Nonprofit Hospice Provider Agrace Plans New Dementia Village Concept

A Wisconsin-based nonprofit hospice, Agrace, is launching a new memory care initiative that includes a village for residents inspired by the Hogeweyk model in The Netherlands.

The hospice and palliative care provider recently announced the project, which will be dubbed as the Ellen & Peter Johnson Dementia Village at Agrace. Fueled with the Johnsons’ donation of $7 million, construction of the new dementia village will begin in spring 2026 and is slated to complete by fall 2027.

The village will be the first of its kind to launch in the United States. The initiative has been several years in the making as Agrace worked to identify demand, as well as gaps in memory care needs and resources. They also had to develop a care model that would address these issues, said President and CEO Lynne Sexten. The new dementia village’s aim is two-fold: to improve both quality and caregiver support, Sexten indicated.

“We’re really trying to address two dire issues at the same time,” Sexten told Senior Housing News sister publication Hospice News. “For those living with dementia, we want to restore their sense of autonomy, self-determination and happiness. We want to keep that quality of life as high as we can as they progress. At the same time … the caregiver burnout issue is real. We’re hoping that this village really starts to address the caregiver burden.”

Agrace provides hospice and palliative care, dementia support and adult day services throughout south central Wisconsin. Established in 1978, the nonprofit has seven locations across the state.

The organization is updating its campus in Madison, Wisconsin, which is currently home to its general inpatient hospice facility, which features a memory care unit. The hospice facility will remain onsite at the campus, which will undergo renovations and expansion to build the new dementia village. Other campus updates will include a new grief support and education center, along with a training and education center for staff and family caregivers. The village will be licensed as an assisted living, memory care and adult day community.

An innovative design

The new initiative was born out of growing demand, Sexten said. Nearly all of the individuals in its adult day program have some type of dementia or Alzheimer’s diagnosis, with caregivers in significant need of respite support, she stated.

The village’s concept is based on The Hogeweyk model, which was developed in the Netherlands in 2009. The model has since expanded in parts of Europe, Australia, China and Canada. Founders of the model designed a dementia village aimed at providing inclusive, person-centred, high-quality memory care and treatment. The design was intended to be more community-based, rather than the traditional facility-based settings of memory care and support.

“We started studying the model [that asks] what a person’s true north is, were it not for dementia,” Sexten said. “What would be normal for this person? One of the unique things about the Hogeweyk model is that it is small homes and very much emulated after a family setting.”

Agrace’s new dementia village will feature eight small homes, each with a capacity for roughly six to eight individuals. The homes will be assigned a specific lifestyle, with the organization currently analyzing data on the specifications based on individuals’ beliefs, preferences, behaviors and symptoms. The intention is for housemates with similar lived experiences to live in harmony, according to Sexten.

Housemates will engage in activities of daily living together, as well as leisure and social activities. The village will be enclosed by natural landscape barriers and buildings such as a coffee shop, pub, theatre, restaurants and areas for social gatherings, indoor activities, exercising and classes. It will feature amenities mirroring a small town including outdoor gardens, parks and playgrounds.

The village will also feature an adult day program for individuals with dementia as an opportunity for caregiver respite.

“It’s very much a village that keeps people safe, and helps them in a variety of ways to be ambulatory and engage with the outdoors, which can improve their mood, reduce depression and help mitigate some of those challenging behaviors that can be associated with latter stages of dementia,” Sexten told Hospice News. “The outdoors is a huge, huge part of our village. Normally, people in memory care units don’t go outside very much and they’re in a large building with corridors. This model has proved to be successful … fewer people are bedridden with advanced dementia.”

Agrace has rolled out a $30 million capital campaign to support the village’s development, of which 45% has been raised thus far, according to Sexten.

Clinical staff and caregivers will provide 24/7 care to residents of the new village. It will feature on-site workforce housing for household caregivers, which will include eight private studio living spaces. The organization is collaborating with local universities and colleges to attract medical students as a way of gaining exposure and increasing awareness of hospice, palliative and dementia care, Sexten stated.

A main goal is to address prolific health care staffing shortages by attracting new caregiving professionals who seek meaningful, relationship-based work.

“A portion of our workforce will get free room and board, and in exchange they’ll work for the village,” Sexten told Hospice News. “There is definitely a category of health care workers who just love working with this population of patients. And so, to be exposed to that earlier, even when you’re still studying for your degree, can get people into that pipeline all the sooner.”

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