About Dementia

http://www.alz.org.sg/about-dementia/dementia-overview

Dementia Overview

Dementia is an illness which affects the brain, causing the brain cells to die at a faster rate than normal. It is NOT normal ageing. As a result, the mental abilities of the person with dementia declines. This leads to failing memory, deterioration of intellectual function and personality changes.

Singapore Statistics
Year Prevalence (000s) 2005 22 2010 30 2015 40 2020 53 2025 69 2030 92 2035 119 2040 146 2045 171 2050 187

Diagnosis & Assessment

Have you noticed a change of behaviour in your loved one? If yes, do seek an early assessment and diagnosis for dementia from specialists that include geriatricians, psycho geriatricians, neurologists and psychiatrists.

Understanding Dementia
What is dementia?

Dementia is an illness which affects the brain, causing the brain cells to die at a faster rate than normal. It is NOTnormal ageing. As a result, the mental abilities of the person with dementia declines. This leads to failing memory, deterioration of intellectual function and personality changes.

Who are affected?

It affects mainly elderly people. In Singapore, the prevalence rate of people with dementia aged 65 years and above is about 6.2%. Types of dementia There are two main types of dementia : Alzheimer's disease and Multi-infarct dementia. In Alzheimer's disease, the onset of symptoms and the progression of the illness is gradual. Although the cause is still unknown, present research suggests that there is a familial tendency and certain chemicals in the brain are lacking. As yet, there is no known medical cure for the disease. Multi-infarct dementia results from a series of strokes in the brain.

What are the symptoms of dementia?

Generally, there are three stages which mark the onset and progression of the disease. Early stage: Mild dementia The individual appears forgetful or occasionally repeats himself. Sometimes they behave oddly and become withdrawn, lethargic or agitated. Planning of day-to-day activities becomes difficult. Middle stage: Moderate dementia In this stage, the changes become more noticeable. The memory lapses are more obvious. Behaviour becomes problematic and may interfere with normal day-to-day activities. Some examples of behaviour which may be symptomatic of moderate dementia are: Wandering and getting lost Repeating words Neglecting personal hygiene Losing track of time and events Forgetting the names of common objects and familiar people Irritability and agitation Last stage: Severe dementia The individual is unable to recognise family members and will need help in personal care such as bathing, going to the bathroom, dressing and eating. Their speech may be difficult to understand and they may not comprehend what is being said to them. Below is a checklist of symptoms: problem with recent memory misplacing things difficulty performing familiar tasks problems with language disorientation of place and time poor or decreased judgement problems with abstract thinking changes in mood or behaviour changes in personality

loss of initiative Please consult your family doctor for a referral to be made.

What can be done?

If you have a relative with memory problems: 1. He/she should see the doctor for an assessment and diagnosis. 2. You will need help in understanding the illness. Your doctor can put you in touch with people who can help. 3. You will need support. Caring for people with dementia is challenging and can be exhausting both physically and emotionally. Learn to talk about your problems. Make sure that you get enough rest. Take care of your own physical and mental well-being. 4. Group support is important. Meet with others who are also caring for people with dementia. Sharing provides mutual support for caregivers. 5. For other types of challenging behaviour, specific advice may be needed. Here are some ways of coping with forgetfulness: 1. Remind people with dementia constantly of reality around them, for example, the day, date, month, year, time of day, place and the names of people around them. 2. Keep to a regular routine. 3. Use memory aids like diaries, memo boards, signs, clocks, calendars, etc. If you require further information or assistance, please call our Dementia Helpline 6377 0700 or contact us.

Living with Dementia

People with dementia exhibit challenging behaviours because the disease has caused changes within the brain. This leads them to have difficulties expressing their needs to you. The following are some suggestions to help you manage these challenging behaviours. Learn to understand their underlying needs, ensure the person's safety and provide them with as much dignity and independence as possible. 1. Do not expect the person to remember Because of the disease, people are not able to remember many things, you will frustrate the person by asking, "Don't you remember?" 2. When the person becomes agitated When the person becomes agitated or displays a challenging behaviour, try to distract him with another activity. For example, when he wanders around the house seemingly lost, ask him to take a cup of tea with you. 3. Be flexible Ask yourself "Is the behaviour hurting anyone or the person himself?" and if the answer is "No", you may wish to allow the behaviour to continue. 4. Simplify activities and communication Break an activity down into simple, step by step tasks. The person with dementia will be able to focus on one step at a time and complete the activity. 5. Create routines A consistent plan for each day including what time to get up, take meals and do activities helps decrease anxiety and promote a sense of comfort for the person with dementia. 6. Offer reassurance and praise This will increase the person's self esteem and reinforce the behaviour. 7. Do not argue with the person with dementia His reality is not your reality. 8. Identify and remove triggers to behaviour For example, if the person wants to go out of the house each time he sees shoes by the door, remove the shoes.

9. When the person demonstrates a new challenging behaviour Try to establish if he have any underlying needs that he could not express. For example, he could be too hot or too tired, or he could need a drink or use the toilet. If he seems uncomfortable, it could also be related to a medical problem. 10. Daily exercise Make sure the person has opportunities to have exercises every day. 11. Maintain social activities Social activities ensure that the person with dementia remains in contact with other people and offers a sense of wellbeing. 12. Ensure that the environment is safe and secure 13. Simplify and create a calm, quiet environment

Research
Family caregivers remain the main persons providing care, having to face much emotional, practical and economic strain in the process. Two local research were carried out in 2006 and 2008 by Alzheimer's Disease Association, in attempt to have a better understanding of the caregivers in terms of their needs and how they are coping with the task of caregiving. "Well-being Programming for People with Dementia in Day Care Centres in Singapore and Australia: Guiding and Evaluating Person-Centred Practice" Report "Profiling the Dementia Family Care in Singapore" Report "Profiling the Dementia Family Care in Singapore" Executive Summary

Statistics
This statistical appendix presents individual estimates of prevalence and incidence for each of the economies included in the Asia Pacific region, for the period 2005 to 2050. Particularly, the prevalence of dementia in Singapore, those aged 65 years and above in year 2005 was 22,000. By 2020 it is projected the figure will increase to 53,000 and by 2050 the projected figure will further increase to 187,000. A summary of the regional data is presented.

Publications
Reports by World Health Organisation (WHO) and Alzheimers Disease International (ADI)
The WHO and ADI have released a joint report dated 11 April 2012 (Geneva) calling upon governments, policymakers and other stakeholders worldwide to recognise dementia as a public health crisis. The report provides an overview of the impact of dementia worldwide, best practices, case studies, as well as "hard-to-get" statistics from low- and middle-income countries. It also captures a glimpse of the local situation as well as information on the services provided for persons with dementia and their caregivers by the Alzheimer's Disease Association, Singapore. WHO and ADI Raising Alert on Dementia as a Global Health Crisis

Reports by Alzheimers Disease International (ADI)

The 15 Asia-Pacific member organisations of Alzheimers Disease International (ADI) agreed at their meeting in Singapore in May 2005, to commission a report that would draw the attention of governments, international organisations and aid agencies to the dementia epidemic and the threat that it posed to public health systems. "Dementia in the Asia Pacific Region: The Epidemic is Here" Report "Dementia in the Asia Pacific Region: The Epidemic is Here" Executive Summary

On an annual basis, ADI publishes The World Alzheimer Report which meant to provide the latest updates relating to dementia. In the recent report, released on 21 September 2012, the report shares results from a worldwide survey conducted with people with dementia and caregivers on their personal experiences of stigma. The report provides information on stigma and dementia, highlights best practices in the field of dementia, and makes recommendations which could help reduce stigma. World Alzheimer Report 2010: The Global Economic Impact of Dementia World Alzheimer Report 2010: The Global Economic Impact of Dementia Executive Summary World Alzheimer Report 2011: The benefits of early diagnosis and intervention Executive Summary World Alzheimer Report 2012: Overcoming the Stigma of Dementia World Alzheimer Report 2012: Overcoming the Stigma of Dementia Executive Summary World Alzheimer Report 2012: Overcoming the Stigma of Dementia Executive Summary (Mandarin)

Report by All Party Parliamentary Group (APPG)

In December 2010 the APPG on Dementia announced that it would undertake an inquiry into how to make the best use of the resources currently spent on dementia while at the same time improving outcomes for people with dementia and carers. "The 20 billion question - An inquiry into improving lives through cost-effective dementia services" Report
Report by Ministry of Health
In Singapore, the Ministry of Health regularly reviews the Clinical Practice Guidelines for the various fields in healthcare sector, so as to ensure that care within the sector is constantly advancing. A manual on Clinical Practices Guidelinesfor dementia was developed in 2007.

Person Centered Care

Person Centered Care in dementia places a high value on the person experiencing dementia while at the same time, acknowledging the importance of the care partners. It regards people as unique individuals deserving of understanding and respect, with opportunities to continually engage in positive interactions and experience well-being in their lives. The foundation of Person Centered Care is based on the work of Professor Tom Kitwood who headed the Bradford Dementia Group in the United Kingdom from 1992 to 1998.

Practicing Person Centered Care

The Person With Dementia The practice of Person Centered Care begins by looking at the individual as a person whose dementia forms only part of his total identity. The larger part of this individual continues to be the possession of his or her own uniqueness, the retention of the need for self-recognition and identity as well as the preservation of their ability to act and respond to the environment that surrounds them. A care partner practicing Person Centered Care will attempt to discover and develop an understanding of this unique individual, their life experiences, network of relationships as well as their personal values and beliefs. Possessing this rich history, the care partner will then be able to effectively empower, reassure and nurture the person with dementia. This will form the basis of a positive supportive relationship in which the person with dementia continues to live life the way he or she would like to, in the manner which he or she is still capable of. The Care Partner

Person Centered Care also acknowledges that the care partner, whether family member, an employed helper at home or a professional care partner, needs to be valued and supported in their endeavor to learn about and reach out to the person with dementia. They have to be empowered to make decisions about their work and how care plans should be carried out. They should be encouraged to design and develop innovative methods of care practices based on Person Centered Care principles and must be sustained in their practice by opportunities to experience a rich variety of training and continuous learning both within and outside of their care environment. The Organization An organization that has a fully developed Person Centered Care model will clearly express this through their vision and mission statements as well as through policies regarding hiring, training, supervising and recognizing professional care partners and their contributions. It is committed to dedicate resources to build an environment supporting Person Centered Care practices and comprises of members who all understand this value system and feel responsible for building and sustaining this approach. Read more about our Person Centered Care and Dementia Care Mapping Steering Committee

The Person Centered Care and Dementia Care Mapping Steering Committee
The Alzheimers Disease Association has formed a Person Centered Care and Dementia Care Mapping Steering Committee with the vision over the next 3 years that all professional care partners and organizations caring for persons with dementia in Singapore embrace Person Centered Care as their philosophy of care. The Alzheimers Disease Association is also the Strategic Lead Partner in Singapore of the Bradford Dementia Group in the United Kingdom and is responsible for the implementation and development of Person Centered Care and Dementia Care Mapping in Singapore. The Committee has 4 key objectives: 1. 2. 3. 4. Advocacy Support and development Training, education and research Enhancing its partnership with the Bradford Dementia Group. Organizations who are involved in dementia care and would like to learn more about Person Centered Care through our training workshops or consultancy can contact us here.

Interested to Know More?

If you would like to read more about Person Centered Care, Dementia Care Mapping or on culture change, you can visit some of the websites below: Eden Alternative The Eden Alternative is a small not-for-profit organization making a big difference in the world. Based on the core belief that aging should be a continued stage of development and growth, rather than a period of decline. Pioneer Network Pioneer Network is dedicated to making fundamental changes in values and practices to create a culture of aging that is life-affirming, satisfying, humane and meaningful. Pioneer Network advocates for culture change in eldercare models from long-term nursing home care to short-term transitional care to community-based care to create homes that are consumer-driven and person-directed. Best Friends Approach The Best Friends Approach redefines how we can enhance the lives of individuals living with Alzheimers and dementia. It is a philosophy that is easy to understand, learn and apply. Adopting the Best Friends Approach will teach you the knack of providing good care and how to do it with ease.

THE GREEN HOUSE Project The Green House Project creates small, intentional communities for groups of elders and staff to focus on living full and vibrant lives. The Green House model replaces large, impersonal, nursing facilities with inviting, comfortable, social living spaces that research shows help elders to live happier, more satisfying lives. Father of Person Centered Care: Professor Tom Kitwood Professor Tom Kitwood was a pioneer in the field of dementia care. He developed innovative research projects and training courses, challenging the "old culture of care". His aim was to understand, as far as is possible, what care is like from the standpoint of the person with dementia.

Public Education
We reach out to the community via public forums, awareness talks, exhibitions and the media. Click here to view more photos.

Dementia Awareness in Public Libraries

Dementia Awareness in Shopping Malls

Dementia Awareness In Hospitals