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A ‘village' where Alzheimer's patients move about freely: Perennial's new care model in China
[XI'AN] Near the scenic Qinling mountains of Xi'an is a life-sized replica of a typical Chinese town.
It features residential blocks, a post office, grocery store, florist and playground. Bus stops line the road running through the town. Geese honk near a fountain, looking for food. Elderly people go about their morning exercise routines.
This facility is China's first Alzheimer's disease care village, built by Singapore-based healthcare and real estate company Perennial Holdings and opened progressively from March 2024.
The 43,000-square-metre development is premised on a novel idea: that Alzheimer's patients should be able to move freely – whether shopping for their own groceries or posting their mail – rather than being restrained within a nursing home.
A post office (left) and florist within the Perennial Alzheimer's Care Village Xi'an; the facility looks like a typical Chinese town. PHOTO: ST
'We are building a healing community where people can live independently,' said Dr Song Xiangying, dean of the Perennial Alzheimer's Care Village Xi'an.
'The daily living abilities of those aged 60 to 70 are still quite strong, so there is a need for such an open-living community. They are very mobile – you can't lock them up in one place unless you use psychiatric drugs, which will do the greatest harm,' she said.
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The facility is 'still ramping up', said Tan Bee Lan, Perennial's healthcare chief executive. To date, it has hosted more than 50 residents, with 26 current residents. The development includes an eldercare complex, and nursing and rehabilitation hospitals, as well as a research institute for geriatric health management.
Residents can choose between a single or double room, or suites for families with high-need patients. The average monthly fee ranges from 8,500 yuan (S$1,517) to 13,000 yuan, depending on the level of care and room type.
Lu Jing (right) with her mother-in-law, who resides in the care village; the facility is 'cost-effective', she notes. PHOTO: ST
While such a facility is not necessarily cheap, it is 'cost-effective', said Lu Jing, whose 76-year-old mother-in-law is a resident. Private helpers are expensive and unable to work over the holidays, she noted.
'She is happy here,' Lu said of her mother-in-law. 'At home, there wouldn't be as many people to accompany and talk to her.'
Non-drug approach
Patients here are encouraged to take ownership of their daily routines – strolling the grounds, meeting for coffee, or learning to play the Bunne guitar, a three-chord instrument designed for seniors.
'Just like normal people, they can fulfil all their needs with the outside world and have close contact with nature,' said Dr Song.
'If we confine them to a building, they may lose their sense of space and feel little relief from anxiety and illness.'
Dr Song (left), with residents of the care village, notes that they can fulfil all their needs with the outside world and have close contact with nature. PHOTO: ST
Running such a facility is no easy feat, as some Alzheimer's patients can display behavioural issues, including aggressive outbursts. The care village uses facial recognition technology to keep its residents safe as they move about, while also incorporating non-drug intervention to deal with behavioural issues.
One room within its clubhouse is dedicated to play therapy, where seniors can amuse themselves with figurines in a small sandpit. Dr Song cites this as a means for patients to express their feelings.
In some cases, their outbursts could simply be related to discomfort with the temperature or hunger – these can be managed, she noted.
Traditional Chinese medicine treatments are also provided to help patients with common symptoms of Alzheimer's, such as insomnia.
A resident of the care village undergoing multi-sensory therapy; other treatments provided include traditional Chinese medicine. PHOTO: ST
Market need 'beyond doubt'
Perennial had in fact initially planned to build such a facility in Singapore, said its chief executive Pua Seck Guan. In 2020, it bid to develop a dementia village comprising 10 bungalows in Gibraltar Crescent in Sembawang.
'But it was a shame; we were the only bidder… and it ended up that (the authorities) did not award us because they cited that we did not meet the reserve price. We didn't know there was such a reserve price,' he said.
Pua was nevertheless convinced of the need for an Alzheimer's care village. He cited how even wealthy patients who can hire two nurses would still lack the stimulation needed to manage the condition if they remain stuck at home.
As part of his research, Pua visited care villages in Europe, such as De Hogeweyk in the Netherlands, which serves patients with severe dementia. He was impressed by the autonomy that residents there enjoyed.
'Since we tried to do it in Singapore – (and) couldn't do it – I spent a fraction of the money and did it in China in a bigger way,' he said, adding that he could lease the real estate rather than have to own it, making the project more affordable.
Residents getting onto an electric buggy for a joyride in the village compound; residents are able to move freely within the facility. PHOTO: ST
That said, such a project still comes with manpower challenges. Taking care of dementia patients requires specialised skills and requires not just nurses, but also nutritionists and social workers, said Dr Song.
'So labour costs may be higher – not because of the individual staff cost, but because of the manpower requirements of the work we want to do,' she said.
Asked about the breakeven timeline for the Xi'an facility, Pua estimated that it may take three to four years. 'This project is not easily money-making, mainly because it's new,' he said.
Dr Song echoed this sentiment, noting: 'As first movers, we have our difficulties… It takes time to cultivate the market.'
But there is undeniably a need for more Alzheimer's care options in China, especially with its ageing population. 'This is beyond doubt,' she said.
