Policies, programmes and statewide interventions for dementia.
Summary: A new study that emerged from Yale school of public health has indicated that stress from negative beliefs about aging is associated with Alzheimers disease.
From source: Alzheimer’s Disease Photo credit: Dreamstime
Negative Beliefs About Aging Predict Alzheimer’s Disease in Yale-led Study | Yale School of Public Health
Read full article here: Negative Beliefs About Aging Predict Alzheimer’s Disease in Yale-led Study | Yale School of Public Health
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:
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
My husband and I have been talking about kids for a long time now, and I’m certainly not getting any younger. As the days tick by and my facebook is filled with walls of baby photos in my activity feed, I wonder about having my own. On top of that I wonder what the future will hold for my children? I am Singaporean, my husband is Australian, our racial and cultural differences are vast. We look like chalk and cheese and our cultures are chalk and cheese. I am born and raised in Singapore and proud of it.
Looking back at my youth when I was growing up, the house was filled with an orchestra of languages. Instead of the wind, brass, drums and percussions, we had English songs from Abba, Michael Jackson, Kenny Rogers, playing on the radio. I remembered my mum even attended a Debbie Gibson concert. That was really cool! I remembered the souvenir she brought back, it was a fan in the shape of a blue hand, sounds odd now but when I was a kid, that was possibly super cool.
There would be English in the background, my great grandmother speaking in the Teochew dialect, my mum in Mandarin and my dad would speak in either English or Teochew. Sometimes I hear him speaking Malay to the man who comes to collect the payments for our daily newspaper. Singapore was an amazing melting pot of cultures and languages, and I embraced every crumb of the colourful heritage that I can call my own. There was never a dull moment growing up in Singapore, my childhood was certainly a happy one.
Image from abusymom.wordpress.com
My child will have an Asian migrant parent depending on where we will reside when we retire, and I often wonder what will happen to my children when I have dementia. Will they be able to speak my language if I regress to Mandarin or Teochew? Will I lose the ability to communicate because there will be no one who can understand me? I remember caring for a lady who spoke Russian and I would carry a notebook with me with some basic words like “dobroye utro” or good morning, “Da” for yes and “Net” for no, and about 20 other phrases for different times of the day and meals. I wondered if her children could speak the language?
Sometimes I watch the western videos on nursing homes or visit residential aged care homes and I think, I’m never going to be comfortable in a place like this. It’s beautiful, no doubt about it, but there’s nothing familiar in the four walls. Even the people look foreign, no one speaks my language, the food is all wrong and if I were to live in a residential aged care facility, it would be like living in a foreign television show. I would think I was on the Truman show or something. I have only seen one Asian nursing home in Australia, the home is lovely, with Asian staff and sumptuous simple Chinese meals, with menus beautifully printed in Mandarin, but the environment itself looks like community hospital on the inside with nursing reception counters and a very modern western feel.
There are 10.6 million Asian immigrants in the United States of America in 2009, in the United Kingdom almost 10% of immigrants are from South Asia and in Australia a million immigrants were from Asia according to the statistics in 2011.
I wonder if I am the only person with these worries and thoughts? I wonder what happens to Asian immigrants who work long and hard to bring their children to the west, only to live out the end of their lives in confusing and disorientating environments? What can we do for them, and how can we make their lives better? Will there be more places that can cater for Asian migrants? Where can we go to feel at home when we have dementia?
I have no answers and only questions, hopefully, time will tell.
References:
Australian Bureau of Statistics 2004, ‘Where do the Overseas-born population live?’ in Australian Social Trends, cat. no. 4102.0, viewed: 18 May 2012, <http://www.abs.gov.au/AUSSTATS/abs@.nsf/mf/4102.0>.
Department of Immigration and Citizenship, Booklet 6, General Skilled Migration, viewed: 24 April 2012, <www.immi.gov.au>.
Australian Bureau of Statistics 2010, Migration, Australia, 2009-10, cat. no. 3412.0, viewed: 18 May 2012, <http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3412.0Main+Features12009-10>.
Salt, J. “International Migration and the United Kingdom, 2010.” Report of the United Kingdom SOPEMI correspondent to the OECD, Migration Research Unit, University College London, 2011.
U.S. Department of Homeland Security, Office of Immigration Statistics. 2010 Yearbook of Immigration Statistics.
I’ve attached a video that I found very moving about the trials and tribulations experienced by migrant parents to help people understand the difficulties of resettling and raising children in a foreign land. I also found a funny video about the same group of kids and parents imitating each other and that’s actually really funny.
Children Of Asian Immigrants Reveal Sacrifices Their Parents Made
So what can our kampung spirit and technology do to help people aged in place in the community? A report last year by the ABC pointed out that there were 5 million people with dementia in Japan and thousands are going missing every day. In another report, it was cited that 10,783 people with dementia have gone missing in Japan in 2014 alone. Even in Singapore, there are more frequent reports about older adults who have gone missing. Some people have turned to social media for help, posting images on facebook and requesting friends to spread the word and be on the lookout. According to Alzheimer’s Association in America, approximately 60 percent of older adults with dementia wander. It is no surprise when you google the words “dementia” and “news” to find at least one report of a person diagnosed with dementia who has been missing and more has to be done about the issue.
Revealed: Sad plight of the thousands of elderly left alone in homes ‘without letters, visits or calls’ in their final years Read more: Click here to read article by the daily mail
We all want to age in place in the community, with our loved ones around us. We want to remain in the home where we have cultivated our memories, where our stories are embedded in the walls and every little item and furniture has a story that speaks to our soul. Unfortunately, when we have dementia, we may wander out of our homes and have difficulties finding our way back.
This brings me to point out the ‘Safe Wander‘ device designed by Kenneth Shinozuka. He invented a sensor that can be attached to the base of a sock which can send alerts to the smartphone. For Kenneth, the push to design such a device was the result of his grandfather who has dementia. For all caregivers out there, this will possibly make you skip a beat, but his grandfather wandering alone at night and had walked onto the highway. Thankfully, he was found by the kind boys in blue and the police officers brought his grandfather home safe and sound. Stories like these are not new and many caregivers would have experienced this at one time or another. For 16-year-old Kenneth, he decided that he had to do something about it.
With growing success in technology support from neighbours and the police force, pockets of residential estates with a high density of older adults may benefit from an age or dementia friendly community programme. With the community attaining awareness or dementia, everyone will be able to work together to not only enable more people to age in place in the community but it allows community ties to be strengthened and friendships to form. This builds community spirit, and with that a sense of pride and care for the people around them and the community. Or as some Asians may know, the “kampung spirit”.
Let’s be honest, I’m not the only one here that feels that the kampung spirit is dwindling in our communities. Gone were the days that I would know everyone that lived on the right and left of my home. Us kids knew what dialect and language everyone spoke and we even knew the routine of the lady we affectionately call 婆婆 (grandma in mandarin). We knew all the shopkeepers in the market and would holler “大老板早”。Whenever, we pass the herbal smelling Chinese medicine shop, the owners were an older couple from China in their 60s, possibly 80s now. We don’t know our neighbours anymore, we are busy all the time and with millions of people around us but we are truly alone. A volunteer with a senior group once mentioned that he lived in an apartment block for thirty years and a neighbour he had never known had passed away downstairs, all alone. He wished he could have done something about it. At a staff session, a colleague pointed out that a lot of older adults in residential aged care, despite having all the care staff and nurses around them, they felt isolated. Such is the irony of our lives.
Before the intellectual debate, to which many have fallen prey to what D.T Suzuki describes as the force of intellect without moral construction. The need for intellectuals to hastily call attention to, deconstruct, criticise and tear down concepts and ideas like a negative force of deconstruction without the provision of positive contributions.
We should reflect on what we can do for the community to allow people to age in place in the community.
To not feel ashamed of growing old or having dementia, to not feel like everyone have been let down. To not feel like living in an isolated institutionalised facility, thinking that living away from family is the only option, as a punishment for not being “normal”. To think that it is alright to be restrained, bed bound and living to 103 as a result of nasal gastric feeds. To not feel like a burden on society, the community, our friends and the people we hold close to our hearts. We need to look deep within ourselves and work on reducing our need for deconstruction, to stop critiquing ideas, people and ultimately ourselves when we observe the cracks on the wall. Let’s work together as a community to fix this crack of stigmatism against the elderly and dementia and be builders as our forefathers had been before us. Let’s do something about the stigmatism behind dementia before the wall that is our society crumbles before us.
I wish Hobart were a global age-friendly city, a city for all ages. It comes to no surprise that this was inspired by Alexandre Kalache’s talk recently. He held a public lecture at the Medical Precinct in the University of Tasmania on the 19th June 2015. There he spoke about the change in demographics on a global scale, the systemic impact of longevity, his home in Copacabana and the call for action to create more global age-friendly cities in the world.
Retirement age in the 1970s was 60 years of age, and now it ranges from 60 to 67 years across the globe. Life expectancy in 1970 was an average of 71 years of age, and now it has risen to 82. In 2050, many first world countries will be seeing the average life expectancy climb to 90 years of age. We are enjoying longevity; we are also forced to retire for a longer length of time. In the 70s, it was approximately 11 years if one retired at 60, now perhaps 22 and in 2050, it will be a daunting 30 years.
Retirement may not be a joy for everyone, and it carries with it a burden of ambiguous loss and grief that is not acknowledged by society. Many people see it as an entitlement or a luxury, but the excitement and bliss are short-lived. For most people in the middle socio-economic class, they will be an impact on their quality of life. They will come head to head with issues such as social exclusion, income insecurity, and negative perceptions of self-worth..
Looking at Tasmania, according to the Australian Bureau of Statistics, in 2014, 17% of the population of Tasmania were aged 65 and above. Revenue was generated mostly by natural resources, tourism, agriculture produce and the service industry. Tourists have been streaming into Tasmania, hitting a whopping 1.1 million and with them 2 billion in contributions. Tasmania boasts the “cleanest air in the world”, and in picturesque Hobart, you can dive into the city to try beautiful, fresh produce, fine Tassie wines, hand-crafted beers and an assiduous art scene that has captured the hearts of people world over.
On one hand, we have an ageing population that requires the city and communities to be prepared for the shifting demographics, inter-generational solidarity and to benefit from an environment that supports “adding life to years”. On the other we have a growing influx of tourists, a booming service industry and an increasing call for exports. So why not make Hobart a sustainable global age-friendly city that can cater for one and all? A global age-friendly design is an inclusive design, as Bernard Issac had put it, “if you design for the old you include the young; if you design for the young, you exclude the old.” Currently, Clarence is the only city council in Tasmania that has attained an age-friendly status, which is evidence that this not an impossible feat.
Just this morning in Sandy Bay, I chanced upon a new coffee shop, and like the old days, you get old fashion service. People who want to get to know you and not to get your name so that they could write it down on a takeaway cup. People that take the time to care and above all genuine down to earth service that is lost in many establishments in the monolithic cities. People who let you take the time to order your food, who will help you with any questions you have in a helpful and respectful manner. Signs are all simple and straightforward, communicating clear messages in the shop. There’s no rush, signs of impatience or a multitude of visual stimulus, which serve as a stressor and ultimately a negative experience. Sash coffee is a lovely place and only one place that I had chance upon this morning out of the many heartwarming businesses in the city.
Hobart already offers some of the features of an age-friendly city. I hope more can be done to improve the city to not only create an inclusive environment for everyone living here but to attract others to this city to enjoy the beauties that Hobart has to offer. Until then, Hobart certainly has to do much more to pass the test to become a global age-friendly city.
Designing for Aged Care 