
| Living Arrangements | Small households (6–7 residents), lifestyle-themed, meals cooked in-house | Private or semi-private rooms, centralized meal service |
| Daily Life | Residents shop, walk, attend events, follow familiar routines | Structured group activities, staff-driven scheduling |
| Care Philosophy | Life-centered: dignity, autonomy, and normalcy | Care-centered: health and safety prioritized over lifestyle |
| Socialization | Natural interaction, reduced isolation, less reliance on medication[1:2] | Clinical environment, higher risk of behavioral decline |
| Mental Health Impact | Familiar settings reduce anxiety and confusion | Institutional settings often increase agitation or wandering |
| Global Reach | Originated in the Netherlands; inspired similar efforts abroad[1:3] | Still remains the most common model globally |
Residents in dementia villages often experience less isolation, fewer behavioral issues, and a lower reliance on medication. Familiar surroundings reduce anxiety and confusion, allowing them to remain engaged in life.
Why It Matters for New York
This isn’t just an idea overseas. In 2019, the New York State Bar Association’s Elder and Special Needs Law Section convened a task force to explore how the Hogeweyk model could be adapted in New York.[2] The goal was to bring together housing developers, service providers, advocates, and attorneys to reimagine elder housing in the state.
If New York were to adopt this model, it could shift the focus of elder care from institutions toward communities of dignity and purpose.
Looking Ahead
The dementia village concept isn't just about building design—it’s a care philosophy emphasizing autonomy, familiarity, and respect, even amid cognitive decline. As our population ages, we must ask: Will we continue down the path of institutional care, or will we invest in environments where people with dementia truly live?
See Hogeweyk, Wikipedia, https://en.wikipedia.org/wiki/Hogeweyk; Sarah Zhang, The Dutch Village Where Everyone Has Dementia, The Atlantic (Nov. 14, 2014), https://www.theatlantic.com/health/archive/2014/11/the-dutch-village-where-everyone-has-dementia/382195/; Amelia Gentleman, Shops, Cafés and Round-the-Clock Care: Life in a Dementia Village, Guardian (Mar. 12, 2018), https://www.theguardian.com/society/shortcuts/2018/mar/12/life-dementia-village-development-kent-hogeweyk. ↩︎ ↩︎ ↩︎ ↩︎
Judith D. Grimaldi, Message from the Chair, N.Y. State Bar Ass’n, Elder & Special Needs Law Journal, Vol. 29, No. 2, at 4–5 (Spring 2019). ↩︎
Hani Sarji
New York lawyer who cares about people, is fascinated by technology, and is writing his next book, Estate of Confusion: New York.
Leave a Comment