In August 2019, Canada’s first “dementia village” – a community specifically designed for people living with dementia – opened in Langley, B.C.
“We practice person-directed care, focused on enriched living” said Adrienne Alford-Burt, executive director at the Village Langley. The philosophy of person-directed care is centred on values including choice, preferences, self-determination and meaningful living.
Villagers live together in cottages, with private rooms and ensuite bathrooms as well as a communal kitchen, activity space and library. The homes encircle a plaza and community centre, which includes elements like a grocery store, cafe, salon, workshop and medical clinic. The surrounding grounds contain a vegetable garden, water garden, sensory garden and barn with animals.
Inspired by dementia villages in the Netherlands and United States, the Village Langley was designed to encourage residents to live as normal a life as possible. They’re free to explore the enclosed five-acre property and engage in whichever activities they wish.
Understanding & treatment
Dementia is a medical term describing conditions occurring when the brain stops functioning properly. Symptoms may be minimal in the early stages, but as the disease progresses memory disorders, personality changes and impaired reasoning increase. Over time, dementia can reduce a person’s ability to live a normal independent life.
There are hundreds of different types of dementia, all with different symptoms. Some people may not have a poor memory but find speaking difficult. Others may not remember the day of the week but can still cook and bathe. And there are some people diagnosed with dementia who also suffer from anosognosia – a total lack of awareness of their disease.
In Canada, more than 700,000 people – about one percent of the population – live with some form of dementia, according to the Alzheimer’s Association.
With so many Canadians facing this life-changing disease as they age, organizations are shifting their approach to dementia care.
This spring, the Federal Minister of Health released Canada’s first national strategy on dementia. Their vision is “of a Canada in which all people living with dementia and caregivers are valued and supported, quality of life is optimized and dementia is prevented, well understood, and effectively treated.”
In September, the Brenda Strafford Foundation published A Guide to Create Dementia Friendly Communities in Alberta. Defining a dementia-friendly community as one where people feel comfortable being themselves, the foundation released their guide with the goal of creating local supports, removing barriers and reducing stigmas associated with dementia.
The Glebe Centre in Ottawa uses an approach called “butterfly care” for their patients with dementia. This method includes bright colours, music and community meals. It focuses on the patient’s need for connection and meaning more than on rules and schedules.
Happiness & safety
Dementia consultant and educator Karen Tyrell says care homes are not always ideal for those with dementia. Many families decide to care for their loved one at home and must find a way to balance caregiving with day-to-day life.
Providing care for someone suffering from both dementia and anosognosia can be challenging, since the individual believes they can live a normal life while their family knows certain behaviours, like driving, are unsafe. In this situation, Tyrell recommends therapeutic reasoning.
“Something that is therapeutic is also known as beneficial,” she said. “If we use therapeutic reasoning, families can keep the peace in the house by agreeing with them. ‘I know you can do it, but let me do it today.’”
In regards to dementia care, this means reasoning in a way that is logical to the person. This could feel dishonest, but Tyrell said for those dealing with anosognosia it’s a survival tactic since there is nothing you can do to convince them they have a disease.
“They firmly believe there’s nothing wrong with them. They have the diagnosis but they refute that. It’s strong in a lot of people,” she said. “Make them as happy as possible. Make them feel like they’re fine, but also provide the proper care and safety measures.”
The person-directed model practiced at the Village Langley is based on preference and permission, regardless of ability or cognition. Now three months old, there is a waiting list to join the privately-funded community.
“We give options where they can feel respected and they’re enabled,” Alford-Burt said. “Their preferences may change and we change accordingly.”