A dementia-friendly Singapore
With the number of people with dementia set to increase in time to come, the country is looking at ways to support them and their caregivers.
BY: Eleanor Yap
With the prevalence of dementia in Singapore for those aged 65 years and above currently standing at about 40,000 and is set to increase to 187,000 by 2050, the country wants to move towards a dementia-friendly Singapore. The Alzheimer’s Disease Association (ADA) recently held its 25th anniversary symposium looking at how we can do this.
Jason Foo, CEO of ADA, said there is still much to be done to get there. “Singapore needs to work towards becoming dementia-friendly in order to cope with the rising prevalence of dementia,” he said, adding that funding and support continue to be a hurdle.
Other countries way ahead
Dr Ng Li Ling, vice-president of ADA and chairperson of the Symposium Organising Committee, said that countries such as UK, US, Scotland, Germany, Japan, Australia and Taiwan have successfully embarked on dementia-friendly initiatives that improve the lives of those with dementia and their caregivers. For instance, symposium speaker Prof Richard Fleming from the Faculty of Science, Medicine and Health, at the University of Wollongong in Australia and director of the NSW/ACT Dementia Training Study Centre, shared two interesting initiatives dealing with volunteers coming out from Japan.
The first is a scheme called Dementia Friends, which was started in 2005 and is Government-funded. The idea is simple – people get trained to become dementia friends so they are able to spot the signs of the illness and help sufferers. The initiative has grown from a million Dementia Friends in 2008 to now six million Dementia Friends. By 2018, they have plans for eight million friends. The UK has launched a similar scheme in its country.
The other scheme is a ‘watch’ network led by volunteers to act in partnership with the police, local businesses and charities to steer ‘wanderers’ safely home. It provides invaluable support and reassurances for carers and families – as well as the essential safety net for those living with dementia. Evidence of its need and success is reflected in the fact that 61.3 percent of Japan’s 1,741 local authorities embrace this scheme.
Added another symposium speaker, Glenn Rees, chair, Alzheimer’s Disease International, “Dementia-friendly has the power of changing the way we live and allowing those with dementia to live holistically. There is a world of difference in dementia-friendly communities – reducing of stigma and understanding dementia at all ages. Second objective which is not talked about – empowering people with dementia and recognising their rights and capabilities. It creates a society that normalises and accepts dementia as a disability.”
Singapore taking first steps
In Singapore, there is much work to be done as shown by ADA’s focus group discussions which involved those with dementia, caregivers, members of the public, and representatives from the media (which Ageless Online was included), architecture and design, the arts, healthcare and social services community, faith-based organisations and business groups including legal, banking and insurance. Some 87 percent of participants said Singapore is not at all or only fairly dementia-friendly. “They talked about the lack of awareness and the stigma of dementia. Of people with dementia being accepted and included, and how they can still continue to contribute to society,” said ADA’s Dr Ng.
There are several initiatives already rolled out to get the country heading in the right direction. Minister for Health (MOH) Gan Kim Yong, the guest-of-honour at the symposium, shared that MOH and the Agency for Integrated Care (AIC) is working with voluntary welfare organisations (VWOs) to reach out to seniors within the community and share with them about the signs and symptoms of dementia. He added that they have set up 10 outreach teams to date, and reached out to more than 32,000 seniors islandwide.
He also noted that they are increasing the capacity of services such as senior care centres, home care, nursing homes, respite care and caregiver support services to manage and support persons with dementia and their caregivers. “We have put in place 650 dementia day care places and expanded our home-based caregiver respite services such as the Eldersit programme.”
Minister Gan also said MOH has been incorporating dementia-friendly designs in various hospitals, community hospitals and nursing homes which allow for more personal space and therapeutic areas for persons with dementia. He also touched on AIC and Alexandra Health System (AHS) piloting a dementia-friendly community in Chong Pang, which was started last year. They have reached out to community partners, schools, police and retailers to share with them about identifying the symptoms of dementia and how to provide help and assistance to persons with dementia. “With the success of the pilot, we hope to develop more dementia-friendly communities in other regions,” said Minister Gan.
Added Assoc Prof Philip Yap, a senior consultant for geriatric medicine at Khoo Teck Puat Hospital, who is involved in the pilot, “There will be more people with dementia who will not have family arrangements, will be alone and vulnerable in their later years. They will be wandering around, getting lost in the community and dealing with traffic hazards, etc. They will also have other medical conditions.” He explained that what they are doing with Chong Pang is creating a home outside of a home and getting the community, not just the authorities, to drive it.
“The goal is to engage people of all sectors such a retail outlets, schools, transport operators, banks, residents, police and GPs, and the man on the street,” said A/P Yap. With about 20 percent or 10,000 who are 65 years and above, he shared that it is likely that 10 percent or 1,000 might have dementia in Chong Pang. He added that they did public outreach activities in schools and faith-based organisations, engaged the arts to do shadow puppets in schools, and went to retail malls to teach tenants and staff on how to help those with dementia.
He added: “It takes a village to raise a child, it takes a community to care for seniors and seniors with dementia.” There is also a draft of a book in the works on how to help people with dementia.
Like with Australia’s Fareham Shopping Centre being the pilot for a dementia-friendly mall in November 2013, there is also the Hibiscus Shopping Centre there that provides morning tea for groups in a community to discuss dementia issues. In Singapore, ADA is looking at making Jurong Point Shopping Centre dementia-friendly. In the first phase, the VWO placed educational posters in washrooms on dementia and conducted talks with tenants and customers such as understanding dementia and tips on how to handle someone with dementia. In phase two, ADA held a memories café in selected eateries including Bakerzin and in phase three, it is using incentives to encourage tenants to raise awareness of dementia.
As we move forward, only time will time if all these efforts will bring Singapore close to becoming a dementia-friendly country.