Ageing & Culture – Page 9 – Designing for Aged Care

Ageing & Culture, Caregiving, International Policies, Research & Best Practice, The Built Environment

Memory Cafes: Working towards inclusion

Posted on December 16, 2015December 16, 2015 by Joanna Sun

No one person with dementia and their caregivers should be isolated, and a social program in the United Kingdom, America, some parts of Australia are doing just that. We all know that loneliness affects both the person with dementia and their caregivers. Studies have reported that isolation and loneliness can bring about lowered self-esteem, feeling of abandonment, and increase mortality rates, and these are but just some of the issues associated (Brotons & Marti 2003; Reijo et al. 2011; Goll et al. 2015). Even the UK Department of Health (2012) has recognised that loneliness is a major public issue and needs to be urgently addressed.

Just along the lines of government and major organisations, when one thinks Memory Cafe, we may have a schema of a 24-hour cafe with people running around to man the joint. Administrators and funders, I can imagine pinching themselves, great idea but what’s the cost? The gears will be moving in their heads thinking about all the capital involved and the manpower cost associated with it, not counting the overheads and getting the right people to be able to make coffee and run a cafe, followed by other operational issues of burnout, turnover manpower training and development.

This memory cafe is way ahead of the game. With a number of memory cafes popping up like peonies in full sun, this program only operates a few times a month depending on the cafe. It can be once a month or twice a month and time for an hour or more. It’s free for people living with cognitive impairment/dementia and their significant other, be it their spouse, partner, child or carer.

Just having a peek at the Facebook page of one of the memory cafes in America (Brown County: Click here to visit page), you can see images people sitting in small groups of eight working together and having fun with craft activities and in one post they even mentioned that they were putting together harvest recipes for a cookbook. Another photo has a heartwarming image of people sitting around, really relaxed and laid back enjoying Christmas carols performed by the NWTC choir.

It’s hard to find programs where both the person with dementia and their significant other can actually enjoy social activities. Most activity centres would boot the caregivers, expecting people to drop off the their loved one with dementia at the centre and leave. If you hang around, you might feel a bit out of place or in the way. Or a caregiver program where caregivers come together and the person with dementia gets allocated to an activities area.

It’s just great to see a program that is so warm and inclusive, where people can just come together and there’s no stigmatism, no funny looks, no barriers. You can share stories, ask questions and there’s no stigma, no judgemental looks, no nonsense. Everyone can just be themselves, enjoy a cuppa and have some fun. A program that provides an environment that supports movement and engagement, optimises helpful stimulation, creates a familiar social space for people to have the opportunity to be part of the community, allows people to be seen and to be part of something meaningful (Fleming et al. 2003).

Isn’t this what life is about, just being able to kick back, have a cuppa and a laugh with friends.

Anyway hoping to see them catch on in Asia as well in the coffee shops and dim sum cafes.

For more information about starting a memory cafe in your community, please refer to the links below.

UK: Memory Cafe

USA: Brown County Memory Cafe

Aus: Memory Lane Cafe

Reference:

Brotons M. and Marti P., 2003. Music therapy with Alzheimer’s patients and their family caregivers: a pilot project. Journal of Music Therapy, 40(2), pp.138-150.

Department of Health (2012) Caring for our future: reforming care and support. London: The Stationary Office. Retrieved fromhttps://www.gov.uk/government/publications/caring-for-our-future-reforming-care-and-support.

Fleming R, Bowles J. Units for the confused and disturbed elderly: Development, Design, Programmimg and Evaluation. Australian Journal on Ageing. 1987 November;6(4):25-8.

Fleming R, Forbes I, Bennett K. Adapting the ward for people with dementia. Sydney: NSW Department of Health; 2003.

Goll JC, Charlesworth G, Scior K, Stott J (2015) Barriers to Social Participation among Lonely Older Adults: The Influence of Social Fears and Identity. PLoS ONE 10(2): e0116664.

Reijo S. Tilvis, Venla Laitala, Pirkko E. Routasalo, and Kaisu H. Pitkälä, “Suffering from Loneliness Indicates Significant Mortality Risk of Older People,” Journal of Aging Research, vol. 2011, Article ID 534781, 5 pages,

Ageing & Culture, Caregiving, International Policies, Research & Best Practice, The Built Environment

Individuality & Person Centred Care in Asia

Posted on December 14, 2015February 24, 2016 by Joanna Sun

Since a fortnight ago this tweet have been shared over 29,000 times and 21,720. Tweeted by Harudajin, he shares an unforgettable experience in his youth in primary school when his teacher shared with his students the meaning of individuality.

The teacher explained that when an instruction is provided to have the class write the word 晴, then everyone in the class will write the word 晴. However, the result of the word 晴 will differ slightly from each student. However if given an instruction to write the word 晴 and the student wrote the word 雨, that is not viewed as individuality.

Below is the original tweet:

https://twitter.com/harudajin/status/670747731510452224

There is a lot of discussion about a social culture in Asia and the differences between the cultures between the East and the West. Individuality in this discussion is working together as a social being, but at the same time appreciating and accepting the differences that we exhibit as individuals. No two handwriting can be exactly the same and despite our very similar daily routine and habits, it’s the small intricacies and preferences that make us all different. Here the teacher explains that we don’t have to radically stand out to be different, we can all be different and still maintain a sense of cohesion and harmony without our culture.

No two handwriting can be exactly the same. Despite our very similar daily routine and habits, it’s the small intricacies and preferences that make us all different. Here the teacher explains that we don’t have to radically stand out to be different, we can all be different and still maintain a sense of cohesion and harmony without our culture, and that’s what individuality is all about.

For Asians, harmony and cohesion are important factors and at times residents, and patients may not voice out our needs as they may not wish to inconvenience their carers and caregivers.

At a talk a few months ago about the Fukushima earthquakes, it was said that older adults that sought shelter in a gymnasium developed incontinence issues and muscle atrophy. Afraid that they were being disruptive and inconsiderate to fellow residents living in the open space temporary shelter, many remained sitting in their allocated space, not going to toilets allocated outside of the gymnasium.

Image source: Japan Earthquake: Rescue, Recovery, and Reaction – The Atlantic

This scenario is not unfamiliar to nurses working in acute care, step down facilities, nursing home and other community care facilities where families complain about their love ones developing incontinence and decreased mobility. It’s a common case study where you have a person coming out of the hospital with incontinence and decreased mobility and nurses and loved ones are concerned about falls resulting in the person spending the rest of their life sitting in wheelchairs. Being put on pads due to their incontinence issues, the person may not wish to venture out in the public, and participate in activities reducing their social engagements and decreasing movement. So starts a vicious downward spiral where mobility is lost and depression sets in.

All it takes is for us to care; to ask and encourage. To encourage our residents and patients and engage with them socially and to support movement. To ask about their preferences and how we can encourage our residents and patients to retain their independence and to maintain their mobility. This is a community effort, from governments to management to directors of nursing to the nurses and the care staff, we need to make time to care. Our residents and patients make an effort to not inconvenience us isn’t care a priority in healthcare in the first place?Person-centred care in Asia isn’t about being indulgent

Person-centred care in Asia is not about indulging a persons’ need for choices or the ability to be drastically different from everyone. It is about celebrating and supporting individuality and autonomy whilst maintaining harmony and social cohesion in the community. A fine balance, not in the pursuit of happiness but in a pursuit of peace. To be satisfied with the balance in life that brings us peace within.

it’s not 兴高采烈 but a 幸福美满的生活 that we yearn for.

Reference: Handwriting

Ageing & Culture, Caregiving, International Campaigns, International Policies, Research & Best Practice, The Built Environment

Dementia Language Project

Posted on December 13, 2015December 13, 2015 by Joanna Sun

Read an awesome ad inspiring news piece about Lingo Flamingo, a social enterprise in Glasgow that provides individualised lessons and workshops that aid cognitive function with the aim of tackling dementia. The founder Robbie Norval founded Lingo Flamingo to help his grandmother who was living with dementia.

There’s been a sea of research recently reminding us that being bilingual or multilingual has it’s benefits, everyone from the Singapore Management University, Georgetown University Medical Centre, Northwestern University, the University of Houston and even the American Heart Association.

The research states that being bilingual or multilingual can

improve our ability to process information
gain more grey matter than monolinguals
better cognitive functions post-stroke than monolinguals
be a constant challenge to the brain

A dementia language project such as Lingo Flamingo is an inspiration. It not only aid cognitive function, it helps to support engagement and movement, it gets people into the community and builds an inclusive environment. Most of it, it’s people coming together to learn and to have fun learning.

Hopefully, more of these initiatives will be set up globally, certainly would love to see a programme such as this in Asia as well. Though a large number of Asian are bilingual, it’s always not a bad thing for your brain health to pick up another language.

Reference:

Govan dementia language project launched – BBC News

Bilingualism and the Brain

Bilinguals of Two Spoken Languages Have More Gray Matter Than Monolinguals

Speaking multiple languages linked to better cognitive functions after stroke

Ageing & Culture, Dementia, International Campaigns, International Policies, Research & Best Practice, The Built Environment

Living Tiny & the Psychological Issues that go with it

Posted on December 12, 2015January 16, 2016 by Joanna Sun

In Asia, it is not uncommon for us to be living in tiny living space. From Tokyo, Singapore, China and even Thailand, we’ve all heard, know or even are living in very tiny homes in a very overcrowded city. Cost of living is high, we pay a mint for our homes and we end up living in little shoeboxes in the sky. In a recent article by the Atlantic. The issues of micro apartments were discussed and the question is “how small can our living spaces get before it starts to impact on our physical and psychological health?”

The article talks about how these apartments serve their purpose for young, childless couples who had just started out in the world and wish to live close to the city or work or play. However, for people with children or living in a multigenerational family unit, how do people cope?

Looking back in Asia, for many in the sandwich generation, working long 10 to 14-hour shifts, caring for children and our parents. The home is suppose to be a safe haven, but when overcrowding occurs some people may feel a sense of dread befalling on them when it is time to go home. Trapped between the tortures of work and the stress of claustrophobic home.

The article talks about how living in small apartments can affect the concentration of children and in turn, impact on their studies. The article also talks about the lack of privacy and how it may cause children to become withdrawn. If these housing conditions can have such fundamental impacts on children the implications for older adults living in such apartments with cognitive impairment and dementia must be very challenging.

However, in Japan, despite the overcrowding and challenging living conditions, strong community initiatives have risen to help support the physical and mental well-being of older adults living in these housing conditions. The Dementia Support Caravan (DSC), founded a decade ago help apartment managers to work with older tenants who may be living with dementia and require support from the community. As the number of people with dementia

The Dementia Support Caravan (DSC), founded a decade ago help apartment managers to work with older tenants who may be living with dementia and require support from the community. As the number of people with dementia continue to grow in Asia and housing conditions continue to remain unchanged; initiatives such as the DSC can help older adults with dementia age in place in their units within the community. It is in hope that more urban regions in Asia may develop similar programmes to support the people with dementia and their family living in the high-rise communities.

Source: The Health Risks of Small Apartments – The Atlantic

Source: Hand for dementia – Japan Times

Ageing & Culture, Caregiving, International Campaigns, International Policies, The Built Environment

Expert highlights dangers of over-prescribing psychotropic dementia medication – The Japan Times

Posted on December 8, 2015December 13, 2015 by Joanna Sun

Saw this article below this morning and I thought it’s a very important article to highlight the dangers of over-prescribing psychotropic medication for people with dementia. Some of the risk factors include:

falls
bone fractures
suffer impaired consciousness

It was recommended in the article that non-pharmaceutical options should be the first intervention before the introduction of drugs. It was also recommended that the low doses of the drugs should be prescribed in the initial stages of treatment for BPSD.

As a massive wave of Japanese enter their twilight years, an expert is calling for prudent use of psychotropic drugs to treat dementia patients, some of whom have suffered ill health due to over-prescription.

The Health, Labor and Welfare Ministry released guidelines on how to prescribe such drugs for dementia patients in 2013 to avoid casual prescription by doctors. The Japanese Society of Psychiatry and Neurology is also training doctors on the appropriate application of the drugs…

Click here to read the full article: Expert highlights dangers of over-prescribing psychotropic dementia medication | The Japan Times

Ageing & Culture, Caregiving, Research & Best Practice, The Built Environment

Walking with my mother

Posted on December 2, 2015December 13, 2015 by Joanna Sun

Director Katsumi Sakaguchi’s newest film “Walking with My Mother”
Official selection of Tokyo International Film Festival 2014

Director Katsumi Sakaguchi captures the life of his mother, Suchi, 78 through film, as she lives with dementia and depression, coping with the loss of her daughter and then her beloved husband. In the film Katsumi documents a life of distress, frustration and grief as his mother tries to remain resilient against all the trials and tribulations that life has hurl against her. He captures his own feelings and emotions as he tries to understand the needs of his mother and his own, and to cope with the changes that life has brought for both of them. The film also showcases their travel back to Suchi’s hometown and the positive improvements that such a change brings.