Alzheimer's: to discover an experimental village

By fashionlifeshopping 10/09/2022 1244 Views

A soft wind that blows in the leaves of the trees, a smell of fresh coffee floats in the air, the sound of a swing that creaks on the central square of the village, a donkey that brands in the distance ... this simple and common decorHowever, there is nothing commonplace.We are in the heart of the Landes village, a pioneering scientific project which intends to innovate both in terms of social life, health and research.Inspired by a project developed from the 1990s in Hogeweyk in the Netherlands, this is one of the few Alzheimer's villages in the world.

Initiated and carried by the Departmental Council of Landes with the support of the Regional Health Agency (ARS) of Nouvelle-Aquitaine, the Landes village Alzheimer was designed, both architectural and functional, to allow suitable careand respectful of people who suffer from cognitive disorders.Since June 11, 2020, it has welcomed 120 villagers of all ages in an alternative environment, turned towards accompaniment, and rid of the signs and symbols of medicalization.The goal ?Offer these Alzheimer's patients a life that wants to be as ordinary as possible.But is this device really different from classic nursing homes?What effects does it have on well-being, symptoms and evolution of patients?Has any advantages for caregivers too?This is what Hélène Amieva*wants to determine, psycho-epidemiologist at the Bordeaux Population Health Research Center at the University of Bordeaux.Because despite appearances, research was invited to the village square.

The Landes village is a unique experience in France, which comes out patients from the medical and sanitized EHPAD context and places them in an environment where places, interactions and events have all."The originality of the project lies in the village itself," explains Hélène AMIEVA.There are neighborhoods made up of housing, but also shops, a brasserie, a media library, a central place as well as a park open to the public inviting to the promenade.In the morning, the villagers will buy enough to prepare their lunch's meal, eat together, take coffee on the terrace, weave links.They experience a semblance of normal life, even though they are losing autonomy."Here, even if the disease is omnipresent with its procession of cognitive and behavioral disorders, and if the medical staff are constantly on the lookout, the framework has nothing in common with the organization of a nursing home," explains the researcher.

The village is part of a national ambition, concretized by the global strategy aging in good health 2020–2022 presented by Agnès Buzyn in January 2020.It is a question of improving the quality of life and the well-being of patients and their caregivers, while best preserving the cognitive and practical capacities of residents.Doctors, nurses, psychologists, animators, gerontologists accompany the villagers in their days ... but they are not the only ones.Indeed, many volunteers also intervene.Volunteering is a structural element of the village!These volunteers do not replace employees, but however play an essential role in the animation of collective activities.They make it possible to multiply the proposals: physical, artistic and creative activities, gardening, cultural facilities, readings ...

Alzheimer : À la découverte d’un village expérimental

Although the setting and the staff inspire great sympathy, is the Landes Alzheimer village really an alternative model at the EHPAD?Is it viable and reproducible, and does it really contribute to the quality of life of the villagers, their social participation and their health?This is the question to answer researchers from the Bordeaux team of Hélène AMIEVA, specialized in the epidemiology of aging and chronic diseases.The researcher and her team were asked by the Landes department with the approval of the ARS of Nouvelle-Aquitaine."We are interested in the psychosocial factors that modulate and determine the aging trajectories, and the diseases associated with it.We also wonder to what extent psychosocial innovative interventions can help slow the loss of autonomy of the elderly, she explains.Currently, we assess the real effects of the village on people losing autonomy, and the validity of care.»»

To assess the village but also make it reproducible nationally, even international, several lines of research have been chosen: social participation of villagers, stress at work of professionals, feeling of guilt of families linked to the placement of their loved one, andMaintaining the link with their loved one.For this, psychological, cognitive, social and physical health indicators are regularly raised.The social perception of Alzheimer's disease is also analyzed.Indeed, old age and disease have extremely negative representations in our societies.An investigation was carried out with the general public to assess the image conveyed by the village, compared to conventional establishments."Certain representations of Alzheimer's disease, in particular the loss of identity, or the feeling of disgust towards the patients have been less present since the opening of the village. Il aurait donc un impact modeste, mais positif sur les représentations de la maladie»», se réjouit Hélène Amieva.

Part of the project, carried out in collaboration with economists of health of the Bordeaux Health Center of the University of Bordeaux, is interested in the medico-economic interests of the village to quantify precisely both the cost of care (direct and indirect), but also possible benefits: certain EHPAD hospitalizations could be avoided with different monitoring of patients.By following the villagers as closely as possible, it may be possible to reduce certain drug prescriptions, certain hospitalizations and the associated additional costs.

We will still have to wait before obtaining solid answers to all the questions raised by this radical change in the care of illness.In particular, assess and compare the benefits of this experimental village in relation to a classic EHPAD will require prolonged time for monitoring and observation.The results are eagerly awaited, in view of the issues: to lighten the weight of a dreaded disease, in a softer and friendly context.

A report to be found in n ° 52 of the Inserm magazine

Note:*Unit 1219 Inserm/University of Bordeaux, Psychoepidemiology team of aging and chronic diseases (SEPIA), Bordeaux Population Health Research Center