Le Village Landais Alzheimer, located near Dax, welcomes around one hundred patients suffering from this neurodegenerative disease. They live there almost “like at home”, surrounded by healthcare professionals and volunteers. It is a large building, clad in light wood, at the edge of a departmental road. An agent controls the entrance. What do the doors leading to the large park, which only open with a magnetic key, protect? A village square, a hair salon, a supermarket, and a café-restaurant. In the middle, a fountain and a children’s play area.
The Village Landais Alzheimer, a few kilometers from Dax, opened its doors to the first residents in June 2020. Today, more than a hundred people live there permanently, distributed in 16 houses. They are all suffering from Alzheimer’s disease, at varying stages. This neurodegenerative disease is characterized by memory and orientation disorders and a progressive loss of cognitive abilities. It affects around 900,000 people in France*.
Person-centered care
While strolling along the pond, Christiane shows her friend Hélène the park. Patients’ freedom to come and go is one of the particularities of the village. “Our medical project is person-centered,” explains Dr. Gaëlle Marie-Bailleul, psychogeriatrician and referring physician at the Alzheimer’s village. “We are taking the risk of protecting the villagers’ quality of life.” Respecting the patient’s individual rhythm, needs, and desires has been a strong principle established by the medical team. “It is up to the institution to adapt to the villagers, and not the other way around,” explains the healthcare professional. A flexible organization has therefore been put in place, without imposed waking or sleeping times for the residents. Care, such as showering, is also not forced but postponed if the villager opposes it. The goal of the approach is to improve mood and prevent socio-behavioral problems. “At the moment, Alzheimer’s disease cannot be cured,” reminds Dr. Marie-Bailleul. “We are looking for a way to live with it in the village.”
Patients at home
In this secure space, a world as close as possible to normal life is offered to the residents. So hospital references, such as white coats, are out. But the hundred or so medical-social professionals working on site are never far away, well assisted by 80 volunteers responsible for animating local life. In the hair salon this afternoon, Nathalie offers galette. “These are moments of sharing, which do not last long but are very strong,” smiles the hairdresser, who set up shop from the opening of the village. In the intimacy of her salon, laughter and tears follow one after the other, sometimes only a few minutes apart. “Benevolence is part of our care philosophy,” continues Dr. Gaëlle Marie-Bailleul. “It’s not about bringing the villagers back to normal, but reassuring and accompanying them in the reality they live in.”
Preserving the autonomy of the villagers
In the middle of the small supermarket, well-stocked with dry products, fresh fruits, and preserves, Albert frantically searches his pockets for change. He wants to pay for the kilo of grapes that Fred, a volunteer, has just served him. To preserve their achievements and their autonomy, the villagers are involved in many everyday gestures: setting the table, cutting vegetables, or doing the shopping at the village grocery store. Here, the residents do not pay for their shopping, included in their rent. But they often forget about it due to their illness. “Our goal is to avoid putting the villager in a situation of failure, so we find subterfuges,” explains Fred. Faced with Albert’s insistence, an old military man firmly standing in his gray raincoat, the volunteer pretends that a bill will be sent later.
Marie-Hélène is a nurse at the village. Here they are called “house mistresses”. They give the rhythm of the day, from medication to meal preparation, including care. “Always adapting to the resident and letting them do as much as possible,” she specifies. In her career, Marie-Hélène has had the opportunity to work in many geriatric services. “Here, it’s a whole different way of taking care of the person. We provide truly comprehensive care.”
Studies on the impact of the village
As an experimental project, the Alzheimer’s village has equipped itself with a resource and research center to scientifically evaluate its activity. Over a period of 5 years, the validity of care provided to people with Alzheimer’s disease and their families is measured. “We hope to see a decrease in depressive symptoms six months after entry into the institution compared to other ways of doing things, and less exhaustion for families,” says Dr. Marie-Bareuil. In parallel, a research project in partnership with Inserm aims to measure the impact of the Alzheimer’s village on patients, their families, and healthcare professionals. Its goal: to determine whether this model could become an alternative to the nursing home. Interviews with caregivers, residents, and their families will be conducted every six months for four years. They will focus on their quality of life, health, and social activities. In parallel, the study will need to measure the cost-effectiveness ratio of the establishment. Interim results from the experiment should be published at the end of 2023.
*According to Inserm (2019).
Note: This is a machine translation and may not be completely accurate.
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