Jikka: a beautiful & unique aged care facility in Japan

This is such a heartwarming facility, perhaps not the most dementia-friendly, but it is beautiful, enchanting and absolutely lovely. Nursing homes done differently. Food for thought, this nursing home in Japan was designed by 2 women and is known as Jikka. Created by architect Issei Suma, this facility in the mountains of Shizuoka Prefecture and brings together the community into the care facility.

Wheelchair accessible spa.

What does a person with dementia look like in Asia?

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I spoke to a few people about dementia recently and some were shocked at the fact that people with dementia are able to live in the community. I was quite surprised at the fact that they were surprised, I guess to me it’s been such a norm that I forget that people have different ideas and perceptions about people with dementia. One person even said to me that she thought people with dementia were people who have forgotten how to do anything, and that they get lost all the time, and maybe scream a lot or are angry. Or people who sat around in nursing homes and were the shell of themselves and stared into space all day. It was an incredibly painful feeling to sit and know that people with dementia are thought of that way.

However, with the media continuously labelling people with dementia as “sufferers” and movies portraying people with dementia as people with high care needs, staring into space or being highly disabled, it’s no wonder people have such negative stereotypes. In a cab ride last week, a cab driver pointed out that there’s not much point designing services for people with dementia since there will be a cure or a vaccine out in 5 to 10 years; he had seen the headline in the papers. I listed out the evidence on vaccine development and talked about the damaging impacts of the media and highly misleading headlines that are taking away the focus of providing care to people who are now living with dementia in the public eye. Again, who could blame him, he’s seen it in the papers. I left the cab feeling frustrated.

Media gurus with little understanding of dementia undermine the objective and essence of research, turning publications into another holy grail headline but it is their job to create publicity for the institution or organisation, and most of the time the rehashed facts are close but no cigar. Do these media personnel understand the devastating effect this has on people with dementia and their families, to be constantly thrown a lifeline every day that says a cure has been established only to find out it’s another sensational headline in the making.

Coming back to the person with dementia? Can the media change the way dementia is portrayed? An associate shared a good example of enablement. He talked about how he has a visual impairment and in the past without the aid of glasses, he would be severely disabled, however ,with glasses, he is enabled and can function just like everyone else. People with glasses are accepted just like everyone else. So how can we change the way the public think, accept and include people with cognitive impairment, in the same way as visual impairment? You don’t see a headline every day screaming that my vision can be cured or there’s a vaccine developed for my short-sightedness, could this be attributed to the knowledge base of media personnel having an understanding of visual impairment.

I’ve attached a 6 min trailer of the Last Laugh; here Kate Swaffer shares her experience of living with dementia and her experience after receiving a diagnosis of dementia. She’s an amazing woman, championing the rights of people with dementia, working on her Ph.D., is the inaugural Chair of the Alzheimer’s Australia Dementia Advisory Committee, author of “what the hell happened to my brain” and a founding member of the dementia alliance international.

Below is a video featuring the amazing Christine Bryden who has been living with dementia for 20 years and has been advocating for better quality of care and life for people with dementia. She was diagnosed with dementia in 1995 and when she was diagnosed with Alzheimer’s Disease at 46, doctors had prescribed that she stop working and prepare herself for the inevitable. 20 years now, Christine is an author of 2 books, lectures international, is a well-known dementia advocate in Japan, completed her post-graduate studies and is into her 15th year of marriage.

These active champions who have never given up, are true heroes in the face of dementia, and their hard work to make a change while living with dementia is truly admirable. However, looking back at my home encounters in the  last couple of weeks, it was a stark reminder that we still have a lot of work to do in the space of creating awareness about dementia in Asia, because what we think a person with dementia should look like, is not reflective of reality at all.

Travelling with your loved one with dementia

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My greatest fear!

When people who do not practice respect and dignity are in charge of care.

This trip back to Singapore, I spent much of my time running focus group discussions for my research project and meeting people involved in the care of people with dementia. So far in my care experience, all the people I have known in healthcare have hearts bigger than the universe, and dedicate a lot of time and effort into making a difference to people living with dementia. I have been inspired, awed and swept off my feet by people who continue to work against the tide to bring better care to their clients come hell or high water.

I never thought I would meet such a person, perhaps I am idealistic and always hope to see the best in people but I actually met a person who not only had little respect and disregard for her fellow staff, she was unemphatic and condescending to external staff. They may not bear the same rank as her but everyone deserves the same level of dignity and respect.


It scares me that a person that have such little respect and dignity, with so little understanding of person centred care is running a ship of programmes and services for people with dementia.

How can the person be truly aligned with the needs of the person with dementia, caregivers, staff and the philosophy of care? I hope organisations will look beyond the qualifications and also consider the attitude, understanding of dementia and the person’s ability to promote person-centred care in their organisation when they look to find leaders spearheading dementia care programmes.

Benefits of a Rehabilitative Environment

An inclusive rehabilitative environment that promotes dignity, respect and positivity, and it clearly reduces negative behaviours and promote a restorative change, empowering the people undergoing rehabilitation.

An environment that strips people of dignity, respect and positivity, increases or maintains the level of negative behaviours exhibited by an individual.

Like the guard said, “do you want people who are angry?”. Like Prison, nursing homes should not be pathogenic environments that confine, constrict and constrain. It should be salutogenic therapeutic environments for people to age in place with dignity and respect, such environments will reduce the amount of negative behaviours and create a systemically inclusive community for everyone.

 

Magnetic Shoe Laces

Everyone knows someone who loves their sneakers, unfortunately, sneakers and shoelaces have always been a real hassle, a trip hazard and a perpetual pain in the bottom when they keep coming lose. Saw this on facebook posted by a mate of mine. Looks like a good solution to those annoying shoelaces that keeps coming untied.

How Vitamin D can protect your Brain

For a lot of us Asians, we want fair, smooth porcelain skin, much like our yummy soft tofu or beancurd puddings that we eat as a staple. A student from an article by Martin (2010), when asked about fairer skin was quoted as saying “If my skin is lighter, I will be happier because I think I look good. It makes my emotion better, yes.” Just walking into Changi airport, I was swamped with numerous skin whitening products. Even when I went to Sephora at ION Orchard, the person at the MAC counter recommended a “brighter” foundation for my tan skin colour. When I am out and about on a hot day with my adorable mum, out pops the umbrella to shield her against the rays of the sun preventing her from getting a T-Shirt tan. Walking along Orchard road, it is no surprise to see umbrellas popping out on a hot day, where the streets are drenched with sunlight. asian-1294263_960_720.png

Sunlight is a good source of Vitamin D and we really shouldn’t be straying away from it. A recent study conducted by Duke-NUS Medical school on Chinese elderly in Singapore; found that Vitamin D can help to maintain a healthy brain. Individuals with low Vitamin D levels are 2-3 times more at risk of cognitive impairment.

So what is Vitamin D and where can we get it?

Vitamin D is synthesised when our skin is exposed to ultraviolet or UV rays from the sun. Vitamin D can also be found as a supplement that is available at the chemist,pharmacies and in some foods. However, before we rush to consume copious amounts of vitamin D tablets or get a sunburn, there are some things that we need to consider.

We need to take everything in moderation and too much Vitamin D has potential adverse effects on our body as seen in Table 1 below from the US Department of Health and Human Services. The table also provides some information on the recommended levels of Vitamin D. Get your Vitamin D levels checked out with your local General Practitioner (GP) to find out what your recommended daily allowance should be before starting on supplements.

Table 1: Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations and Health* [1]
nmol/L** ng/mL* Health status
<30 <12 Associated with vitamin D deficiency, leading to rickets
in infants and children and osteomalacia in adults
30 to <50 12 to <20 Generally considered inadequate for bone and overall health
in healthy individuals
≥50 ≥20 Generally considered adequate for bone and overall health
in healthy individuals
>125 >50 Emerging evidence links potential adverse effects to such
high levels, particularly >150 nmol/L (>60 ng/mL)

* Serum concentrations of 25(OH)D are reported in both nanomoles
per liter (nmol/L) and nanograms per milliliter (ng/mL).
** 1 nmol/L = 0.4 ng/mL

Source: Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010.

 

What are some foods that contain Vitamin D? 

Several food sources of vitamin D are listed in the infographic below.

new-piktochart

Source: U.S. Department of Agriculture, Agricultural Research Service. 2011. USDA National Nutrient Database for Standard Reference, Release 24. Nutrient Data Laboratory Home Page,http://www.ars.usda.gov/ba/bhnrc/ndlexternal link disclaimer.

Please note that Jo does not work or receive any funding from the company or organisation in this article.