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This study takes us inside a different kind of dementia care home. Pioneered in the Netherlands and now spreading across Europe and Australia, dementia villages are small, secure neighbourhoods built to look and feel like ordinary streets, with houses, shops, gardens, and open paths, designed so people living with dementia can keep walking, choosing and belonging. A new peer-reviewed Norwegian study asks what actually happens to care when the building changes that much. Please note, this article is from late February 2026, it is within the year but it is not the latest to date.
The Key Findings
Dr Daniela Lillekroken and her team ran 10 focus groups with 53 healthcare staff working in two Norwegian dementia villages. All of them had previously worked in traditional nursing homes, so they could compare the two worlds directly. Three clear themes came out.
1. Adapting to a new care environment. Staff described the village layout, open courtyards, small home-like houses, accessible outdoor space, as freeing for residents but harder for them to oversee at first. They had to let go of constant visual supervision and trust the design.
2. Managing increased freedom of movement. Residents could walk further, visit a cafe, sit in a garden, knock on a neighbour’s door. Staff celebrated this but wrestled with new safety dilemmas, particularly around weather, falls and residents getting tired far from their house.
3. A changing caregiver role. The job shifted from task-driven care toward relationship-based, person-centred support, cooking together, walking together, joining everyday life rather than running it.
What Can You Take Away?
A dementia-friendly building is not a finishing touch. It actively reshapes what care looks like. When the environment offers space, choice and ordinary daily life, staff can move from managing behaviour to supporting personhood. But the building alone is not enough, staff need new skills, time and trust to work with it, not against it.
Implementation and Action
For people living with dementia and families: when looking at residential options, notice how the building treats freedom of movement. Are residents able to walk outside safely? Are there small home-like clusters rather than long corridors? Are there places to do something familiar, like make a coffee or potter in a garden? For aged and dementia care workers: a more open environment asks for different routines, less hovering, more presence; less correction, more company. Training and team conversations help staff adjust without feeling they have lost control. For designers, architects and providers: the lesson is that physical design and care model must be planned together. A beautiful village layout with task-focused staffing will not deliver the promised quality of life. For policymakers: dementia villages can work, but only with the workforce, training and staffing levels to match.
The Critical Messages
Buildings shape care. Move from corridors to streets, from wards to houses, and the daily life of dementia care changes with it. Freedom of movement is a gift and a responsibility. Residents gain autonomy; staff inherit new ethical and practical decisions. And the caregiver role evolves, from doing things for residents to doing things with them. That shift needs to be named, taught and supported.
Dementia villages are no longer a Dutch experiment. They are appearing in Norway, the UK, Canada and Australia, including in Tasmania and on the mainland. The research agenda is catching up: how do these settings affect residents’ quality of life, family experience and staff retention over time? For dementia-inclusive design more broadly, this study is a useful reminder that the most powerful design choice is often the one that gives people somewhere meaningful to walk, sit and belong, and the staffing model that lets them actually use it.
Reference
Lillekroken, D., Hessevaagbakke, E. E., Grov, E. K., Hansen, L. S., Hovland, O. J., Indregard, A. R., Lindeflaten, K., Röhrl, K., Strømstad, A., Torbjørnsen, A. C. V., Øygarden, A. U., Tørris, C., & Bjørnnes, A. K. (2026). Navigating new pathways – healthcare personnel’s experiences transitioning from traditional nursing homes to the dementia village care model in Norway. BMC Health Services Research. https://doi.org/10.1186/s12913-026-14223-9