I didn’t exactly have a normal home life growing up. My parents ran a foster home in Alberta and provided kids who had difficult childhoods with a loving home. There were often 30 to 50 kids living with us. This taught me to value connection and community.
I graduated from the University of British Columbia with a degree in community recreation in 1975 and worked for several years in the recreation department in Richmond. In 1989, an opportunity came up to work as the general manager for a new senior residence in Richmond with a senior living company called Verve. I initially managed existing senior homes, and later had a hand in designing new ones. I wanted seniors to have a sense of community, so I designed solo living units with shared spaces where people could interact and form connections. But we struggled to provide an enriching environment for people living with dementia. The standard approach was to designate a wing or floor of a given building to dementia patients, with locked doors on either end. When the doors wouldn’t open, they would get frustrated and agitated. I’d panic if I couldn’t move about freely—wouldn’t anyone? Newer facilities have doors that open into a fenced-off courtyard instead, but people still feel trapped. The focus was always on their safety; their freedom and connection with others took a back seat. This approach didn’t sit right with me: life should be about more than just safety.
In 2015, my wife’s aunt developed dementia and could no longer live alone. We moved her into a retirement community near her home. She didn’t adjust well to it: she loved walking outdoors but didn’t have the support to do so safely. She would wander out of the facility, get lost, and then get frustrated and distressed when she was put behind another locked door. In an attempt to provide her with more support and freedom, we relocated her to a care community that I managed near our home. She died six months later, in spring of 2016. Seeing her struggle broke my heart. I knew I needed to do something to help those with dementia live more fulfilling lives.
I attended conferences and workshops in the United States, where I heard about innovative models of care for people with dementia. I was particularly intrigued by the Hogeweyk Dementia Village in the Netherlands, where people with dementia live in a real community—complete with a grocery store, movie theatre and barber shop—where they can roam free with minimal supervision. They share houses with other residents, build relationships and live some semblance of a normal life. I wondered why we couldn’t implement a similar approach in Canada.
When I started workshopping the idea of a similar dementia village, I was Verve’s VP of operations for Western Canada. I pitched the idea to my bosses, and Verve became one of the owners (and now day-to-day operations manager) of the project, along with a handful of private investors, which were mostly family trusts. One of the biggest challenges was finding the right location: I needed enough land to create a village-like setting, but rising prices made it almost impossible. Then I came across a newspaper ad about B.C.’s Langley School district selling four unused schools. There was no sale price listed, so we knew it would be a bidding process. The site was perfect—seven acres of land, complete with trees, greenery and real potential to build something remarkable.
We bought the land for $5 million and started building in early 2017. As part of the development, we had to bring in all the infrastructure, including routing the buildings to a sewer from three blocks away. By the time we were done with construction, the project cost just under $30 million.
In the summer of 2019, we opened the doors to the Village Langley. The site features six houses with 12 to 13 rooms each, accommodating up to 75 residents total. Four houses offer assisted living with some support, and two are designated complex-care environments, which means they’re for villagers with advanced dementia who require more support. The idea is for villagers to move in when they’re mobile, and as their dementia progresses, they move into complex care, where they can hopefully stay for the rest of their lives.
Too often, dementia patients are treated as a collection of needs and symptoms to manage, rather than real people with unique life stories, preferences and habits. One of our residents is a former professor named Peter. One day, I ran into him at reception. He had a piece of paper in his hand, and he seemed quite agitated. It was a letter from the dean of education at UBC commemorating his 25 years as a professor. He wanted to get it copied. When I asked him why, he said: “I need to show copies to the ladies in my house because they don’t know who I am.”
Another resident was a Japanese-Canadian woman who, in the later stages of her dementia, felt a strong pull to return to Japan. That wasn’t an option for her, and in a traditional setting, staff might tell her so and leave it at that. But in the Village, something different happened. When asked how she would get to the airport, she said she would take a bus. And so outside her house, staff put up a bus stop sign near a bench. She would pack her bag, sit on the bench, and wait. After a while, someone would walk by and chat with her. She would eventually forget that she was waiting to go to Japan, talk to them and get back to village life.
Identity is so important for people, and that doesn’t change if you have dementia. When I went to see Peter in his home, he asked if I wanted to come see a picture book about his life his family made for him. I learned that when he was younger, he and his wife were attacked by a grizzly bear on a hike. He took on the grizzly bear, scared it away and saved them both. Peter was much more than a professor, a runner and a good man—he was a hero. At the Village Langley, we take the time to learn about people.
The village was designed to feel like a real community with homes that don’t look like assisted living facilities. Each home has big windows, a living room, dining room, kitchen, family room and sunroom. The houses also have double rooms where we can house couples, even if only one of them has dementia. At traditional dementia care institutions, couples are often split up at a vulnerable time in their lives.
A community centre serves as a gathering place for villagers. There’s also a general store, a café and bistro, a woodworking shop and a beauty salon. There are beautiful landscaped gardens, and even a barn with chickens and goats. Community activities like exercise programs, crafts and book clubs are organized throughout the day. The goal is to engage each person based on their unique abilities and preferences. Depending on the time of day and the residents’ care needs, there are usually two to four facilitators—nurses, PSWs, recreation facilitators or other professionals—present. They’re dedicated to specific houses, which allows them to develop strong connections with the villagers.
Our approach to daily life in the village revolves around villager-directed living. We recognize that each person has different interests, abilities and preferences. Some residents rise early and have breakfast, while others have a more relaxed morning routine. Many villagers enjoy taking walks outside, and we’ve designed the village to minimize barriers and restrictions, promoting a sense of freedom. Yes, there’s an eight-foot fence around the facility, but it’s mostly hidden by trees and flowers, so it doesn’t look or feel like a barrier. I’ve only ever heard of one villager attempting to climb the fence. Generally, they don’t encounter physical barriers, and are free to roam as they please, which improves their emotional well-being.
We want villagers to make their own choices, learn and grow, and be of service to their community. One day, I met a former lawyer named Don who was a new resident at the village. His family had enrolled him when his dementia became too advanced for him to live without assistance. He wasn’t too pleased to be there and had various delusions accompanying his dementia, which added another layer of difficulty. But with time, he settled in. I’m not sure Don had built anything in his life before coming to the village, but he loved our crafts workshop. He built a big clock out of wood, and he was so proud of it. Don would often stop by the village’s grocery store to grab litres of chocolate milk, and eventually, staff asked him to come along on grocery runs. He would push a big cart around, delivering groceries to homes. The team found out what he wanted to do, allowed him to do it himself, and helped him be of service to his community. He now has purpose and joy—a reason to get up in the morning.
This model of care works, but it’s not for everyone. Since we’re not government-funded, all of our operational costs come out of residents’ pockets. Monthly fees range between $8,000 and $10,000, which is a tremendous amount of money and not affordable for many people who would benefit from living at the Village. But the hope is that with time, organizations or government agencies will recognize what we’re doing is a better model of care for people with dementia.
We can treat people with dementia like the unique individuals they are, instead of collections of symptoms and risks to manage. We can set up facilities that give them joy and purpose. When you get to know people on a deeper level, you can help make their lives worth living.
—As told to Liza Agrba