Circular Society / Dementia Care

A previous post introduced the concept of circular society as necessary to address social resource wastage, just as the circular economy is required to end physical resource degradation.

The circular society requires personal social resources like time and skills to be used better, by for example keeping these in circulation in a neighbourhood.

To further explore the nature of circular society, I enlisted the inverted pyramid diagram I came across in the Greater London Authority’s Design for a Circular Economy Primer. It shows the circular economy’ required change in emphasis from demolition and recycling to refurbishment and repurposing:

In this post I look at the nature of circular society from an elderly person’s point of view, using as a reference the dementia care provision at the award-winning Hogeweyk Dementia Village.

My gut feeling is that Hogeweyk holds pointers to key circular society principles: I use it to make a stab at building the inverted pyramid for circular society.

Hogeweyk turns dementia nursing home care on its head. Seven things make it unique:

1. The village set-up resembles the familiar world outside, architecturally and programmatically. Residents are comforted by being able to lead a familiar life, in and out of their homes.
2. Groups of six residents live in 23 houses, each with a distinct character and organisation to reflect residents’ backgrounds. A live-in care giver is head of the household and attends to residents’ needs including cooking, cleaning and basic therapeutic care.
3. The public realm resembles a typical town centre’s pedestrian streets, with amenities such as a supermarket, hairdresser and beauty salon.
4. The neighbourhood community is encouraged to use the village restaurant, café/bar, theatre and bookable event spaces. They also form the majority of the 150 support volunteers who further help bring a sense of the outside world into the village. Working at Hogeweyk gives the volunteers a richer social life. School pupils regularly use the theatre and seminar spaces and neighbourhood children can play in the network of courtyards and streets.
5. By tapping the local community to generate income and reducing expenses in this way, Hogeweyk is able to operate within the standard nursing home budget set by central government.
6. Doors are generally unlocked to ease anxiety. Even the main entrance to the village is unlocked – but monitored – so that local neighbours, family and friends can come and go.
7. Outcomes include significantly improved physical health and life expectancy.

Circular society wants social capital — free time to provide companionship and help with care — to be spent as locally as possible. At Hogeweyk this happens because carers live in the micro-community, and they are supported by local volunteers and visiting family, friends and local residents using the amenities.

Inspired by Hogeweyk, the inverted circular society pyramid for dementia care looks like this:

I’m keen to get your feedback on this model.

Hogeweyk is currently on the second and third rungs of the above circular society pyramid. However, model “Hogeweyk 3.0” — which has healthy people of all ages living alongside those with dementia — is on the cards, and, once built, would place it on the top tier of the above circular society pyramid.

The dementia care model at Hogeweyk guides us to what the built environment characteristics of a circular society should be:

• A home adapts to inhabitants’ needs as they age. This way they remain in their familiar neighbourhood, and continue to follow familiar routines.
• The public realm is designed to be safe to move about in for everyone; keeping to accustomed mobility routines further enhances wellbeing. New York provides a good example by way of its Safe Streets for Seniors programme.
• To densify and overlap local social networks across generations, a neighbourhood is stocked with a mix of uses, for each age group, to encourage generations to live and work in proximity of each other. Residential typologies suitable for different ages exist alongside each other. Walking, cycling and public transport micro-networks keep people out of cars and local, thus mixing with familiar faces when out and about.
• Such a neighbourhood can be described to function like a village. New York provides another good example in the form of East Harlem.

Putting this into the now familiar inverted pyramid:

I finish with an unexpected link between circular society and circular economy. Remember the guiding principle at Hogeweyk is maximum familiarity of the environment to reduce anxiety and improve health. Retaining familiarity can be achieved by retaining and repurposing / retrofitting existing structures wherever possible, rather than demolishing and rebuilding, a key principle underlying the circular economy.