Dementia "Villages" Are Redefining Alzhemier's Care
The documentary special "Dementia—The Unspooling Mind" explores innovative models of care for dementia sufferers in Thailand and the Netherlands.
These unique residential complexes are the result of out-of-the-box thinking on how to keep this vulnerable population safe and relatively happy for the remainder of their days.
Dementia villages offer excellent individual care for a moderate monthly price. But the downsides are that the wait list is long and you may have to buy Granny a one-way ticket to a destination thousands of miles from home.
In 2015, an estimated 5.3 million Americans will be diagnosed with Alzheimer's disease. This number is expected grow each year as the proportion of the US population above age 65 continues to rise.1 The global cost of dementia is now $600 billion per year and is expected to soar even further.2
The World Health Organization predicts that by 2050, the number of people who make it past their 80th birthday will almost quadruple to 395 million—and one in six will be living with dementia.
More than 80 percent of current care home residents have significant memory problems or full dementia.3 With younger family members footing the bill, the cost of a good residential home is out of reach for many, causing some families to consider options outside of their own national borders.
The Exorbitant Cost of Dementia Care
When you consider what it costs to provide full-time care to a family member with Alzheimer's or other dementia, it's easy to see why some families are considering what might be called radical options—such as care centers on the opposite side of the globe.
Like the US, the average cost of residential or nursing care in the UK ranges from $3,600 to more than $5,000 per month. In Switzerland, the price tag's even higher at $5,000 to $10,000 per month.4 The exception seems to be Thailand.
Thailand is known for medical tourism. There, the cost of nursing care is significantly lower, and yet care quality remains high, according to most reports.
Thai culture places a large emphasis on looking after its elderly, which has paved the way for a different approach to care. A basic residential care package in Thailand is closer to $3,000 per month—and that package is likely to be more comprehensive.
Two 'Dementia Resorts' in Chiang Mai, Thailand
The film features two dementia care centers in Thailand, both located in the northern city of Chiang Mai—and both are in stark contrast to a typical "nursing home" or long-term care facility.
The first center is Baan Kamlangchay,5 established by Martin Woodtli, a Swiss psychologist who previously worked for Doctors Without Borders.
According to Woodtli, patients at his center generally don't require drugs to stay calm or locked doors to keep them safe. Instead, they're never without an attendant, so they have the benefit of continuous human interaction and supervision.
He says his guests "cannot explain it, but I think they feel part of a family, a community, and that's very important."6
About a dozen patients live in individual houses within one Thai neighborhood and are accompanied to local markets, temples, and restaurants, and receive personal around-the-clock care—all for $3,800 per month.
The second care center,7 located about 30 minutes from Chiang Mai, is owned by Peter Brown, a British entrepreneur who converted it from a four-star tourist resort. Brown's goal is to give each guest as much independence as their individual condition allows.
Care Resort Chiang Mai sits on 11 acres of trees, gardens, fishponds, and a lake. There are different designs ranging from studios to one- and two-bedroom villas, each equipped with a full nursing care station. Sightseeing excursions and a spa are part of their treatment.
'Dementia Village' in Weesp, the Netherlands
Perhaps the most interesting place of all is located in the Netherlands. On the outskirts of Amsterdam in a small town called Weesp, is Hogeweyk, also known as Dementia Village.8 Since 2009, more than 150 dementia patients have called this village "home."
As this is typically a person's last residence, the goal at Hogeweyk is to provide the most normal life possible, reminiscent of each individual's formative years.
Dementia Village has the sort of manufactured reality depicted in the movie "The Truman Show," where Jim Carrey portrays a man who discovers his entire life is actually a reality TV show.
There is only one way in and one way out... all doors open automatically, except those to the outside world. This four-acre village was built with the specific needs of dementia patients in mind, designed around common and familiar social and cultural building blocks.
For example, residents with shared interests and backgrounds live together in "lifestyle-groups," with the design and decoration of the 23 homes tailored to each type of lifestyle. Together, the residents manage their own households, in terms of washing, cooking, etc., with the help of staff members playing various roles.
Within each house, residents have their own large bedroom and then share a living room, kitchen, and dining room with their housemates. They buy their groceries at the Hogeweyk supermarket and get their medical needs tended at the outpatient clinic.
The village has all sorts of amenities, including a cafe and parks with gardens and fountains along streets where the residents can freely roam.9 Village staff are everywhere, cleverly blending in as ordinary town folk. According to CNN:10
"Caretakers staff the restaurant, grocery store, hair salon, and theater -- although the residents don't always realize they are caretakers—and are also watching in the residents' living quarters."
The cost of Hogeweyk is $8,000 per month, but families never pay more than $3,600 per resident, thanks to government subsidization. At the time this special was made, Dementia Village had a waiting list of 82.
Families Must Make Heart-Wrenching Decisions
"The pain of this disease is often felt more by family who still hold the memories instead of those who've lost hem."
When considering whether or not to place a loved one in a care center far from home, the saddest part for the family is often leaving their loved one behind, not necessarily knowing if he or she is aware of what's happening or feels abandoned. This is, of course, a very personal decision with multiple factors weighing differently in every situation, and each patient is different.
The majority of dementia patients placed far away from home are in the most advanced stages of the disease. Experts report, while many people with early dementia would find it difficult to adjust to a foreign community where they're separated from their families, many in advanced stages adjust surprisingly well to a place with good care, because they "live in a world of earlier memories."
Continued efforts should be made at improving the quality of life and quality of care for people living with dementia, and this requires this type of "outside the box" thinking. Studies show that loneliness11—as opposed to living alone—is linked to the onset of Alzheimer's, as well as emotional stress. In the final hours of life, whether the person at your loved one's bedside is you or a caregiver thousands of miles away, it's important that they're not a "stranger" to the dying person and that they're being cared for with dignity and respect.
Reducing Your Risk for Dementia Through Diet
- Avoid sugar and refined fructose. Ideally, you'll want to keep your sugar levels to a minimum, with your total fructose below 25 grams per day, or as low as 15 grams per day if you have insulin/leptin resistance. Avoid all artificial sweeteners, especially aspartame, which studies have linked to the development of Alzheimer's disease.
- Avoid gluten and casein (primarily wheat and pasteurized dairy, but not dairy fat, such as butter). Research shows that gluten adversely affects your blood-brain barrier and makes your gut more permeable, which promotes inflammation and immune dysfunction, and both of these are believed to play a role in the development of Alzheimer's disease.
- Optimize your gut flora by regularly eating fermented foods.
- Increase consumption of healthy fats, including animal-based omega-3 fats. Make sure you're getting enough omega-3 fats, such as wild-caught Alaskan salmon, sardines, and krill oil, which helps protect your brain.
- Reduce your overall calorie consumption, and/or fast intermittently. Intermittent fasting is a powerful tool to jumpstart your body into remembering how to burn fat and repair the insulin/leptin resistance that's a primary factor in the development of Alzheimer's.
- Improve your magnesium level. Preliminary research suggests increased magnesium levels in the brain may result in decreased Alzheimer's symptoms. Unfortunately, most magnesium supplements do not cross the blood-brain barrier, but magnesium threonate appears to cross so it may be superior to other forms.
- Eat a nutritious diet, rich in folate and zinc. Without question, fresh vegetables are the best form of folate. Avoid taking a folic acid supplement, which is the inferior and synthetic version of folate. Research suggests zinc deficiency can contribute to Alzheimer's by promoting the accumulation of defective proteins in your brain, which is one of the hallmarks of the disease.
- Avoid environmental toxins and chemicals as much as possible. The rise in Alzheimer's disease may be related to genetically engineered foods and how they're grown; herbicides like glyphosate are mineral chelators, binding up important nutrients, such as zinc.
Other Lifestyle Guidelines That Help Protect Your Brain
Besides diet, there are a number of other lifestyle factors that affect your neurological health. To minimize your risk for developing dementia, make sure you address the following:
- Regular exercise AND minimize sitting. Exercise supports your brain by helping it produce new neurons, thereby helping prevent neural degeneration. Excess sitting is associated with an increased risk of many diseases, including type 2 diabetes, cardiovascular disease, and neurological illnesses. Stand up and walk as often as possible, with a goal of walking 7,000 to 10,000 steps a day.
- Get plenty of restorative sleep. Recent studies indicate that poor sleeping habits cause brain damage and may accelerate the onset of Alzheimer's.
- Manage your stress. Researchers have found that nearly three out of four Alzheimer's patients experienced severe emotional stress during the two years preceding their diagnosis. One of my favorite stress-busting tools is EFT (Emotional Freedom Technique).
- Optimize your vitamin D levels with safe sun exposure. Keep your vitamin D level between 50-70 ng/ml, as there are strong links between insufficient vitamin D and Alzheimer's disease. Vitamin D may enhance important chemicals in your brain, protecting your brain cells by increasing the effectiveness of the glial cells in nursing damaged neurons back to health. Vitamin D may also benefit dementia by its anti-inflammatory and immune-boosting properties.
- Eliminate mercury from your body. Dental amalgam fillings, which are 50 percent mercury by weight, are one of the major sources of heavy metal toxicity. Once you've optimized your diet, consider implementing a mercury detox protocol and then finding a biological dentist to safely remove your amalgams.
- Eliminate aluminum from your body. Many people with Alzheimer's are found to have high aluminum levels in their brain. Sources of aluminum include antiperspirants, non-stick cookware, vaccine adjuvants, etc.
- Avoid flu vaccinations as most contain mercury and aluminum, which are well-known neurotoxic and immunotoxic agents.
- Avoid drugs—especially anticholinergics, statins, and benzodiazepines. Drugs that block acetylcholine, a nervous system neurotransmitter, have been shown to increase your risk of dementia. These drugs include certain nighttime pain relievers, antihistamines, sleep aids, certain antidepressants, medications to control incontinence, and certain narcotic pain relievers.
- Statin drugs are also problematic because they suppress the synthesis of cholesterol, deplete your brain of coenzyme Q10, and prevent adequate delivery of essential fatty acids and fat-soluble antioxidants to your brain. Studies show that adults who use benzodiazepines (Valium, Xanax, Ativan, etc.) for anxiety or insomnia are about 50 percent more likely to develop dementia, especially if used chronically.
- Challenge your mind daily. Mental stimulation—especially learning something new, such as learning to play an instrument or a new language—is associated with a decreased risk of Alzheimer's.
Sources and References:
- 1 Alzheimer’s Association
- 2 Alzheimer’s Association September 21, 2010
- 3 4 BBC News January 5, 2014
- 5 Alzheimer Thailand Baan Kamlanchay Facebook page
- 6 Denver Post December 30, 2013
- 7 Care Resort Chiang Mai
- 8 Dementia Village
- 9 Hogeweyk
- 10 CNN December 27, 2013
- 11 J Neurol Neurosurg Psychiatry March 21, 2012