Dementia Villages Ease Family Caregiver Burden While Residents Thrive, Norwegian Study Finds

Family caregivers of people living with dementia report high self-esteem, low burden, and strong perceptions that their relatives are thriving when cared for in dementia villages, according to a new mixed-methods study from Norway published in Frontiers in Dementia. The findings offer some of the clearest evidence yet that the village model, inspired by the Dutch Hogeweyk concept, may represent a sustainable form of long-term dementia care that bridges professional support with ongoing family partnership.

Dementia villages are small-scale, person-centred care environments designed to look and function like ordinary communities rather than institutions. Residents live in homelike units of roughly six to eight people, move freely within secure grounds, and take part in everyday activities such as walking, cooking, and social events. Safety is maintained through environmental design and welfare technologies, including GPS tracking, electronic access bracelets, and sensor-based monitoring cameras. Norway currently has more than 115,000 people living with dementia, and roughly 80 percent of those needing long-term care reside in nursing homes, prompting national policy initiatives such as the Dementia Plan 2025 to emphasise dementia-friendly communities and innovative care models.

The research team, led by Ann Kristin Bjørnnes of the University of South-Eastern Norway together with colleagues from Oslo Metropolitan University and Mid Sweden University, used an explanatory sequential mixed-methods design. Thirty family caregivers completed questionnaires measuring caregiver reactions with the Caregiver Reaction Assessment, health-related quality of life with the EQ-5D, and residents’ thriving with the proxy version of the Thriving of Older People Assessment Scale, a 32-item instrument scored from 32 to 192. Sixteen of those caregivers then took part in semi-structured interviews lasting 30 to 90 minutes, which were analysed using reflexive thematic analysis.

The quantitative results were striking. Caregivers reported high levels of caregiver esteem, with a mean score of 3.9 on a 5-point scale, and generally low burden across the domains of family support, finances, and health. Residents were perceived as thriving overall, with a TOPAS-Proxy total mean of 4.3 on a 6-point scale and an overall thriving rating of 6.89 on a 10-point scale. Staff relationships received the highest domain rating at 4.7, while meaningful activities scored lowest at 3.9. Overall thriving correlated positively with every TOPAS domain, with the strongest correlations observed for relationships with co-residents, quality of care and support, and attitudes toward the place of living.

Notably, no significant correlations emerged between overall thriving and any caregiver burden domain. Financial strain, schedule disruption, and health burden were strongly associated with one another, suggesting that different dimensions of burden cluster together, but caregivers’ own experiences did not appear to colour their assessments of residents’ wellbeing. The authors interpret this as evidence that family caregivers distinguish between their own caregiving experience and their perception of their relative’s everyday life, consistent with prior research showing that positive and negative caregiving appraisals can coexist rather than sit at opposite ends of a single continuum.

The interviews revealed an overarching theme the researchers summarised as being between trust and uncertainty. Admission to the village was emotionally demanding, but many caregivers described profound relief once responsibility for daily care, particularly overnight supervision, shifted to staff. One wife said the only thing she felt was relief at no longer being responsible throughout the night, while others described the welcome as dignified and warm. Caregiving responsibilities did not disappear after admission but were transformed into new forms of involvement, with many relatives continuing to monitor wellbeing, coordinate appointments, and advocate for residents.

Challenges persisted alongside the praise. Some caregivers reported that staff did not always act on information about residents’ needs, described unclear onboarding procedures, and expressed a desire to be treated as partners in care rather than simply as relatives. Trust in welfare technology was sometimes shaken: one wife recounted that an alarm failed and her husband was found the next morning with a fractured hip, while others described camera-based night monitoring that missed falls. The authors stress that the digital safety net works only when systematically paired with adequate physical staffing, particularly during evenings, nights, and weekends, and should be understood as an auxiliary relational tool rather than a replacement for human presence.

The physical and social environment emerged as the model’s greatest strength. Caregivers valued homelike surroundings, access to outdoor spaces, personalised rooms, and the freedom for residents to walk without getting lost. Organised activities, cultural events, bonfires, and choir sessions contributed to a sense of life and activity. Yet meaningful activities received the lowest quantitative ratings, and some caregivers felt the offerings were insufficiently tailored, particularly for male residents, or that communal facilities sat quiet outside scheduled events. The researchers propose co-designing activities with families, leveraging their biographical knowledge, and aligning activities with residents’ prior professional and gender-specific identities to prevent social withdrawal.

Viewed through Meleis’ Transition Theory, the move to a dementia village is not a single event but a gradual transition in caregivers’ identities, responsibilities, and relationships with healthcare professionals. Successful adaptation depended on information sharing, dialogue, and role negotiation, which explains why confidence often grew over time despite initial uncertainty. The findings also align with recent evidence from the French dementia village Landais Alzheimer, where residents experienced fewer and shorter hospitalisations and were less likely to die in hospital compared with those in traditional nursing homes, outcomes linked to higher staffing levels, interdisciplinary presence, and continuity of care.

The authors conclude that dementia villages may contribute to more sustainable dementia care by supporting residents’ autonomy, social inclusion, and personhood while sustaining constructive partnerships between formal and informal caregivers. Despite ongoing challenges with communication, involvement, and the balance between autonomy and safety, caregivers consistently said they would choose the model again, describing their relatives as safe, engaged, and well cared for. The team cautions that the small sample of 30 caregivers, proxy ratings of thriving, and the Norwegian context limit generalisability, and calls for comparative and longitudinal research to determine how consistently these benefits are achieved across settings and populations.

Subject of Research: Dementia care

Article Title: Family caregivers’ experiences in dementia villages: a model for sustainable and meaningful care

Article References: Bjørnnes, A. K., Grov, E.-K., Hessevaagbakke, E. E., Lindeflaten, K., Tschudi-Madsen, C., Holmström-Rising, M., Tørris, C., Hovland, J., & Lillekroken, D. (2026). Family caregivers’ experiences in dementia villages: a model for sustainable and meaningful care. Frontiers in Dementia, 5, Article 1949032. https://doi.org/10.3389/frdem.2026.1949032

Image Credits: AI Generated

DOI: 10.3389/frdem.2026.1949032

Keywords: dementia villages, family caregivers, resident thriving, mixed methods, sustainable dementia care, Norway, Hogeweyk model, welfare technology, Family, caregivers, experiences, dementia