Every Wednesday, 10 to 20 senior folk with mild dementia would show up at Khoo Teck Puat Hospital (KTPH).
They are not there for a check-up. Instead, they head to a room to pit their wits and skills against each other, playing a variety of games.
It is not a casual activity but a structured, purposeful programme that aims to slow down their memory deterioration and improve their cognitive skills.
The games include worksheets with tangled lines which patients have to trace with a pencil. There are also puzzles, coloured blocks and pictorial cards.
They may appear to be simple but these games have many benefits, such as improving memory and motor and social skills.
The games were developed by Alexandra Health and Noble Education.com, a consultancy that designs and makes games.
These game sessions began 11 years ago. They were initiated by Associate Professor Philip Yap, senior consultant and director of KTPH's geriatric centre, and nurse and dementia programme specialist Chionh Hui Ling.
Ms Chionh said the daycare programmes that were available then were specifically for patients with moderate levels of dementia.
She said the programmes could not engage patients with mild dementia as they found the activities unsuited to their level.
She helms the two sessions held every Wednesday, each lasting about three hours. The morning session has simple games for outpatients with mild dementia.
Afternoon sessions are for outpatients with mild cognitive impairment, which can be a precursor to dementia. This means they may experience a slight decline in skills like memory. To match their ability, their games are more complex.
Ms Chionh said: "The games train them to remember things. Our memory works in complex, sometimes even bizarre ways. Through things like categorisation, patterns, sequences and association, the games help improve their memory."
SLOWING DOWN MENTAL DECLINE
Dementia, which describes symptoms of cognitive decline, including memory loss, is irreversible. Playing the games will not cure patients, but it can slow down the onset of the illness.
"Some of the patients have been coming since we started the programme over a decade ago and their condition has stabilised," said Ms Chionh.
Patients are grouped according to their abilities, so that they can compete on a level playing field.
"We do not want to lower their self-esteem; we want to treat them with dignity," Ms Chionh added. "Sometimes, peer support and peer pressure encourage them to play along, even if they might not play such games on their own at home. It is also an opportunity for them to socialise and make friends."
Madam Leng Boon Gek, 65, has been going for the weekly game sessions for the past few months.
The retiree, who used to work as a secretary, was diagnosed with dementia a few years ago.
She said: "I have always loved games like puzzles. My sisters bought games and puzzles to keep me occupied as they know I'm losing my memory."
Her 79-year-old husband, Mr Goh Hoo Chin, who is also a retiree, accompanies her to the sessions. He feels the sessions are vital in helping not just her memory, but also her overall mental well-being.
"The doctors say that people with dementia can forget more and more each year, so these programmes are very important for them," said Mr Goh, who used to work in accounting.
"Being at home, they feel isolated and lonely. The game sessions help them put aside their problems and just have fun with friends."
Sure enough, the social aspect of playing games seems to be important in getting patients interested.
Ms Lee Wai Ying, an arts therapist in drama and movement who is involved in the KTPH programme, said that initially patients may be very resistant to the idea of playing games, as they feel that only children play them.
She said: "We have to explain the purpose of the games so that they understand that they are learning something. Patients are adults with vast experiences and we respect that. We don't treat them like kids."
As they play games, the patients begin to interact and converse with each other, thus increasing their social skills, said Ms Lee.
Prof Yap, who initiated the programme, feels that games for seniors is an important feature which can be extended to other types of patients, such as those who need physical rehabilitation.
"Gaming typically involves the whole person in body, mind and emotion, thus providing an opportunity for the person to be totally engaged," he said. Such games get patients to kick a ball or throw punches in a virtual game, for instance.
Other hospitals, such as Ng Teng Fong General Hospital, also hold game sessions for dementia patients.
The hospital has worked with a trio of students from Nanyang Technological University's (NTU) School of Art, Design and Media to design games for its inpatients with dementia.
Since last October, the students have been creating games that aim to jog the patients' memories of their past and evoke nostalgia.
The games go beyond visual aspects and seek to engage the player's sense of touch, smell and hearing. For instance, Ms Cassandra Seah, 23, devised a game where patients have to guess the textures in various coloured boxes. She used studs to create roughness, wood for smoothness and rubber for a spongy texture.
Her schoolmate, Ms Grace Goh, 24, made scented non-toxic dough with flavours such as rose and mango to stimulate the patients' sense of smell and help them remember when they had encountered such scents in the past.
Ms Khaw June Ming, 22, got the patients to use geometric wooden blocks to create animals from the Chinese zodiac. The game also encourages the seniors to have conversations on the topic, she said.
After 10 months of work, the three undergrads took the games to the wards for inpatients to try out.
Madam Chong Cheng Moi, a 93-year-old patient, said: "The games are fun. They make me smile and make me happy. The students are so smart to make these games for me."
Her fellow games player, Mr Chan Wing Sum, 86, said: "I want to play another time and, maybe, challenge others in my age group."
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