The concept of specialized residential care for people living with dementia is shifting away from traditional, institutionalized settings. This innovation led to the development of “dementia villages,” a care model first popularized by the Hogeweyk facility in the Netherlands. These unique communities aim to normalize the living experience for residents with advanced cognitive decline by creating a fully functional, small-scale world. This article explores the characteristics of this model and estimates the scale and geographic distribution of these communities.
What Defines a Dementia Village
A dementia village is an innovative, self-contained community designed to replicate a typical neighborhood while providing 24-hour supervised care. The core philosophy is de-institutionalization, replacing the clinical feel of a nursing home with an environment that promotes autonomy and a familiar daily routine. This is achieved through architectural design and a specialized approach to staffing and activities.
Physically, these communities resemble a small town, often featuring streets, gardens, and public amenities like a grocery store, hair salon, or café. This design encourages freedom of movement, allowing residents to wander and engage in everyday activities within a secure perimeter. Residents are housed in small, homelike units, typically shared by six to eight people with similar backgrounds or lifestyle preferences.
The care approach emphasizes person-centered support, where staff often dress in civilian clothes instead of medical scrubs to minimize the sense of being in a facility. Caregivers are integrated into the household, helping with cooking and cleaning alongside residents to maintain a domestic and purposeful routine. This focus on normalcy and small-group living is intended to reduce anxiety, agitation, and the need for anti-psychotic medications often seen in traditional long-term care settings.
The Current Global Count and Key Locations
Pinpointing the exact global number of operational “dementia villages” is challenging because the term is not strictly standardized. Defining a dementia village as a fully self-contained, Hogeweyk-style community with simulated town amenities, the global count remains small, likely numbering in the low double digits. This limited number reflects the high construction costs and regulatory hurdles associated with developing such a complex facility.
The Netherlands, the birthplace of the model, continues to lead with the Hogeweyk facility near Amsterdam, opened in 2009. Europe has seen the most successful replication, with notable examples including Village Landais in Dax, France, and Il Paese Ritrovato (“The Rediscovered Village”) in Italy. These facilities often benefit from national healthcare systems that support the high staff-to-resident ratios and specialized architectural requirements.
Beyond Europe, other countries have implemented similar large-scale projects. NewDirection Care at Bellmere in Australia separates residents into small homes clustered around a central community hub. In Canada, the Village Langley in British Columbia utilizes a specialized design with vibrantly colored homes and a central artery connecting amenities. These examples demonstrate that the model has inspired fully realized communities across multiple continents.
Emerging Models and Future Expansion
The future expansion of this care model is trending toward adaptation, with new projects modifying the original concept or integrating its principles into existing structures. In the United States, the first full-scale, purpose-built dementia village is in the pipeline, such as LIVASU Village in Wisconsin. This project plans to use a unique, privately owned home model, providing homeowners with dementia full autonomy, 24/7 care, and community amenities like a grocery store and theater.
Other emerging models focus on smaller-scale applications, such as the “cottage” model adopted by organizations like HammondCare in Australia. This model groups residents into small, domestic-style homes within a larger care campus, allowing for a homelike feel without the expense of building an entire simulated town. Facilities are also adapting the village concept into day care settings, such as Glenner Town Square in California, which recreates a 1950s-era town square to engage participants through reminiscence therapy.
Planned developments continue in Europe, with facilities like Furuset Hageby in Oslo showcasing how the village design can be adapted to colder climates and confined sites through interconnected buildings and courtyard designs. These new developments, whether full villages or integrated “neighborhoods,” signal a growing global commitment to deinstitutionalizing dementia care. Although the number of full-scale dementia villages remains small, the foundational principles of normalization, freedom, and small-group living are rapidly becoming the standard for modern memory care design.