Dementia and informal care · is a garden home the right fit

In the early stages of dementia, a garden home (mantelzorgwoning) often works well. The resident keeps a front door and a rhythm of their own, and you are fifteen metres away instead of half an hour's drive. As the illness progresses that balance shifts, and at some point supervision matters more than independence.

The honest limit lies with wandering and with care that requires supervision twenty-four hours a day. A front door of their own is then no longer freedom but a risk. That is no reason not to start now, but it is a reason to think about it from the very beginning.

Why being close makes so much difference with dementia

Well over a quarter of a million people in the Netherlands have dementia, and most of them live at home. What helps with this illness is familiarity: the same room, the same belongings, the same order to the day. Moving house is a bigger upheaval for someone with memory problems than for anyone else, because their surroundings do part of the remembering.

That is exactly where the tension lies. A garden home is itself a move. So if you are considering one, it is wise to do it early, at a stage when someone can still get used to a new layout and have a say in it. Waiting until there is no other option means moving at the worst possible moment.

What being close gives you is usually not the care itself but the checking in between. Glancing to see whether the light is off. Seeing that the post has been taken in. Noticing that no shopping has been done for three days. Those are the signals that stay invisible from a distance.

What changes at each stage

Dementia progresses in stages, and a home that works well in one stage can become a tight fit in the next. It helps to look ahead, even if things are still manageable now.

Stage	What is going on	What the home needs to offer
Early	Forgetfulness, difficulty with planning and paperwork	Independence with a front door of their own, closeness for the checking in between
Middle	Orientation and daily rhythm get disrupted, help needed with washing and cooking	Short walking routes, a view of the toilet door, contrast, cooker safety
Advanced	Restlessness at night, wandering, supervision needed at unpredictable moments	Usually a place with permanent supervision, no longer a home of their own

The fact that the third stage will come does not mean the first two do not count. In practice they cover years, and those years are demonstrably different in a home of their own next to their children's house than in a flat three villages away. What it does mean is that you think about the way out before you need it. With us, that is the buy-back: the home can be removed when the situation changes.

What the design needs to do

With dementia, the floor plan counts for more than the finish. In practice, eight choices make the most difference.

A view of the toilet door from the bed. Someone who wakes up at night and can see the door does not have to search for it. This is the most important design choice of all.
A short, straight walking route from bedroom to bathroom, without corners and without doors blocking the way.
Step-free and single-storey, including the shower.
Colour contrast. A toilet seat and grab rails that stand out against the wall are easier to see for someone whose perception is declining. Plain white on white is a poor choice.
Plenty of daylight. Light supports the day-night rhythm, and with dementia that rhythm is fragile.
Night lights that switch on automatically along the route to the toilet.
Simple controls. One thermostat with a turning dial works better than an app or a display with menus.
Room for their own furniture. The familiar chair and their own photos on the wall do more for orientation than any adaptation.

Every model page shows the floor plan with dimensions in millimetres, and you can download it as a PDF. Put it next to this list and trace the route from bed to toilet with your finger. That is a more useful check than looking at the kitchen photos.

Technology that really helps

There is a lot on the market and most of it is unnecessary. We see four things come up again and again in families where it goes well.

Cooker safety. An induction hob that switches off automatically removes the biggest fire risk.
Smoke alarms, which are compulsory in every home, with an alert that also reaches you.
A doorbell with a camera, so the resident does not simply open the door and you can see who is there.
Simple motion sensors, for example an alert when the front door opens at night. This is where a garden home can still just about do what a home further away cannot.

What we advise against are systems with an app that the person has to operate themselves. In this situation, technology should be invisible to the resident and visible to you.

When it no longer works

There will be signals that mean an independent home is no longer responsible, not even fifteen metres from your back door.

Wandering outside, especially at night and especially in winter.
Restlessness at night, where day and night get reversed and someone needs to be there at unpredictable moments.
Dangerous behaviour with fire, water or medication, despite adaptations.
Fear or suspicion that makes being alone unbearable.

Then the question is not which adaptation is still possible, but whether a place with permanent supervision is needed. A dementia case manager or the GP can help with that decision and with applying for care under the Wet langdurige zorg (Wlz, the Long-term Care Act). Start that conversation before it becomes urgent, because arranging a place takes time.

What a day like this looks like in practice

What families describe is rarely dramatic. In the morning someone pops round to see whether the curtains are open; that is the first check without it feeling like a check. At lunchtime you eat together, in one house or the other. In the afternoon nothing happens, and that is exactly the point.

The gain is in the evenings. No half-hour drive after work to see whether the light is off, no phone calls that go unanswered, and no weekends taken up entirely by travelling back and forth. What remains is time that goes to company instead of logistics, and with this illness that is precisely what disappears fastest.

What it asks of you as a carer

Caring for someone with dementia is harder than caring for someone with a physical disability, and that is not because of the lifting. It is because of the unpredictability, because of grieving for someone who is still there, and because it has no weekends.

So arrange respite care before you are ready for it, not when it is already too much. Under the Wmo (Social Support Act), your municipality is obliged to support carers, and the dementia case manager knows the way. What other help exists is set out in who a garden home is intended for.

The conversation with someone who does not want it

This is the hardest step, and it is rarely about the home. Someone who hears that they can no longer live alone hears that they are losing something.

What helps in practice is turning it around. Talk about what stays the same: a front door of their own, a key of their own, deciding for themselves what time to make coffee. Talk about the travel time that disappears rather than the care that is needed. And involve the person in choosing the model and the layout, for as long as that is still possible. Taking part in a decision is something very different from having it imposed.

What to arrange before you need it

Two things can only be done while someone still has mental capacity, and those are exactly the things people put off too long. A power of attorney or a levenstestament (a document in which someone sets out who may decide for them) drawn up by a notaris (civil-law notary), so that you can take financial and care decisions when the person can no longer do so. And a conversation about what someone wants, written down, so that you do not have to guess later.

On the practical side there is also the question of whether it is possible on your property. Do the permit check for your address, because it takes ten minutes and it determines whether this whole conversation leads anywhere. Related situations are covered in are garden homes safe for older people with memory problems and in can a garden home be adapted for dementia care.

Sources

[Research] Alzheimer Nederland — number of people with dementia in the Netherlands and the share who live at home — accessed 20 August 2026
[Act] Wet maatschappelijke ondersteuning 2015 (Social Support Act) — support for carers and respite care — accessed 20 August 2026
[Act] Wet langdurige zorg (Long-term Care Act) — care with permanent supervision — accessed 20 August 2026
[Decree] Besluit bouwwerken leefomgeving (Bbl, Buildings Decree) — requirements for residential use, including smoke alarms — accessed 20 August 2026

Are garden homes suitable for people with dementia?