Revolutionizing Dementia Care on the Nature Coast

By Debbie Selsalvage Posted on October 28, 2021

Debbie Selsavage has a mission. This compassionate, energetic Citrus County resident was introduced to dementia when she became a caregiver for her husband, Albert. In the early 2000s, she found it almost impossible to find information, support, and the resources needed to deal with her difficult and exhausting task.

Debbie entered the field of memory care when she took a job as an administrative assistant at an assisted living facility (ALF). She loved the work, became certified, and led that community to a better standard of care, recognized by its deficiency-free rating.

After becoming an Independent Certified Trainer and a Certified Consultant in Teepa Snow’s highly respected Positive Approach to Care. In 2015, she launched her own company, Coping with Dementia LLC with a mission to make life better for individuals and families living with dementia.

Debbie pursues this mission through knowledge, training, education, and an unwavering belief in the effectiveness of Person-Centered Compassionate Care. She has designed and led classes for caregivers, professionals, and businesses throughout Citrus County and into the Nature Coast. She created the Citrus County Walk Aware in Floral City to raise awareness of and funds for Alzheimer’s care. She even contributes a monthly column to NatureCoaster to help readers who are in a position of caregiving. You can read her columns here.

In September of 2021, she visited Hodgeweyk, a village created to care for about 200 residents with severe dementia located in the Village of Weesp, Netherlands.

The Hogeweyk provides a Model

This art on the second story of Hogeweyk depicts the four lifestyles that residents are grouped by. Can you guess what they are? Image by Debbie Selsalvage.

Known as the first ‘dementia village’, Hogeweyk opened in 2009. It is world-famous for its inclusive, person-centered high-quality care and treatment that breaks the stigma of dementia. This is done so that people with dementia can continue their lives in a world that is safe for them and open to everyone.

Hogeweyk provides a familiar and safe environment in which people with dementia live while retaining their own identity and autonomy as much as possible. They live in a social community with real streets and squares, a real restaurant with real customers, a supermarket for groceries, and a theatre that hosts real performances.

Outdoor Space provides opportunities for Healthy Exercise and Interactions

The town center at Hogeweyk provides plenty of outdoor gathering space, outdoor chess, an information station with upcoming activities and tents for private gatherings. Image by Debbie Selsalvage.

Hogeweyk has streets, courtyards, alleyways, and squares in the ‘Randstad’ style appropriate to the surroundings.

They have plenty of outdoor space, with a large courtyard that features gathering places, fountains, a huge chess set, and lots of greenery and fresh air.

There are streets with signs, a music store, a theater, a café, a restaurant, and an indoor common area with plenty of gathering spaces, and a grocery store where residents go to “buy” their food and drink.

The village of Hogeweyk offers street signs, just like the rest of the Netherlands. Image by Debbie Selsalvage.

There is an events office. The residents come here to book their weekly events, including music club, movies, performances, bingo, flower arranging, painting, baking, cooking, and many others.

After a resident books the event, one of the 120 volunteers will pick them up and take them to the event. The care workers do not leave the house.

Housing is Provided in Group Homes

Hogeweyk residents live in small houses for six like-minded people served by six to seven staff members who help with care, activities, and cleaning. People cook, eat, and live in these small groups, leaving their houses for social activities.

To minimize conflict and stress, Hogeweyk houses people with similar cultural norms together. These include food, music, decorating style, and lifestyle preferences.

Courtyard homes provide a village feel. Does this look like a nursing home? Well, it is a village. Image by Debbie Selsalvage.

Residents may leave Hogeweyk, and locals from outside Hogeweyk may visit and enjoy the restaurant also. The visitors pay for their meals, which helps subsidize the cost of this wonderful facility.

Come and Dine and Learn a New Way

Locals and residents are welcome at the Hogeweyk village restaurant. Look at the wines and desserts! Image by Debbie Selsalvage.

Hogeweyk is a truly innovative way to care for people who are afflicted with Alzheimer’s and Dementia, providing plenty of fresh air and active pursuits to keep the mind agile. Additionally, this model can meet social needs to help fight off the loneliness of these diseases.

Debbie Selsavage joined a group from America in touring Hogeweyk in September, 2021, as part of her ongoing education in compassionate care for dementia and alzheimer’s patients. The two people farthest back are founders of this pioneering facility.

Debbie Selsalvage joined this group from America attending a two-day workshop in the restaurant in Hogeweyk,
Two of Hogeweyk’s founders, Jannette Spiering and Eloy van Hal are in attendance. Image by Debbie Selsalvage.

A friend of hers from Oregon who has an assisted living facility made arrangements for the visit and invited Debbie to attend. She came back full of passion to improve the current nursing home care model here!

Hogeweyk was Originally a ‘Tough Sell’ in the Netherlands

One of the founders of Hogeweyk, Eloy van Hal, explained to a group exploring the possibility of bringing this concept to the United States in 2018 that the concept was a tough sell in the Netherlands.

Like the United States, his country heavily regulates nursing homes, and there were many concerns about safety. If residents with severe dementia could walk outside, they might fall or jump into the fountains. It seemed dangerous to let them prepare food with knives. “Many people said, ‘You’re completely insane,’ ” van Hal said, according to Stacy Burling in her Philadelphia Inquirer story.

It is great to see residents and staff in an environment that provides them with a purpose and a great quality of life. They all have severe to late dementia and this is a nursing home that looks nothing like a traditional nursing home.

Debbie reported on Thursday, Sept 30, which is the last day at Hogeweyk, the Dementia Village in Amsterdam, “This has been a dream to be here, to spend this time with two of the founders of this concept.

It did not rain today so there was much activity in the town square. We just have had an amazing time.”

Bringing Hogeweyk Home

Van Hal said the biggest barrier to change is entrenched attitudes. “It’s really hard to change existing models,” he said, “and to change the medical model to a more social-relational model.” (also from the April, 2018, Stacy Burling story in the Philadelphia Inquirer)

And, although I may be putting words in her mouth, I am sure Debbie is ready to make this Quality of Care happen here. Maybe we can help her?

Four Walks to Help

Let’s start by gathering at the Citrus Walk Aware on November 13. It’s a fun walk through Floral City, where the emphasis is on history and hospitality and we donate $20 to participate. Register Here.

  • WALK AN ARCHITECTURAL SCAVENGER HUNT TO DISCOVER THE HISTORIC ENVIROMENT OF FLORAL CITY– Match an Architectural feature in the SCAVENGER HUNT brochure with an historic building in the Floral City National Register Historic District.A successful completion will be rewarded.
  • WALK A HISTORICAL PATH TO SEE FLORAL CITY’S PAST– This WALK will take you past buildings in the National Historic District and on to other Historic buildings and sites such as the National Hernando De Soto Marker, Steamboat Landing, and locations of the early school houses.
  • WALK THE LABYRINTH REMINISCENT OF THE MIDDLE AGES – This brick path in the Town Center is based on the early Christian spiritual paths constructed in European cathedrals during the Crusades.
  • WALK THE FLORIDA STATE BLACK HISTORY TRAIL – Only two sites in Citrus County are listed in the State of Florida’s Black History Trail, and they are both in Floral City: the Floral City Community Cemetery established in 1908 and the Pleasant Hill Baptist Church developed to serve workers during the Phosphate mining boom of 1890 to 1911.  Visit them both.
Walk for Alzheimers Group Photo
Citrus Walk Aware for Alzheimers Record Setter in 2019. Image courtesy of Coping with Dementia Education, Inc.

More about Debbie Selsalvage and Coping with Dementia

In addition to fee-based counseling and training services, Coping with Dementia LLC sponsors free workshops, conferences, and family caregiver support meetings.

Debbie is also the past president of the Alzheimer’s Family Organization, and is currently a director of Dementia Education, Inc., a Florida nonprofit that develops educational programs and publications.




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