Dutch-style care facilities offer independent living

A supermarket in a dementia village, De Hogeweyk, in Amsterdam, where patients are encouraged to shop for their daily needs, using a monthly budget allocated to each household. PHOTO: DE HOGEWEYK

Some nursing homes here could soon opt for a more independent style of living for dementia patients, after four voluntary welfare organisations (VWOs) took a study trip to the Netherlands last month to visit facilities that treat patients with the condition.

Key staff from Thye Hua Kwan Moral Charities, Peacehaven Nursing Home, St Joseph's Home and Lions Befrienders visited a dementia village, a farm and an apartment complex for seniors on a trip by ageing consultancy Ageing Asia.

They were won over by the Dutch way, which advocates the philosophy of pursuing your own life as much as possible even if you are old and have dementia.

This style of living helps to slow the rate of decline in the patients, as it discourages dependency.

At dementia village De Hogeweyk in Amsterdam, there are facilities such as a supermarket where patients are encouraged to shop for their daily needs.

The residents are grouped together with about seven to one apartment, each with his or her own room. All have to manage the household with help from staff members.

"Everything is natural and nothing is forced. Each house is given a budget every month, and every day the residents can pick up what they want for their meals," said Ms Janice Chia, founder of Ageing Asia.

The residents are also allowed to wander around the village, which has facilities such as restaurants - giving them a sense of independence and freedom.

In Singapore, nursing homes have been criticised for being too institutionalised, with patients placed in hospital beds. At some facilities, patients are not allowed to leave their rooms without supervision.

The group also visited a green care farm for dementia patients, where agricultural activities are combined with care services.

Activities include growing vegetables, milking cows or doing household chores.

Around 250 green care farms in the Netherlands care for dementia patients and aim to get them to participate in meaningful activities.

While it is not possible to adopt all these measures in space-constrained Singapore, the VWOs believe some aspects can be tweaked.

Peacehaven executive director Low Mui Lang is even thinking of sacrificing some office space to make room for social activities, for her residents.

Another idea is a shared kitchen, where patients can help themselves with simple tasks, such as getting a drink.

"In Singapore, there is a culture of workers doing everything for patients, just because they pay for the service," she said. "But when they have maids or nurses, they aren't independent anymore. They begin to lose a lot of their physical mobility and social skills.

"What we need to re-think is the model for nursing homes, which is now like a medical institution rather than a place where people stay. They should be more like homes."

Most such facilities in Singapore are around eight storeys high but Madam Low wants them to expand even higher to give patients more space to move around.

"If they have space to hang out and move around, they can help themselves instead of staff helping them all the time. We should be increasing their well-being, rather than making it so medical and routine, like now, " she said.

Madam Low also wants to give volunteers incentives such as meals for helping patients.

"In the Netherlands, their volunteer recruitment is very good, and it's how they handle the manpower crunch. They reimburse transport and meals."

At the national level, VWOs also want to introduce insurance for long-term patients and diplomas for those who care for them.

Mr Norman Tan, divisional director for community outreach services at Lions Befrienders, said: "We should build on MediShield Life or have another insurance scheme. Right now, ElderShield doesn't quite cover long-term care."

In the Netherlands, the payout can be as high as €2,000 (S$3,000) per month for such patients, enough to pay for a home-based carer.

Mr Tan added: "We must start building such jobs and career paths now."

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A version of this article appeared in the print edition of The Sunday Times on January 24, 2016, with the headline Dutch-style care facilities offer independent living. Subscribe