For millions of people living with dementia, quality of life often takes a drastic turn downward. But it doesn’t have to be that way.
Agrace Hospice is planning a new village to be built in Madison, WI, that will house dementia patients in a “Main Street USA” setting.
“We’ll restore a sense of autonomy and spontaneity, and a return to the normal daily rhythms someone has before their dementia diagnosis,” says Lynne Sexten, CEO of Agrace Hospice.
“It might be, ‘I was supposed to go to my mahjong club today but I don’t feel like going, I want to sit and read a book or sleep in’,” she says. “And they can absolutely do that. Or they can go on a walk by themselves and not be followed along by a staff member.”
According to the Alzheimer’s Association, an estimated 7.2 million Americans age 65 and older are living with the disease, which is about 1 in every 9 people. By 2050, that number is projected to grow to about 13 million.
Alzheimer’s and other forms of dementia can cause severe memory loss and other behavioral changes and impairments.
A dementia diagnosis for a loved one can often mean that person has to move into a memory care facility that offers an “institutional lifestyle where residents have very little spontaneity or connection to ordinary life.”
“As your disease progresses, people want to keep you safe, so they start limiting your world,” says Sexten.
The $40 million Agrace Dementia Village, to be built on the hospital’s 6-acre campus, will instead offer a true village, one where patients can stroll quaint store-lined streets, sit in parks with friends or family, and generally feel like they are living an ordinary life.
There will be eight one-level houses, with eight residents each, featuring a kitchen, living and dining room, separate bedrooms with en suite bathrooms, plus a front porch.
“It will look like any regular ranch house in any neighborhood in the U.S.,” says Sexten. “People will cook and clean and live normal lives like they usually do.”
The key difference is that these homes are safe for dementia patients and also come with a full-time caretaker. Residents will also be assessed for interests and lifestyle, so that housemates will have a much better chance at harmonious living.
Additionally, the village will host 40 to 50 “day club” members who don’t live on-site but come daily for indoor and outdoor recreation and amenities, all in a dementia-friendly, safe environment.
Also planned for the village is workforce housing for university students training to be in health care professions.
Sexten hopes this will not only attract more people into the long-term care sector, but offer plenty of opportunity for younger people to interact with those living with dementia, which will benefit both groups.
Inspiration: The Netherlands
The Agrace village is based on Hogeweyk Dementia Village, located just outside of Amsterdam.
“The Hogeweyk model maintains a much higher quality of life for much longer,” says Sexten. “And in the end, when someone dies, it comes quickly, rather than this elongated, painful approach of death for many months.”
This style of dementia care—gaining popularity in Europe, Australia, China, and Canada—has been slow to take root in the U.S. It’s likely not a coincidence that the U.S. is the only one of those places with a for-profit medical care system.
“I think the reason that [Agrace] is able to make this leap first is because we’re a nonprofit,” says Sexten. “[The village] has to be financially viable, but we won’t have a bunch of investors looking for a significant return on their investment. A fair amount of senior facilities across our country are nonprofit, but the preponderance of them are investor-owned.”
Yet she says that the cost to the village resident will be the same as traditional memory care facilities.
Also in Wisconsin, another nonprofit-led development, Dementia Innovations in Sheboygan County, is developing a similar dementia-care village called Livasu, also based on Hogeweyk.
This village will offer 124 manufactured homes for sale in the $95,000 to $175,000 range, all with dementia-friendly design such as one-level living and bedrooms with a direct line of sight to the toilet, helping to prevent incontinence.
Instead of fences, specialized landscaping will prevent wandering, and there will be care staff living on-site.
Getting into the village
Those interested in the Agrace Dementia Village, which opens in fall 2027, can currently sign up to be notified when the wait list opens.
“I think we will have a tremendous wait list,” Sexten says. “Every single memory care facility has a wait list, and I don’t think ours will be any different. There has been a lot of excitement around the concept.”
She says it is “about time” village-style dementia care takes hold in the U.S.
“This is an approach whose time has come,” she says. “People with dementia are your neighbors—they are just regular people who need to live in an environment that is a bit different.”
“We’re trying something that hasn’t been done before, and we’re excited to see the wonderful impact it’s going to have on those living with dementia.”
