Nursing homes of old were modeled for the efficiency of the staff, many being replicas of WWII military hospitals. Times are, thankfully, changing.

Much of this change in the US has been lead by people involved in the Pioneer Network, an organization dedicated to culture change in elder care. However, world-wide, culture change in the care of the aged is happening in a big way.

An article on ABC News titled Alzheimer’s Disease: Dutch Village Doubles as Nursing Home, describes a Dutch Village that resembles, according to the article, a stage setting in that the residents live in such a village like atmosphere with a familiar, homey feel, while the actual nursing home activity goes on “backstage.”

The article quotes Marianne Smith, assistant professor of nursing specializing in dementia care at the University of Iowa. Smith says, "I'm personally fascinated by the concept of a self-contained village…I don't think it is living out a fantasy as much as it is accommodating the person's desire to live a normal life in a community-like environment. … The program is surely better than the usual care nursing homes that can resemble hospitals."

The director of the home adds, “…they feel like they're living a normal life, and that's what we think is very important."

The changing face of nursing homes

Culture change in nursing homes refers to an evolving change from old models of hospital-like care to newer models that give residents a chance to feel that they are really at home. Often, that home has an old fashioned feel that feels familiar to elders with dementia.

A couple of years ago, I visited a local nursing home that had been recently remodeled. I was impressed by their small village atmosphere. Rooms were grouped in a private, homey arrangement, with old fashioned gathering places conveniently located to encourage people to mingle. These places were much like local “mom and pop” cafes in small towns and the old neighborhood beauty shops.  Each shop, library, café or other room had a slightly different feel, but all were homey and familiar enough to encourage serenity and a sense of security in an elder.

The staff at the home dressed in casual clothing and acted as much like friends as is possible when caring for elders with health problems, often including dementia.

Other homes in my community have “main streets” that are so convincing I can momentarily feel as though I really am visiting a small town. They have kitchens where residents can bake if they choose, game rooms, exercise rooms, art rooms and abundant music, but the feeling of community remains. Small groupings, in cozy environments, often sooth people who are prone to anxiety and confusion.

Of course, staff members are part of the group, walking around doing their work while they visit with the elders, joking and teasing with those who enjoy a jolly approach, comforting those who need comfort. The residents are shielded from the more medical aspects of the nursing home when possible.