Journal of Sacred Work

"We have to remind ourselves constantly that we are not saviors. We are simply a tiny sign, among thousands of others, that love is possible, that the world is not condemned to a struggle between oppressors and oppressed, that class and racial warfare is not inevitable.” -Jean Vanier

In the American healthcare landscape, we recognize that expensive care does not guarantee quality. There is tremendous waste in our system, care is often fragmented and impersonal, and our outcomes are less than stellar. The latest buzz word is patient-centered care. However, as I learned about Hogewek Village in the Netherlands, this concept took on a whole new meaning.

In 1992, Yvonne Van Amergon received a dreaded call. Her father had died suddenly of a heart attack. At the time, she was working in a nursing home. She comforted herself with the thought that at least he did not end up in a nursing home. This also left her with the unsettling question of why? What could be done to transform a nursing home into a place someone might want to live in?

She shared her thoughts with a few colleagues and they brainstormed ideas about alternative  living situations. Overtime, the nursing home was redesigned into Hogewek Village; a gated community for people living with advanced dementia. What makes this village unique, and the only one of its kind world-wide, is a reverence for human dignity.

At Hogewek, the 152 residents share homes with people who have similar interests. Each of the 23 homes is distinguished by lifestyle themes, such as; city life, working man, aristocratic, spiritual, country, etc. The residents are actively engaged in daily life. They help with grocery shopping cooking, washing and typical household management. These activities include exercise, music and community living, which are all regenerative in nature.

There are no locks on any of the house doors and residents are free to come and go about the village as they wish. They can go on walks and breathe in fresh air, feel the sun upon their faces and notice the changing of the seasons. The village has a town square, park, theater, grocery store, café, garden, post office and a pub. The shops are run by caregivers who work as cashiers, hair dressers, neighbors and the like. All of the caregivers are specially trained in dementia care. They dress in street clothes rather than uniforms and the ratio of patients to caregivers is 2:1 with 24 hour care and supervision.

To avoid unnecessary frustrations residents do not have to worry about paying for things because it is included in their monthly rent. The cost to live at Hogewek is comparable to a typical nursing home and the facilities are all government funded. Safety is of utmost concern. The elevators have door sensors so a person does not have to remember to push a button.

The goal of Hogewek Village is to create a sense of normalcy for residents, nurture a sense of community and enjoyment of life. Thus far, the people living in this community require less medication and tend to live longer, happier lives.  In the future, Hogewek would like to enlarge their accommodations so that a patient’s partner could live at the village too. Switzerland has plans underway to develop a similar community that is scheduled to open in 2018. I hope the innovation of Hogewek Village expands far and wide and is adopted in our country.

"These people also show their 'helpers' their capacity for love, the forces of love in their hearts. A poor person has a mysterious power: in his weakness he is able to open hardened hearts and reveal the sources of living water within them. It is the tiny hand of the fearless child which can slip through the bars of the prison of egoism. He is the one who can open the lock and set free. And God hides himself in the child.” -Jean Vanier