Tuesday, 16 July 2013


(Watch "World's Untold Stories: Dementia Village" on CNN International on Sunday at 11.30 pm, 14July2013)

·       Dutch dementia facility shows new way of providing long term care
·       It lets residents roam while staff work in village shops to keep an eye on them
·       Living quarters are furnished to reflect a person's younger days
·       Health experts from across Europe and Japan are looking at the Dutch model

Weesp, Netherlands (CNN) - Theo Visser was thirsty. He got up from his seat during the half-time break in a soccer match to purchase a drink from the concession stand.

"There she was, standing behind the bar," he recounts, 58 years later. "It was love at first sight." Theo asked the young woman out to a movie - and the rest, they say, is history.

It's quite a shame, then, that Corrie Visser doesn't remember any of this. Or if she does, she can't say so. Corrie is one of 152 residents at Hogewey, a cutting-edge elder care facility on the outskirts of Weesp, the Netherlands, just minutes from downtown Amsterdam.

'Dementia Village' - as it has become known - is a place where residents can live a seemingly normal life, but in reality are being watched all the time. Caretakers staff the restaurant, grocery store, hair salon and theatre - although the residents don't always realize they are carers - and are also watching in the residents' living quarters.

Residents are allowed to roam freely around the courtyard-like grounds with its landscaped trees, fountains and benches - but they can't leave the premises.

Their two-story dormitory-style homes form a perimeter wall for the village, meaning there is no way a resident can accidentally wander out.

And if they do approach the one exit door, a staffer will politely suggest the door is locked and propose another route.

Placing an aging family member here is far less expensive than round-the-clock, in-home care. It also takes an enormous amount of stress off family members who don't have ample time or proper training to care for their loved ones.

Corrie has received a diagnosis of severe dementia, meaning she requires attention and support 24 hours a day. That clinical indication is necessary to gain admittance into Hogewey.

The burden of caring for Corrie eventually became unmanageable for Theo and his daughters, so together, they made the decision to place her here.

He says: "It's perfect. I wouldn't know a better place for her. It's 100% good."

Nearly every day of the week, Theo drives 15 kilometers (10 miles) each way to spend a few hours with his 80-year-old wife.

"I do it for myself," he says. "I need it for myself. She (still) recognizes everyone... so it's important I be here every day."

Although they can't chat with each other, Theo and Corrie will often sit for hours, holding hands and lovingly look into each other's eyes. Every so often, Corrie offers a smile, a laugh, a squeeze of the hand. At least part of her memory, it seems, is still intact, though she can't verbalize much these days.
Like other residents of Hogewey, Corrie may not know exactly where she is, but she always feels right at home. That's precisely the idea.

For Yvonne van Amerongen, one of Hogewey's Founders, the need to create the small village was deeply personal.

"It was the moment my mother called me and told me my father had passed away suddenly," she recalls. "Nothing was wrong with him. He just had a heart attack and he died. One of the first things I thought was, 'Thank God he never had to be in a nursing home.' That's crazy that I have to think that!
I'm in the management of a nursing home and I don't want my father to come here."

Van Amerongen sat down with her colleagues in November 1992 to discuss how they could transform the typical nursing home into more worthwhile living.

They created a 1.5 hectare (four-acre) complex, completed in 2009, that is home to 23 housing units and seven different "lifestyle themes," such as crafts, culture, religious and urban.

Art lovers get paintings on the walls and music is always playing while the religious get more conservative d├ęcor and Christian crosses on the walls.

The simple goal:  provide the most normal possible life, reminiscent of each individual's formative years. 

From the furnishing of her unit to the decorations and the type of food served, Corrie is led to believe that nothing in her life has changed. It's this sense of normalcy that they strive for day in and day out at Hogewey.

In some ways, this is similar to the manufactured reality depicted in the movie "The Truman Show," where a man played by Jim Carrey discovers his entire life is actually a TV program. Everything he thinks is real is in fact a mirage, created by television producers for the viewing public's entertainment.

Van Amerongen dismisses any accusations that she and her staff are duping their residents. "We have a real society here," she says. "I don't think people feel fooled. They feel fooled if we just tell them a story that's not true and they know it. We're not telling stories."

But telling stories is exactly what some of the residents do, all day long, including Corrie's housemate, Jo Verhoef. Like all of Hogewey's residents, Jo's dementia is rapidly progressing. Her "loop" is getting shorter; the conversations she carries and the questions she asks are becoming more repetitive in a shorter amount of time.

"Do you know Steve Matthews?" she asks, multiple times over the course of an hour. Of course, no one does, but each time she seems surprised that we haven't met.

Steve may be a relic of Jo's past, a distant, foggy memory of a baseball player she says lived with her for a short time when she was younger. Or, he may be a figment of her imagination. Sadly, we'll never know.

Worldwide, 35.6 million people have dementia, according to the World Health Organization, with 7.7 million new cases being diagnosed every year. At that rate, the number of people with dementia is expected to double by 2030 and triple by 2050. This will be an additional burden for governments already struggling to contain the runaway costs of health care.

In Holland, everyone pays into the state health care system during their working years, with the money then disbursed to pay for later-in-life expenses - and that means living in Hogewey does not cost any more than a traditional nursing home.

Could this innovative model work in other countries? Health care industry leaders in Germany, England, Switzerland and Japan are all beginning to take notice.  At Hogewey, says van Amerongen, "We have Dutch design, Dutch cultures, Dutch lifestyles, but the concept is to value the person, the individual ... to support them to live their life as usual, and you can do that anywhere."

On a physical level, residents at Hogewey require fewer medications; they eat better, and yes, they live longer. On a mental level, they also seem to have more joy. It's a difficult thing to measure, but that is the most important thing here at Hogewey.

So could this work in other parts of the world? That's the next question.

(Source:  By Ben Tinker, CNN, 14 July 2013)

Wednesday, 10 July 2013

SAT/20JULY13 2PM-4.30PM ADFM Public Talk & Workshop Session on "Challenges Faced in Alzheimer's Disease" Organized By ADFM National Caregivers Network

ADFM National Caregivers Network is holding a FREE Talk & Workshop Session on:


·     Ms Bavani ThavaRajah, Manager, Rehab Services, Columbia Asia Extended Care Hospital   
·     Ms Liyan Abdullah, Chief of Nursing, Columbia Asia Extended Care Hospital

DATE:      SATURDAY, 20 JULY 2013
TIME:        2.00pm – 4.30pm (Registration Attendance starts 1.30pm-2.00pm)
VENUE:    ADFM PJ Daycare Centre, No. 6 Lorong 11/8E, Seksyen 11, 46200 Petaling Jaya, Selangor.

The Talk and Workshop Session will be covering the following Topics:
·           Stages of Caring of Patients with Alzheimer’s / Dementia
·          Transferring Patients at various stages in this progressive illness
·           Bed Care
·           ADLs
·           Mobility (Exercise and Movement)
·           Risks of Falls and Fractures
·           Pressure Sores
·           Nutrition

Who should attend:
The Caregivers and their families, Allied Health workers and all those who directly or indirectly are involved in the care of persons with dementia.

To the Caregivers and their families, PLEASE DO NOT MISS the above talk and workshop session.   

PRE-REGISTRATION IS REQUIRED, on first-come-first served basis:
1. Registration Form to jenny@adfm.org.my or Fax to 03 7960 8482.
2. SMS 016 608 2513 indicating full name, Caregiver (Yes/No), and contacts if you do not have email access.
3. Any enquiries, Email jenny@adfm.org.my or call 016 608 2513 / 03 7956 2008.

See all of you on 20 July at 2.00pm at the ADFM PJ Daycare Centre !!!

Thursday, 4 July 2013


Keeping active, having a balanced diet and staying healthy may keep dementia at bay.

Keeping Fit: Regular exercise can improve cardiovascular
      status, functional ability and reduce fracture risk. In the long
run, it can reduce one's risk of developing dementia - AFP

DEMENTIA is an umbrella term to describe the symptoms of a large group of illnesses that can result in loss of memory, orientation and social skills as well as cause changes in personality, behaviour and mood which are severe enough to affect daily function. However, having memory loss alone does not mean one has dementia, said Dr Chin Ai-Vyrn, who is an Associate Professor at the Geriatric Division of Universiti Malaya Medical Centre (UMMC) in Kuala Lumpur.

“Dementia indicates issues with at least two brain functions, such as memory loss and language difficulties or impaired judgement that are significant enough to cause problems with the ability to perform some daily activities. Symptoms vary, depending on the cause and the area of the brain affected,” explained Dr Chin, 46, in a recent interview.

While some types of dementia such as those caused by nutritional deficiencies and endocrine abnormalities can be reversed, most cases are progressive and worsen over time. There are four main types of progressive dementia – Alzheimer’s disease, vascular dementia, Lewy body dementia and Frontotemporal dementia. These four types make up about 90% of all cases.

Research findings published in the Annals of Internal Medicine in February showed that physically fit mid-lifers were nearly 40% less likely to develop dementia or Alzheimer’s disease by the time they were 65 years old, compared with their counterparts who were less active.

Changes in physical activity in midlife may lead to improved fitness levels, resulting in less all-cause dementia with ageing.

Another study from the Journal of Neurology found that exercise helped minimize arterial plaque build-up, and this was linked to improved performances on memory and mental acuity tests, reports huffingtonpost.com.

“Some studies also show that sticking to a Mediterranean type of diet (which emphasizes healthy fats, vegetables, fish and fruits) may help reduce dementia. Reducing alcohol intake and not smoking is good for the brain, too,” added Dr Chin, who graduated from the Royal College of Surgeons in Ireland in 1993 and was the Lead Clinical Fellow at the Mercer’s Institute Memory Clinic in Ireland prior to returning to Malaysia in 2007.

Besides a healthy lifestyle, a well-balanced diet and regular exercise are important, too. 

“Regular exercise is important as it helps in many ways. It can improve cardiovascular status, functional ability and reduce fracture risk. In the long run, it can reduce the risk of developing dementia,” said Dr Chin.

He said it is equally important to keep the mind active. “Retirees should take up activities that are cognitively stimulating. Mental games like mahjong, sudoku or chess and hobbies like reading, sewing or something outdoors like gardening provide cognitive stimulation and may reduce dementia risk. Learning something new, as long as it’s enjoyable and not causing additional stress, is good,” he explained.

Memory clinics

UMMC’s Geriatrics Division, formed in 1998, runs outpatient clinics in three specialised areas – memory, falls and general geriatric medicine (which caters to patients 65 years old and above). The Memory Clinic, the first in a university hospital, specializes in the early diagnosis and treatment of dementia.

The Memory Clinic accepts only patients with referrals and the waiting period is usually about three months. The clinic operates every Thursday afternoon. On average, Dr Chin and his colleagues – including Geriatricians, Prof. Dr Philip Poi, Associate Professor Dr Shahrul Bahyah Kamaruzzaman and Psychogeriatrician, Dr Chong Lu Ann, together with allied health professionals - see around 20 patients (four to five per specialist) every week.

Their patients’ levels of dementia range from mild to severe. Over the last 12 months alone, over 250 patients with dementia have walked through the doors of UMMC’s Memory Clinic.

Every new patient undergoes a brief neuro-cognitive test and a functional assessment before seeing the specialist, who then takes a history and performs a physical examination. The patient’s family is often asked to attend to provide additional information. Further investigations, such as blood tests or brain scans, are arranged as appropriate. Patients are then given feedback on the results of the assessment at a subsequent visit. Being seen by a specialist in dementia is important as studies show that the diagnosis is accurate in over 90% of cases.

Since there is no specific test to diagnose dementia like Alzheimer’s disease, the patient’s history, physical examination and information from caregivers are key to determine the diagnosis. Dr Chin explained that early accurate diagnosis is vital to help manage the patient’s medical concerns.

“We also look into other areas, including safety, legal aspects (to ascertain if the patient is able to make decisions), care and medication. It’s important to start planning for services and support as early as possible. Patients referred have different degrees of dementia, ranging from mild to moderate to severe.

“Currently, 30% of people over 80 years will have a demented condition. If nothing is done, the potential numbers are scary. It is vital for us to take care of our health and start taking steps to keep our brains active as we age,” said Dr Chin.

(Source:  The Star, Senior Star2, by Sheela Chandran, 3 July 2013)