Enrichment lessons for dementia patients

Music teacher Wan Hui Ling (left, in black) engaging a dementia patient on the xylophone as part of the music activities at the Montessori for Dementia Care centre in Upper Bukit Timah Road.
Music teacher Wan Hui Ling (left, in black) engaging a dementia patient on the xylophone as part of the music activities at the Montessori for Dementia Care centre in Upper Bukit Timah Road.ST PHOTO: NEO XIAOBIN

The sessions improve their quality of life and give them a sense of purpose

Twice a week, Madam Wee Soh Lan attends a three-hour enrichment class to stimulate her mind.

There, she plays games, makes music, does exercises and other activities. She even has homework that is designed just for her.

"Mum is over the top. She refers to it as school and wants to go every day," said her daughter, Ms Jesmine Lim, 53. "She feels loved. It's amazing that she will remember her homework and is so eager to do it."

However, Madam Wee is not your ordinary student: She is 76 and has dementia.

She goes to The Care Library, the newest player here to offer dementia enrichment classes aimed at helping patients improve their quality of life as well as give caregivers a respite from their duties.

  • Where to seek help

  • THE CARE LIBRARY

    Where: 103 Lavender Street

    Cost: $50 per three-hour session for now. Rates are set to rise.

    For more info, go to www.thecarelibrary.com

    MONTESSORI FOR DEMENTIA CARE

    Where: 276 Upper Bukit Timah Road

    Cost: $50 per three-hour session

    For more info, go to www.mfdcsg.com

    KHOO TECK PUAT HOSPITAL

    Where: 90, Yishun Central

    Cost: $30-$40 per session for subsidised patients. Pioneer Generation card holders pay half. Private patients pay $80 to $90. Outpatient programmes are only for KTPH patients.

    For more info, send an e-mail to ktph.memorycare@alexandrahealth.com.sg

    FAMILY OF WISDOM

    Where: 72 Bendemeer Road and 298 Tiong Bahru Road

    Cost: Around $45-$55 per three-hour session. (Severe-stage patients pay more as the group is smaller)

    For more info, go to www.alz.org.sg/support-services/family-of-wisdom-programme-fow

It opened last August at Carepoint in Lavender Street and runs two sessions a week.

A year before that, the Montessori For Dementia Care centre in Upper Bukit Timah Road opened, using Montessori principles of self-learning more usually associated with young children. It runs six sessions a week.

As dementia incidence is set to rise with the ageing population, more resources are being devoted to helping patients and caregivers cope with the condition.

Khoo Teck Puat Hospital (KTPH), the only hospital with outpatient music therapy sessions, started a dementia outpatient programme a decade ago and now has six outpatient programmes for its patients.

These include one that started this year: Therapeutic Activity, which has storytelling, role-playing, puppetry and other expressive activities.

At the Alzheimer's Disease Association (ADA) in Singapore, which started its Family of Wisdom enrichment programmes in end-2013, its client base has grown from about 50 families in the third quarter of 2014 to 140 families now.

Enrichment programmes are typically conducted over two to three hours. Participants play games, exercise, paint, cook, sing or engage in other activities. A three-hour session can cost $50.

 

Such programmes do provide meaningful and enjoyable activities for dementia patients who are being cared for at home.

Research estimates that one in 10 people aged 60 and above in Singapore has dementia, and the condition afflicts half of those aged 85 and beyond.

Alzheimer's disease is the most common cause of dementia, which describes various symptoms of cognitive decline, including impairment in memory, attention, orientation and judgment.

Someone who has it may not recognise familiar faces. He may ask the same questions again and again, or become disoriented in familiar places and so on.

CHANGES FOR THE BETTER

When these elderly persons come for enrichment sessions, their mood improves and the effect can last the whole day.

MR JASON FOO, chief executive of the Alzheimer's Disease Association.

"When these elderly persons come for enrichment sessions, their mood improves and the effect can last the whole day," said Mr Jason Foo, chief executive of ADA.

"Caregivers can also observe and learn what sort of activities interest a person with dementia."

Said Dr Philip Yap, senior consultant and director of KTPH's geriatric centre: "Anecdotally, practitioners will tell you that when people with dementia have something to do that they like and have a sense of purpose in their life, they do better.

"People with a sense of purpose in their life also have a lower risk of getting dementia."

KTPH staff have noticed that patients who have attended the sessions for about a decade experience a very slow decline in their condition, said Dr Yap.

And even if they don't see any improvement, other reasons for coming back are just as important.

"We started a group for early- stage dementia and found that after two years, some are in the moderate stage while others are still in the early stage but they still want to come back to the same group because they have made friends," said Dr Yap.

What is also changing is care moving towards being person-centred, whether it is Montessori for dementia or other person-centred care approaches such as Spark Of Life. These care centres focus on the individual rather than his dementia, tailoring activities to suit his abilities, background, likes and dislikes.

"At the end of it all, what counts is the person-to-person interaction that our dementia patients should get in their lives," said Dr Ng Li Ling, senior consultant in psychological medicine at Changi General Hospital.

So, even as more dementia day-care and enrichment centres spring up to meet rising demand, industry players say more still needs to be done in the interest of patients.

Most important is the support of the larger community for dementia patients. KTPH and the Lien Foundation have spearheaded efforts to create Singapore's first "dementia- friendly" community in Yishun, where there is a network of residents and businesses trained to spot older people with signs of dementia and to assist them.

A second dementia-friendly community - in Hong Kah North - was launched last month. More are expected to follow.

The ADA is also keen to train volunteers to run its Family of Wisdom programme at venues like churches.

As Singaporeans become used to living with dementia in their midst, this can only be good for patients.

"What people need in the early stage of dementia is to carry on with their lives," said Dr Yap. "The ideal situation is to tap existing spaces and create activities for them. Then, they are more likely to go."

Though dementia cannot be cured, someone with dementia can still be happy, he said.

Dementia care is coming to realise that.

"It's about how I can continue to help him do something that he likes, rather than force him to do something that some studies have shown is good for him," said Dr Yap.

A version of this article appeared in the print edition of The Straits Times on April 12, 2016, with the headline 'Enrichment lessons for dementia patients Where to seek help'. Print Edition | Subscribe