99% Invisible – 557- Model Village

Intro

In this episode of “99% Invisible,” titled “Model Village,” the focus is on the design of environments for people with dementia. The podcast explores the history of dementia care in the Western world, the negative perceptions associated with the disease, and the emergence of dementia-friendly design. It highlights the Hogo-Wike in the Netherlands as a model village that prioritizes the needs and autonomy of dementia patients. The episode also discusses the changing perception of dementia and the importance of treating people with dignity and respect.

Main Takeaways

Dementia Care in the Western World

• Dementia care in the Western world is often unstimulating and medicalized, with patients locked away in hospital-like environments.
• Public mental hospitals and nursing homes designed to contain people with dementia often had harsh conditions, with staff using physical restraints and sedatives.
• Very few resources have been used to study the lived experiences of people with Alzheimer’s or to improve the spaces they inhabit.

The Fear and Despising of Dementia

• Dementia was once seen as a natural part of getting older, but new medical technologies led to a fear and despising of the disease.
• Doctors had no way to diagnose or treat Alzheimer’s disease until well into the 20th century, leading to patients being locked away from society.
• Alzheimer’s disease kills 100,000 Americans every year and strikes up to 2 million elderly people.

The Hogo-Wike: A Model for Dementia-Friendly Design

• The Hogo-Wike in the Netherlands is a model for dementia-friendly design, which is personalized, human-centered, and accommodating to the specific needs of dementia patients.
• Dementia-friendly design prioritizes minimizing visual confusion with lots of natural lighting and uniform countertops and flooring.
• The Hogo-Wike is a village made specifically for people with advanced dementia, where they can live until they die, but it does not look or feel like a place of sickness and death.
• The Hogo-Wike’s unique architectural concept includes rings of privacy, where residents are in the outermost ring in public places like the courtyard, allowing them to encounter dozens of passing strangers and friends.
• The Hogo-Wike’s design emphasizes a lifestyle approach, a recognizable environment for people with Alzheimer, a safe built environment, and daily life pleasures.

Changing Perceptions and Stigma

• Perception of dementia has changed from being seen as inevitable to a disease, largely due to Dr. Robert Butler’s work.
• Dr. Robert Butler coined the term ‘ageism’ in 1968 and won a Pulitzer Prize for his book ‘Why Survive, being old in America’ in 1975.
• Butler’s campaign led to a boom in funding and awareness for Alzheimer’s disease, which became a household name and a ‘dread disease’.
• Stigma surrounding dementia and Alzheimer’s leads to mistreatment of those with the disease.

Summary

Designing Environments for People with Dementia

In the Western world, dementia care has historically been unstimulating and medicalized. Patients were often locked away in hospital-like environments, subjected to harsh conditions and physical restraints. However, a new movement is emerging that focuses on designing environments where people with dementia can live as normally as possible until the end. This movement aims to improve the quality of life for dementia patients and challenge the negative perceptions associated with the disease.

The Hogo-Wike: A Model for Dementia-Friendly Design

The Hogo-Wike in the Netherlands serves as a model for dementia-friendly design. It is personalized, human-centered, and accommodating to the specific needs of dementia patients. The design of the Hogo-Wike prioritizes minimizing visual confusion through natural lighting and uniform surfaces. It is a village specifically created for people with advanced dementia, providing a recognizable environment that does not resemble a place of sickness and death. The architectural concept of rings of privacy allows residents to interact with passing strangers and friends, fostering a sense of community and engagement. The design also emphasizes a lifestyle approach, ensuring a safe built environment and daily life pleasures.

Changing Perceptions and Stigma

The perception of dementia has evolved over time, largely due to the work of Dr. Robert Butler. Previously seen as an inevitable part of aging, dementia is now recognized as a disease. Dr. Butler’s advocacy and research on ageism and Alzheimer’s disease led to increased funding and awareness. However, stigma surrounding dementia still persists, resulting in mistreatment and a lack of dignity for those with the disease. It is crucial to challenge these negative perceptions and prioritize the well-being and autonomy of people with dementia.

Conclusion

The design of environments for people with dementia plays a significant role in their quality of life and well-being. The Hogo-Wike in the Netherlands serves as an exemplary model for dementia-friendly design, emphasizing personalization, human-centeredness, and accommodation of specific needs. By challenging negative perceptions and prioritizing dignity and autonomy, we can create spaces that promote engagement, community, and a sense of normalcy for people with dementia.