Completely New Models of Dementia
Care Are Emerging Across the Globe
May 23, 2015
Story at-a-glance
With costs for dementia care soaring, some families
are now considering memory care alternatives across
national lines that provide better care for less
cost
“Dementia—The Unspooling Mind” features three such
alternatives in Thailand and the Netherlands
Dementia Village, just outside Amsterdam, is an
entire village built to simulate the most normal
life possible for dementia patients, in a sort of
“manufactured reality”
By Dr. Mercola
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.
Since there's no conventional cure for dementia, the issue of
prevention is absolutely critical. Evidence points to
lifestyle factors as the driving forces behind dementia, and fat
avoidance and carbohydrate overconsumption are at the heart of
it, as Dr. Perlmutter discusses in the interview above. The
following list of basic nutritional strategies will help keep
your brain healthy as you age:
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.
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.
Copyright 1997- 2015 Dr. Joseph Mercola. All Rights Reserved.