Tuesday, 11 March 2014
A Dutch Village - Prison or Paradise?
There's a story about Hogewey, a village in The Netherlands that's gone viral on social media recently. It's a closed village (ie. it's got walls around it and there's an air lock system to get in and out). The residents are people with advanced dementia or Alzheimer's and their carers. In this village, shops have goods but no cashiers. Nurses have no uniforms and accessibility is the norm. It is an environment designed to provide maximum freedom as well as support to those made vulnerable by their cognitive impairments.
When I first read this article, I thought of the 60's BBC cult TV show "The Prisoner" - a creepy tale of a sinister walled village somewhere in the UK ruled by an invisible dictatorial force. By all accounts, folks in this Dutch village have reduced levels of anxiety as well as more discernible joy and meaning in their lives. Comments on Facebook were almost uniformly positive, proclaiming this model to be an innovative, compassionate and effective alternative to traditional nursing homes. It may be all those things, but it's not normal. I can't decide if it's human or inhuman.
This story got me thinking about the value of segregated settings - are they EVER a good thing? When our son Nick was small, I was a tireless advocate of inclusion for children with disabilities at school. That is, until we moved to the UK and decided to put Nick in a special training institute for a type of therapy called Conductive Education. To me, that decision was akin to sending Nick to ballet or hockey school. Nicholas was there to learn specific skills that were not available in the mainstream and the education on offer was intensive. After two years of that training, we realised that Nicholas had accomplished all that he was able and was ready to move back into the mainstream. All to say that I am not against segregated settings per say, but I'm wary of them.
But the Dutch village is a long way from being an environment to teach specialised skills. It is a rarefied version of life itself, somehow akin to 'The Truman Show'. And yet. My mother does not suffer from Alzheimer's, but if she did, wouldn't I choose a closed village for her as an alternative to a nursing home? I believe I would, but only if there was no third alternative. The question that persists in my mind, is "can't we accommodate our loved ones with advanced forms of dementia within society? Do we really need to construct an alternate and separate reality for them?" Jean Vanier understands the need to reconcile the needs of vulnerable persons with safety and inclusion. His "L'Arche" model leverages the assets of compassionate citizens seeking meaning in their lives who wish to live with, not apart from, people with high needs, including sometimes challenging behaviours. But doesn't any inclusive solution by its nature limit the freedoms of people with cognitive impairments? The Dutch village seems to offer freedom of safe movement within city walls, that is certain.
I am glad that people around the world are developing new ways of caring for our most vulnerable citizens and I think compassionate models are all worth a try. For my family, I hope that we will live together, without walls or air-locked entrances. I hope we can find a way to do that.