Welcome To “Dementia Village,” A European Experiment In Long-Term Alzheimer's Care

Following a similar project outside of Amsterdam, Swiss developers plan to build an entire village for people with Alzheimer's and other forms of dementia. The $27 million Swiss facility will recreate the environment of the 1950s. Not all think i

(Visentico / Sento)
(Visentico / Sento)
Beat Bühlmann

It's a village like many others. Street signs, front gardens with little gnome figurines, a restaurant, beauty parlor and supermarket. What is different about it is that the 150 men and women who live here suffer from serious dementia. They can move around freely in the village. But they can't leave it. This is Hogewey, a nursing facility near Amsterdam that is considered a pioneer in dementia care. Care givers stay behind the scenes, and are dressed like gardeners, hairdressers, and sales people.

Now Switzerland is to get its own "dementia village" in Wiedlisbach, canton Bern. Still in the planning stages, the village will occupy the site of an existing nursing home and will be called the "Village For People With Dementia." Representatives of the community have already approved the plan. "Right now we're planning a village for 100 men and women, but later we could expand to 200 or even 300," says general manager Markus Vögtlin. Construction is expected to last between five and seven years and cost roughly 25 million Swiss francs (nearly $27 million).

Vögtlin, who has visited Hogewey, was impressed by its anxiety-free atmosphere. "People with dementia are often restless and aggressive, but there they were relaxed and content." A village allows them to pursue the accentuated need for moving around that is typical of dementia.

The architecture and design of the Swiss version will also take into account that people with dementia, though they are unable to remember what is going on in the present, usually have memories of the past. The facilities, therefore, will have a 50-year-old look and fell. This environment makes patients feel comfortable, says Vögtlin, who calls it "traveling back in time."

In Hogewey's 23 small houses, residents can choose from seven interior decoration styles, such as homey or craftsy or Indonesian. "Our village will offer two options – country or urban," says Vögtlin. The houses, which will have no more than two stories, will have saddle roofs and 1950s-style front gardens. In the Wiedlisbach village there will also be a doctor's practice, a café, a movie theater and a kiosk. Nowhere in the village will there be any closed doors.

Making a case for the "here and now"

Not all experts think the "dementia village" is such a great idea. "The very notion of a village is an attempt to fake the normality that people with dementia don't have," says Michael Schmieder, the director of Sonnweid, a home for dementia sufferers in Wetzikon, canton Zurich. The nursing facility, which has 150 resident patients, is considered exemplary because within the facility all patients have freedom of movement. "We have 1.5 kilometers of space for them to wander around in, so patients don't keep running up against borders," says Schmieder.

At Sonnweid, 14 million Swiss francs were spent on enlarging the premises without increasing the number of residents. "We offer wellness, just like a four-star hotel. Patients are living in the here and now, not back when," he says. Schmieder disagrees with the idea of binding them to a past life style.

Canton Bern officials, however, welcome the Wiedlisbach project. "It's super, I'm won over by the concept," says Markus Loosli, who heads the department that deals with matters concerning old people and the handicapped. He added that in a village environment people suffering from dementia could live significantly better and with dignity. The references back to earlier times made the patients feel safe and increased their life quality.

But the village concept might not be relevant for all those suffering from dementia, which is to say over half of all nursing home residents. "We also need other ideas," Loosli said.

Seeking sustainable solutions

In Switzerland there are presently 107,000 people suffering from dementia. The number is expected to double within 20 years. Roughly 60% of sufferers are presently receiving home care, but is that sustainable longer term? Many relatives are already overwhelmed, and the number of singles reaching advanced old age is on a sharp rise.

The Swiss Alzheimer Association has been advocating a national dementia strategy for many years. In Germany, the "Aktion Demenz" strategy is neighborhood care so that confused men and women can live in a place that is familiar to them. A project initiated in Zurich in 2008 called "Hausbesuche SIL" ("Home Visits – Socio-Medical Individual Solutions') involves relatives, neighbors and friends in the care of dementia patients.

"Different types of care programs are needed," says Birgitta Martensson, managing director of the Swiss Alzheimer Association, because dementia – the best-known form of which is Alzheimer's – lasts on average 10 years and there are different phases. "The dementia village is a good solution for people in advanced stages of the sickness," says Martensson. They can move about freely without anxiety.

But isn't such a village, closed off from the outside, a ghetto? No, Martensson says. The village offers a protective environment in which residents have lots of space and where they can use whatever abilities and skills they can still access. "It gives them a feeling of self-sufficiency, and makes it possible to put off the day when they won't be able to do things for themselves anymore and will be fully dependent on care."

Read the original story in German

Photo - Visentico / Sento

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How Thailand's Lèse-Majesté Law Is Used To Stifle All Protest

Once meant to protect the royal family, the century-old law has become a tool for the military-led government in Bangkok to stamp out all dissent. A new report outlines the abuses.

Pro-Democracy protest at The Criminal Court in Bangkok, Thailand

"We need to reform the institution of the monarchy in Thailand. It is the root of the problem." Those words, from Thai student activist Juthatip Sirikan, are a clear expression of the growing youth-led movement that is challenging the legitimacy of the government and demanding deep political changes in the Southeast Asian nation. Yet those very same words could also send Sirikan to jail.

Thailand's Criminal Code 'Lèse-Majesté' Article 112 imposes jail terms for defaming, insulting, or threatening the monarchy, with sentences of three to 15 years. This law has been present in Thai politics since 1908, though applied sparingly, only when direct verbal or written attacks against members of the royal family.

But after the May 2014 military coup d'état, Thailand experienced the first wave of lèse-majesté arrests, prosecutions, and detentions of at least 127 individuals arrested in a much wider interpretation of the law.

The recent report 'Second Wave: The Return of Lèse-Majesté in Thailand', documents how the Thai government has "used and abused Article 112 of the Criminal Code to target pro-democracy activists and protesters in relation to their online political expression and participation in peaceful pro-democracy demonstrations."

Criticism of any 'royal project'

The investigation shows 124 individuals, including at least eight minors, have been charged with lèse-majesté between November 2020 and August 2021. Nineteen of them served jail time. The new wave of charges is cited as a response to the rising pro-democracy protests across Thailand over the past year.

Juthatip Sirikan explains that the law is now being applied in such a broad way that people are not allowed to question government budgets and expenditure if they have any relationship with the royal family, which stifles criticism of the most basic government decision-making since there are an estimated 5,000 ongoing "royal" projects. "Article 112 of lèse-majesté could be the key (factor) in Thailand's political problems" the young activist argues.

In 2020 the Move Forward opposition party questioned royal spending paid by government departments, including nearly 3 billion baht (89,874,174 USD) from the Defense Ministry and Thai police for royal security, and 7 billion baht budgeted for royal development projects, as well as 38 planes and helicopters for the monarchy. Previously, on June 16, 2018, it was revealed that Thailand's Crown Property Bureau transferred its entire portfolio to the new King Maha Vajiralongkorn.

photo of graffiti of 112 crossed out on sidewalk

Protestors In Bangkok Call For Political Prisoner Release

Peerapon Boonyakiat/SOPA Images via ZUMA Wire

Freedom of speech at stake

"Article 112 shuts down all freedom of speech in this country", says Sirikan. "Even the political parties fear to touch the subject, so it blocks most things. This country cannot move anywhere if we still have this law."

The student activist herself was charged with lèse-majesté in September 2020, after simply citing a list of public documents that refer to royal family expenditure. Sirikan comes from a family that has faced the consequences of decades of political repression. Her grandfather, Tiang Sirikhan was a journalist and politician who openly protested against Thailand's involvement in World War II. He was accused of being a Communist and abducted in 1952. According to Sirikhan's family, he was killed by the state.

The new report was conducted by The International Federation for Human Rights (FIDH), Thai Lawyer for Human Rights (TLHR), and Internet Law Reform Dialogue (iLaw). It accuses Thai authorities of an increasingly broad interpretation of Article 112, to the point of "absurdity," including charges against people for criticizing the government's COVID-19 vaccine management, wearing crop tops, insulting the previous monarch, or quoting a United Nations statement about Article 112.

Activist in front of democracy monument in Thailand.

Shift to social media

While in the past the Article was only used against people who spoke about the royals, it's now being used as an alibi for more general political repression — which has also spurred more open campaigning to abolish it. Sirikan recounts recent cases of police charging people for spreading paint near the picture of the king during a protest, or even just for having a picture of the king as phone wallpaper.

The more than a century-old law is now largely playing out online, where much of today's protest takes place in Thailand. Sirikan says people are willing to go further on social media to expose information such as how the king intervenes in politics and the monarchy's accumulation of wealth, information the mainstream media rarely reports on them.

Not surprisingly, however, social media is heavily monitored and the military is involved in Intelligence operations and cyber attacks against human rights defenders and critics of any kind. In October 2020, Twitter took down 926 accounts, linked to the army and the government, which promoted themselves and attacked political opposition, and this June, Google removed two Maps with pictures, names, and addresses, of more than 400 people who were accused of insulting the Thai monarchy. "They are trying to control the internet as well," Sirikan says. "They are trying to censor every content that they find a threat".

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