Friday 22 January 2016

Forget Us Not: Help for dementia patients in Yishun

Yishun set to be first ‘dementia-friendly’ town
2,000 people trained so far in community support project
By Janice Tai, The Straits Times, 21 Jan 2016

Madam Chan Poh Keng, 86, was once almost caught for shoplifting because she took and ate a banana from a provision shop but forgot to pay for it.

Several times, she had been lost for hours because she could not remember the way home.

Her daughter, Ms Mok Leng Chan, 65, who has been caring for her for the past 16 years, said: "It is so frustrating for her that she hits her head with her hands to try to recall. Caring for her became so tiring that I once even thought of killing myself with her."

To support people with dementia and caregivers like Ms Mok, Khoo Teck Puat Hospital (KTPH) and Lien Foundation are spearheading efforts to foster Singapore's first dementia-friendly community, in Yishun.

So far, about 2,000 people in the town - from school students to frontline staff in hospitals and businesses to mosque and church members - have been trained on how to spot those with dementia and how to interact with and help or refer them to aid agencies. Dementia guides - which provide information about the condition - will be distributed to 58,000 households and businesses.


Health Minister Gan Kim Yong said last year that tackling dementia needs to go beyond having the "hardware" - such as infrastructure - to fostering stronger community support and creating dementia-friendly communities.

Those who have been trained in Yishun include staff from businesses such as McDonald's and retailers at Northpoint shopping centre as well as students and volunteers who patrol the town regularly.

Organisations such as Sheng Siong supermarket chain and National Library Board are expected to be involved soon.

Yishun was chosen to test out the concept of a dementia-friendly community because it has a significant number of elderly residents. It also has the community resources - such as a geriatric centre at KTPH - to support them.

About 10 per cent or 20,000 residents in Yishun are aged 65 and above. One in 10 people aged 60 and above in Singapore has dementia and the condition strikes half of those aged 85 and beyond, according to findings from a large-scale study released by the Institute of Mental Health last year.

With more training and awareness of dementia, it is hoped that Yishun and, later, other communities will be able to understand, embrace and support sufferers and caregivers in their midst.

Mr Lee Poh Wah, chief executive of Lien Foundation, said: "Often, persons with dementia are stigmatised. The shame associated with dementia is exacerbated when people do not understand its symptoms and react poorly towards dementia sufferers."

With the training, it is hoped that if a person with dementia gets lost, a policeman or student can show him the way home. Or, if the person takes items from a supermarket without paying, its staff will not assume he is shoplifting.

Dr Philip Yap, director of KTPH's geriatric centre, said: "In Yishun, they can get around safely and continue to participate meaningfully in their usual routines because members of their community, be it a favourite neighbour, shopkeeper or local policeman, can understand and assist them."

One person for whom training has been helpful is Nanyang Polytechnic student L. Sakthisvaran, 22, who often sees an old woman shouting at the top of her voice in his neighbourhood. After learning to spot signs of dementia, he now knows what to do. He took down her children's contact numbers and lets them know where she is whenever he sees her.

Such dementia-friendly communities will help the elderly avoid having to stay in institutions such as hospitals or nursing homes and live at home instead. Research has shown that having them at home would be less costly to society.

Said Mr Lee: "Because of its prevalence and high cost to society, we need to make dementia-friendly communities the 'new normal' in Singapore, starting with Yishun."

Organisations or individuals who wish to find out more about dementia or be trained in responding to those who have it can sign up at

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Global movement to help sufferers
By Janice Tai, The Straits Times, 21 Jan 2016

In recent years, large-scale projects to help dementia patients have taken off in Britain, Japan and the US. Last year, a Dementia Friendly America Initiative - announced at the White House Conference on Ageing - drew participation from more than 50 groups seeking to create such communities across the United States.

Six pilot programmes are up and running in Colorado, California, Arizona, West Virginia, Maryland and Tennessee. Nine more are planned for this year.

Volunteers in all sectors are trained to help. Waiters at restaurants, for instance, learn to recognise common signs of dementia in customers such as using incorrect words or becoming agitated easily. They are then trained to respond in a calm and friendly way.

Bank tellers, meanwhile, learn to politely ask elderly patrons for an emergency contact, so that if they try to withdraw a large sum of money or become disoriented over the cheque book, the teller has someone to notify.

Britain has about one million people trained in basic dementia recognition and care since its Dementia Friends campaign started in 2013. The target is to have four million Dementia Friends by 2020.

Japan's Dementia Friends network comprises six million people, with a target of eight million by 2025.

Another significant project is the SOS Wanderers Network which links Japanese cities and towns, making it easier to search for persons who are lost because of dementia. The network, which covers more than half of Japan, involves people in the neighbourhood keeping an eye on those who wander.

In 2014, 10,322 people with dementia were deemed missing in Japan, with 388 eventually found dead.

Some of these networks take reference from the Belgian city of Bruges, a global pioneer in dementia-friendly communities. About 90 dementia-friendly shops in the city display a logo of a knotted red handkerchief that signifies to people with dementia, especially those in the early stages, that staff can offer help.

More than 7,000 dementia guides, or small booklets with communication tips, are distributed and basic two-hour training sessions provided to frontline staff.

The Bruges' police force has a database of residents prone to wandering, so it can help redirect them.

Dementia also a social issue
By Janice Tai, The Straits Times, 22 Jan 2016

Yishun is set to be the first town in Singapore to be "dementia-friendly".

So far, about 2,000 people there - from school students to front-line staff in hospitals and businesses to mosque and church members - have been trained to spot people with dementia, and to interact with and help them.

This is a crucial movement that ought to gain momentum nationally, for a number of reasons.

First, a significant number of people already have dementia or will have it in future.

According to research estimates, one in 10 people aged 60 and above in Singapore has dementia now, and the condition afflicts half of those aged 85 and beyond.

Second, dementia is not just a medical condition to be treated in hospitals and clinics, but is also a social issue that needs community support and understanding.

For instance, people with dementia sometimes forget to pay for items, and storekeepers assume they are shoplifting. Then, there are some patients who fear leaving the house because they often get lost and cannot find their way home.

Unlike Singapore, other countries such as Britain and Japan have recognised the urgency of tackling dementia within communities, and have trained millions of people in local towns on basic dementia recognition and care.

Third, having such communities will enable people who display symptoms of the illness to seek treatment earlier.

Khoo Teck Puat Hospital estimates that seven out of 10 people with the disorder in Chong Pang are not getting medical attention, either because of the stigma attached to it or a lack of awareness.

Fourth, studies overseas have shown that supporting people with dementia so that they can continue living at home, within the community, reduces the need for costly nursing or hospital care.

The economic case for creating dementia-friendly communities is as compelling as the simple need to see our ageing loved ones live dignified and active lives in their neighbourhoods despite their frailty.

Elderly people caught 'shoplifting'? They may have dementia
By Linette Lai, The Straits Times, 25 Jan 2016

If an elderly person shoplifts, there may be a simple explanation. He could have forgotten to pay because he has dementia.

Experts on the condition say it is one that is growing, and they are urging retailers to learn how to handle such cases.

Alzheimer's Disease Association chief executive Jason Foo recounted how one of his clients got into an argument with a shopkeeper over payment. The 79-year-old thought he had paid but the shopkeeper insisted he had not.

"The police handcuffed him and his family had to come down," Mr Foo said. "He was cleared, but it was a traumatic experience for him because he didn't understand why he was put through it."

Last Wednesday, Yishun was earmarked as Singapore's first dementia-friendly town, where residents and shopkeepers have been trained to spot and help those with the condition.

While people with severe dementia often depend on others for their daily needs, seniors with mild or moderate symptoms can still live fairly independently.

They run into trouble only when their symptoms - such as disorientation or forgetfulness - act up.

And while most will be able to recover their train of thought, retail staff must give them the time and space to do so.

"In my experience, the environment is often a trigger," said senior social work manager Wong Yock Leng, who is with Tsao Foundation's Hua Mei Dementia Care System. "When the environment becomes noisy or distracting, their thinking process becomes slower."

Ms Janice Chia, founder of social enterprise Ageing Asia, added: "You don't want to scold or embarrass them in public. What they definitely don't need is a confrontational approach."

Singapore's population of seniors is expected to double to 900,000 by 2030. Dementia affects an estimated one in 10 people aged over 60 here. Alzheimer's disease is the most common form.

While supermarkets that The Straits Times spoke to said they do not keep records of shoplifters with dementia, some, like NTUC FairPrice, have already begun to train staff in serving such customers. About 100 staff members have undergone the training so far.

A spokesman said: "The training programme aims to help service staff understand and anticipate the needs of senior customers... as well as empathise with the difficulties that seniors may encounter so they can communicate and respond better to their needs."

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Dementia-friendly community in Hong Kah North
Volunteers in second such neighbourhood trained to spot signs of illness and offer help
By Linette Lai, The Sunday Times, 20 Mar 2016

At times, an old woman buys items from the supermarket where Ms Sree Devi works - only for her son to return them a day later.

While the 41-year-old retail assistant was puzzled at first, she soon found that the woman had dementia and was buying items she already had at home.

"It was all kinds of things - fish, poultry, even toiletries," Ms Devi said. "We just tried to be more patient and understanding."

She is one of more than 7,000 people who have been trained to spot the tell-tale signs of dementia and lend a hand where needed. Among them, 139 were trained in Hong Kah North, which was officially announced as Singapore's second dementia-friendly community by Senior Minister of State for Health Amy Khor yesterday.

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The first, a pilot project in Chong Pang, was started by Khoo Teck Puat Hospital and the Lien Foundation, in collaboration with the Agency for Integrated Care.

As Singapore's population ages, it is important that people know about dementia and how to help those with the condition, said Dr Khor, MP for Hong Kah North.

"Everybody has a role to play in providing an environment that is elder-friendly and dementia- friendly," she said.

Under the scheme, volunteers are trained to look out for those with the symptoms of dementia - such as aimless wandering - and offer help. For example, they could take those who seem lost to one of five designated Go-To Points. These touchpoints, which are located in places such as community clubs and family service centres, will link those with dementia with their caregivers.

Other dementia-friendly communities to be rolled out later include Bedok, MacPherson and Queenstown.

One person who welcomes the new initiative is Mr Abdul Ghani Haji Hamid, 64, whose 84-year-old mother has the condition.

"It's good that young people know more about dementia," he said. "Sometimes, they're scared of my mother when they see her, but now hopefully they will understand."

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