Inside the Dutch 'dementia village' that offers beer, bingo, and top-notch healthcare

Alzheimer's and dementia sufferers are widely encouraged to stay physically active to keep their minds and bodies engaged.

Residents at Hogewey can stroll through the open courtyard or help caregivers tend to one of the many gardens. Even just sitting on a bench in the outdoors can help improve their mood and overall well-being, research has found.

Research has found that loneliness is just as deadly as smoking and twice as lethal as obesity. As seniors tend to be the age group that most often lives by themselves, Hogeweyk feels a responsibility to make sure people get as much social interaction as they require.

"You are busy, you are outside, you can complain about the weather," he said.

That's important for a sensitive disease like dementia, he added. There are roughly 50 million people worldwide living with dementia, which means there are an equivalent number of stages at which the disease has advanced.

It's up to the Hogeweyk staff to know which residents are more lucid than others, and to treat them accordingly if they slip up with a name or date. According to van Hal, there is no single policy for bringing residents back into "the real world" or letting them live in their bubble.

As a matter of policy, Hogeweyk rejects the idea that people with dementia ought to miss out on the finer things, such as beer or wine — even if they don't follow the social norms that most other people do.

"They have really bad manners and habits, in food and behavior," he said. "We are not going to change that."

Residents can use real money at the facility's pub. If people display signs of alcohol abuse, however, the facility will not serve them.

The residents can also use real money if they want to, Hal said. Only a handful are lucid enough to do so, and typically they spend it on small items like toothpaste and candy bars.

As part of the facility's normal budgeting process, a chunk of money (not real currency) is doled out to each of the 23 houses. With some help from the caregivers, it's up to the houses to budget the money how they see fit over the course of the month.

Hogeweyk places a great deal of importance on word choice, van Hal said. The staff members don't treat patients — they care for residents.

"All the residents living here need medical treatment, yes. They all have medication. They all have [an] advanced stage of dementia," van Hal said. "But they are first a person. That's why there are people living here with dementia, and not demented people."

"We said to each other 'What do we want for ourselves and our moms and dads?" van Hal said.

The consensus was that people wanted normalcy, at least to the extent caregivers could provide it. Gradually, Hogeweyk began folding in elements of the outside world. It started by creating 23 houses in four different "lifestyle" categories — cosmopolitan, nature-oriented, well-to-do, and traditional Dutch.

"You have to choose," van Hal said. "Which is the lifestyle according to your preferences?"