Dutch “farm” offers community living for people with dementia

May 2015

A man tends to the flowers at Reigershoeve farm in Holland
Courtesy of Reigershoeve

At first glance, Reigershoeve looks like a regular Dutch farm. Vegetables grow in raised beds, chickens lay eggs, and goats graze in the grass. But, Reigershoeve is more than a farm; it is home to 27 people living with dementia — a progressive brain disorder that makes it difficult to remember or perform everyday activities.

In the Netherlands, small-scale care facilities, like Reigershoeve, are providing community living for people with dementia who can no longer be cared for within their own homes.

At Reigershoeve, 4 group homes surrounding a large garden accommodate 6 to 7 residents and a care attendant. Inside they enjoy a communal living room and kitchen, but can retreat to their individually furnished apartments for privacy. Residents help the care attendant with chores, cook their own meals or go for a walk when they choose. Independence is greatly encouraged.

“It is important that people with dementia experience freedom and normalcy every day,” says Dieneke Smit, Manager of Reigershoeve. “Our residents are able to enjoy being outside when they choose and it is a safe environment for them. We take the time to learn their daily habits and make them feel at home.”

Coordinated, quality care for all

“It is important that people with dementia experience freedom and normalcy every day,”

Dieneke Smit, Manager of Reigershoeve

In 2012, WHO called on countries to invest in health and social systems to improve care and services for people with dementia and their caregivers in the report: “Dementia: a public health priority”. The Netherlands has been a frontrunner in developing national plans to care for the estimated 250 000 living with dementia in the country.

On average, people with dementia live 8 years after diagnosis — the first 6 are spent at home and the last 2 are spent in care facilities. Coordinating that transition for people with dementia and their families in the Netherlands was not always smooth. Families and patients did not have a central contact who could help coordinate all of the services needed.

“In the Netherlands we found that more coordination in care was necessary,” explains Jacqueline J.M. Hoogendam, dementia specialist, Ministry of Health, Welfare and Sports. “People with dementia benefit from clear pathways of care, and ideally, a one-stop shop for all their care needs and wishes.”

Over the past decade, the Netherlands National Dementia Programme, created in consultation with caregivers, has set national treatment and housing standards for people with dementia, organized case managers to develop patient care plans and increased community involvement in informal care. Additionally, the country is funding research projects to study all aspects of dementia — from cause to diagnosis, treatment, prevention and support for people living with dementia and their caregivers.

Bringing quality care into the home

Prior to the Netherlands National Dementia Programme, options for care included living at home and travelling to services or living in large residential care facilities, that varied in quality and service. This left people with dementia and caregivers looking for other options, says Dieneke Smit, whose grandmother, grandfather and uncle all had dementia and led her father and her to open Reigershoeve.

Now the Netherlands is working to keep people living with dementia in their homes as long as possible by bringing more care into their homes.

“We try to offer care in a way that enables people to stay at their own homes as long as possible,” says Hoogendam. “As of January 2015, we now offer people with dementia and other diseases the possibility to receive nursing home care in their own homes, provided their social network is able to facilitate this type of intensive care.”

If people can no longer live at home, Dutch public insurance funds nursing home care, including in small-scale facilities, like Reigershoeve. But, most of the facilities focused on community living are at capacity.

“The Netherlands National Dementia Programme is working to provide more organized care closer to home so that people living with dementia today and in the future are fully integrated into their local communities,” says Hoogendam.