Support for new dementia patients

First post-diagnostic support plan here also aims to reduce caregiver stress

Madam Ng Chong Poy, 74, has mild dementia, and was initially moody about her diagnosis. But her eldest son and caregiver, Mr Raymond Shong, 51, says that the Post Diagnostic Support programme their family was referred to has helped improve his mother
Madam Ng Chong Poy, 74, has mild dementia, and was initially moody about her diagnosis. But her eldest son and caregiver, Mr Raymond Shong, 51, says that the Post Diagnostic Support programme their family was referred to has helped improve his mother's mood, and lessened his stress considerably. ST PHOTO: NG SOR LUAN

When Madam Ng Chong Poy, 74, found out late last year that she had dementia, she became moody and said she did not want to live any more.

Her eldest son, Mr Raymond Shong, 51, was at his wits' end trying to pacify her while learning about the syndrome, which is marked by progressive deterioration in memory, thinking, behaviour and the ability to perform everyday activities.

But help was at hand - her doctor referred the family to a new programme that offers hand-holding support to those newly diagnosed with dementia.

Calling it a godsend, Mr Shong, a tuition teacher and a father of three, said the programme has helped improve his mother's mood, and lessened his stress considerably.

The programme, announced at an online press conference yesterday, is Singapore's first post-diagnostic dementia support plan. Launched with $2.6 million from the Lien Foundation to defray the costs for those it helps, Post Diagnostic Support (PDS) was developed by the foundation and the Alzheimer's Disease Association (ADA).

Following a pilot at Tan Tock Seng Hospital (TTSH) and Khoo Teck Puat Hospital (KTPH) last year, PDS will also be available to suitable patients at the National Neuroscience Institute in about a month.

A total of 186 people are now on PDS - 126 from TTSH and 60 from KTPH.

With PDS, help can be a call away. A dedicated case worker will make one or two initial home visits and regular phone calls for at least a year. Caregivers on PDS are given a mobile number that they can call for advice and support, should they require it.

People can experience identity loss, a lot of uncertainty and a sense of helplessness when first told they have dementia.

Dr Noorhazlina Ali, a senior consultant at TTSH's centre for geriatric medicine, said yesterday that PDS can help those newly diagnosed with dementia and their caregivers come to terms with the diagnosis, and address caregiver burden and burnout.

The head of ADA's Caregiver Support Centre Stephen Chan said PDS empowers the person with dementia and his caregiver to have a better quality of life instead of "waiting for something bad to happen".

 
 

IMPROVING QUALITY OF LIFE

If we do it well, we'll prevent unnecessary suffering, improve quality of life and (help to) reduce healthcare and societal costs.

LIEN FOUNDATION'S CHIEF EXECUTIVE LEE POH WAH

He said that sometimes, caregivers panic and rush their charges to the emergency department as they cannot cope with aggression in the person with dementia.

"For example, when a person with dementia has memory loss and this (worsens)... they get anxious when doing simple tasks like bathing or even cooking, which can become very complex," he said.

Usually, the first thing people do is to stop the person with dementia from doing "risky activities" when the focus should be on how to support him so that he can continue to cook or do an activity he likes.

Senior social worker Eileen Lee said PDS helped the family of an elderly woman with dementia find ways to manage after the woman forgot she had a new helper and thought the helper was a stranger who might steal her things.

 
 

Ms Lee, one of five case workers with the PDS team, said each client will have a customised care plan when he leaves the programme.

It may spell out the kind of care the person may wish to have in future. For instance, someone with a sweet tooth might like an ice cream when he is moody. Another person may give his children permission to place him in a nursing home when they cannot cope any more.

For about three more years, while PDS is being funded, it will be offered free to about 1,400 people with dementia. The PDS team may be boosted later on with two to three more case workers.

To be on PDS, patients must be referred by a doctor. Mr Chan said PDS is modelled after a similar programme in Scotland that entitles everyone diagnosed with dementia to at least a year of post-diagnostic support.

The number of people living with dementia is projected to rise to 140,000 by 2030, from an estimated 86,050 last year.

 
 

"We want to be able to reduce the caregiver burden and stress... and the crisis situations that could escalate admission to hospital and nursing homes," Lien Foundation's chief executive Lee Poh Wah told The Straits Times.

"If we do it well, we'll prevent unnecessary suffering, improve quality of life and (help to) reduce healthcare and societal costs."

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A version of this article appeared in the print edition of The Straits Times on September 25, 2020, with the headline 'Support for new dementia patients'. Print Edition | Subscribe