Saturday, 28 September 2013

SAT/5OCT13 ADFM Public Talk "Vascular Dementia" By Prof. Dato Dr Raymond Azman Ali from UKM

Dear Caregivers and Members of the Public, 

ADFM National Caregivers Network will be holding a FREE Public Talk for Caregivers and Members on “VASCULAR DEMENTIA” by Prof. Dato Dr Raymond Azman Ali, Senior Consultant Neurologist and Dean of UKM Medical Faculty and Director of UKM Medical Centre.  The Public who are interested are welcome to register.

VASCULAR DEMENTIA is the second most common cause of dementia in older people. Because it has a lower profile than Alzheimer's, many people don't suspect Vascular Dementia when forgetfulness becomes problematic.

Prof. Dato Dr Raymond Azman Ali in his talk will share with our Caregivers and members of the public what Vascular Dementia is and its causes, symptoms and treatments.  Determining the root cause can help determine the best action plan. If it's Vascular Dementia, certain lifestyle changes can help prevent further damage.


Day / Date : Saturday, 5 October 2013

2:00pm      Registration of Attendance
2.30pm      Talk on “Vascular Dementia” by Prof. Dato Dr Raymond Azman Ali
3.30pm      Q & As
4.00pm      Light Refreshments/End

Who Should Attend?
·      Caregivers & families of PWDs (Persons with Dementia)
·      Healthcare Workers
·      Anyone who wants to find out more about Vascular Dementia

Compulsory Prior Registration:
1.   Register online now ->  Registration Form   
2.   Email: or Fax:  03 7960 8482.
3.   SMS 016 608 2513 with full name and contacts if you do not have email access.

Any inquiries, call Jenny at 016 608 2513 / 03 7931 5850 / 7956 2008. 

See you at the talk and, kindly be punctual !!! 

Thank you!


Vascular Dementia is the second most common cause of dementia in older people. Because it has a lower profile than Alzheimer's, many people don't suspect vascular dementia when forgetfulness becomes problematic. It's also difficult to diagnose so it's difficult to know exactly how many people suffer from vascular dementia. Current estimates attribute 15% to 20% of dementia cases in older adults to vascular dementia.

Determining the root cause, its causes, symptoms, and prognosis, can help determine the best action plan. If it's vascular dementia, certain lifestyle changes can help prevent further damage. 

What Is Vascular Dementia?

Compared to Alzheimer's disease, which happens when the brain's nerve cells break down, vascular dementia happens when part of the brain doesn't get enough blood carrying the oxygen and nutrients it needs.

Though they happen in different ways, it is possible to have both vascular dementia and Alzheimer's disease. Discouraging as this sounds, there is ample reason to control the risk factors that contribute to vascular dementia. Allowing the condition to run its course without intervention can make Alzheimer's disease worse.

What Causes Vascular Dementia?

Vascular dementia occurs when vessels that supply blood to the brain become blocked or narrowed. Strokes take place when the supply of blood carrying oxygen to the brain is suddenly cut off. However, not all people with stroke will develop vascular dementia.

Vascular dementia can occur over time as "silent" strokes pile up. Quite often, vascular dementia draws attention to itself only when the impact of so many strokes adds up to significant disability. Avoiding and controlling risk factors such as diabetes, high blood pressure, smoking, and high cholesterol can help curb the risk of vascular dementia.

Catching the condition early also helps limit the impact and severity of vascular dementia. Early detection requires an awareness of risk factors and, more importantly, efforts to keep them under control. Anyone who suspects vascular dementia should talk with his or her doctor.

Symptoms of Vascular Dementia

Symptoms of vascular dementia depend on what part of the brain is affected and to what extent. Like Alzheimer's disease, the symptoms of vascular dementia are often mild for a long time. They may include:

-  Problems with short-term memory
-  Wandering or getting lost in familiar surroundings
-  Laughing or crying at inappropriate times
-  Trouble concentrating, planning, or following through on activities

-  Trouble managing money
-  Inability to follow instructions
-  Loss of bladder or bowel control
-  Hallucinations or delusions

Symptoms that suddenly get worse often signal a stroke. Doctors look for symptoms that progress in noticeable stages to diagnose vascular dementia. Alzheimer's, by comparison, progresses at a slow, steady pace. Another clue is impaired coordination or balance. In vascular dementia, problems walking or balancing can happen early. With Alzheimer's, these symptoms usually occur late in the disease.

Who Is at Risk for Vascular Dementia?

Some risk factors for vascular dementia can be managed; others, like age and gender, cannot. Among all factors, high blood pressure carries the greatest risk; vascular dementia almost never occurs without it.

Likewise, a high risk of stroke goes hand in hand with risk for vascular dementia. One-quarter to one-third of strokes are thought to result in some degree of dementia. People who smoke, consume excessive amounts of alcohol, have diabetes, or heart disease also have a higher rate of the condition.

Vascular dementia most commonly occurs in people between the ages of 60 and 75. Men seem to be more vulnerable than women, and the condition affects African-Americans more often than other races. People whose age, sex, or race puts them at increased risk of vascular dementia have that much more reason to manage risk factors within their control.

Vascular Dementia Treatment

Currently, no available treatments can repair the damage of vascular dementia once it's happened. Nonetheless, diagnosis provides important knowledge and the opportunity to prevent further damage.

Prevention typically involves bringing high blood pressure under control through exercise, diet, and medication. The same goes for diabetes if it exists. Patients should stop smoking and curb the use of alcohol. 

Though medical options are limited, behavioral interventions such as cues and reminders can improve the quality of life for everyone involved. Family members and friends can place notes in visible locations around the house with daily plans and instructions for how to use basic items. Stepping up communication, reminding the person with vascular dementia what day it is, where they live, and what is going on in the family, can help keep them connected to the here and now.

Prognosis for People with Vascular Dementia

If the conditions that cause vascular dementia go untreated, the prognosis is not good. A person with vascular dementia may seem to improve for periods of time until another stroke takes away more brain function, memory, and independence. Eventually, untreated vascular dementia usually ends in death from stroke, heart disease, or infection.

Although vascular dementia is a serious condition, catching it early and preventing further damage are the best medicine. People with vascular dementia can work with their doctors and families to detect and manage the condition.



I call that place the “zombie wall.”
By Mary Gazetas

My husband is living in the last stages of Alzheimer's. Clinically
he’s a Seven.
He’s in a home and he can’t walk, rarely talks, and he can
no longer participate in organized activities.
Reading, writing or watching television disappeared over two
years ago.

One question readers might ask is, “Gosh, Well Then What Can He Do?”

Part of an answer is to share what I tell my children, my three grown children who live far away.  When they check into see how their Dad is doing, I find a huge part of my response is to describe to them what he loves to play with.

He’s now playing with things that would amuse and keep occupied a 9 month old - a one year old child.  I am no expert.  May be it is even a younger age.  I don’t know.

It took me awhile to realize how important it was that he had things in front of him to touch and move around.  It was about a year ago when he could still more or less feed himself to a degree that I began to notice he loved to play with his food.  I called it the “sand box.”

Anything close by his meal tray in the dining room became fair play.  Things that were within reach and that he could see that were there to make him curious.

It was common to see him rip open paper sugar packets, pour his cup of milk into another vessel or make a puddle to put his fingers into. Use his paper napkin to fold into a shape to cover a cup or a piece of uneaten food. Use his blue terry cloth bib to cover and hide things under.  Activities most of us would associate with what a very young child likes to do.

Besides eating, the playing part was a large part of his meal experience as I sat beside him.

For him this was fun. So I never tried to discourage him despite some objections from the residence staff. To me, that kind of behaviour indicated he was still curious about things. He wanted to play. He was bored!  Why would I want to tell him it was not cool to do that?

I read that having a “rummage basket” close at hand was a beneficial method to keep people like him active. I brought in objects from home that I hoped might be a-connect for him. Things that may be he might remember or be curious about.

Into the basket went objects such as his empty wallet, decorated wooden Easter eggs, pens, really small art books of his favourite artists, toy animals, a water gun, and hard-boiled egg covers made of wool from my mother’s kitchen.  He didn’t seem that interested in those objects. Then one day when I showed up one of the care-aides had put the basket on its side on his table. Now he could actually see inside. What a difference!

Pasted on the wall above his bed is a care plan that describes to all the staff what I think is important re his level of care. No more parking him in his wheelchair by a wall after lunch with nothing for his hands to do. I call that place the “zombie wall.” Instead over time they now get it. After the noon meal, take him back to his room so he can sit beside an open window, with his bedside table in front of him, to place an assembly of toys to touch.

A few weeks ago it struck me he needed some new toys. I went to the local IKEA store children’s area and bought a set of stacking cups and another piece made of wooden thick rings to place on top of one another on a small pole.

They are now his favourites.

When I entered his room this afternoon he was wide awake, playing with all in front of him -   stacking, grouping, curious and happy.

One of his care-aides told me another staff person had come into the room earlier and mentioned she had bought the same toys recently - toys for her one year old grandson. I wasn’t there for that conversation.  But I did hear that there is a need to create an awareness that people like my husband have returned to a very early stage of a childhood from long ago.

Meanwhile, I am going to take the wooden stacking rings home to make the holes larger with my drill because he has trouble seeing how to get them to fit on the vertical pole.  I don’t want him to struggle to do that.  I want him to feel he is winning.

Is P L A Y important?  You bet it is. The job of a caregiver is to figure out what is best for their loved one. There are no easy answers - it’s all about trial and error. Plus experimenting to see what might engage them and what might not.

In Bob’s words - Welcome to the Alzheimer's World, we have to be playful and have fun too.

Mary Gazetas was an artist, a writer, a volunteer who lived in
Richmond B.C. Canada.  At the beginning she knew nothing about Alzheimer’s.  In fact she didn’t even know how to spell that word.
At first she and her husband were overwhelmed by so much information available.  Looking back it was a slow learning curve.  Once diagnosed (February 2008) the progression of her husband’s Alzheimer’s was fairly slow until he went into a steep and sudden decline.

Mary went to Heaven on April 17, 2012. Her words sing loud and true.

(Source:  Alzheimer’s Reading Room, 5 September 2013)

Saturday, 14 September 2013

SAT / 21SEPT13 Half Day Carer's Workshop "Safe and Quality Care for Our Elders" Organized By Geriatric Unit, University Malaya Medical Centre (UMMC-PPUM)

Dear Caregivers,

The Geriatric Unit, University Malaya Medical Centre (UMMC-PPUM) has specially organized a Half Day Carer's Workshop under the Theme "Safe and Quality Care for Our Elders" for Carers and their family members.


Day / Date  :  Saturday, 21 September 
Time  :  1.30pm - 5.00pm  (12.00pm - 12.45pm Registration for Geriatric Workshop)


-  To improve awareness among carers about the needs of the elderly under their care
-  To share & update knowledge and skills required in the care of the elderly
-  To help carers understand how to prevent common problems in the elderly


1200-1245   Registration of Attendance
1330-1355   Pamper Me?
1355-1420   Feeding the Elderly
1420-1445   Transferring the Elderly / Suitable Aids
1445-1510   Entertaining the Older Person
1510-1530   TEA BREAK
1530-1615   Workshop 1 - Sponging Vs Bathing
1615-1700   Workshop 2 - Safe Mobility 

Full Details & Registration, Click on ->  Program & Registration.

Registration Fee is only RM60.00 to help defray the expenses in organizing this workshop.

If you require further clarifications and assistance in your registration, you can contact 016 608 2513 OR 03 7931 5850.
Do not miss this workshop which is specially programmed for you and Register Now as you have only few more days left.

Tuesday, 10 September 2013

From Research: The Link Between Late-Onset Depression and Dementia Risk

Depression that first manifests in midlife or later may be a harbinger of dementia, a new study says.  The study was published in the Archives of General Psychiatry (Volume 69, page 493).

Researchers reviewed data from the records of more than 13,000 adults who were long-term members of the Kaiser Permanente Medical Care Program and who had signed up in the 1960s and 1970s to participate in a research study for middle-aged people.

To identify midlife depression, the researchers reviewed surveys that had asked participants whether they often felt unhappy or depressed, and they examined hospital records to identify admissions related to a diagnosis of depression.  More recent medical records were also reviewed to identify late-life depression and dementia diagnoses.

In participants with depressive symptoms in late life - whether or not they were combined with midlife symptoms - the risk of Alzheimer's was doubled. Combined midlife and late-life depressive symptoms more than tripled the risk of vascular dementia.

Takeaway Message 
These findings don't prove that depression that first occurs in midlife or beyond is a sign of dementia. Moreover, the researchers didn't attempt to determine whether treatment could reduce risk. Still, if you are experiencing depression, it's important to discuss it with your doctor. Effective treatments for depression are available.

(Source:  John Hopkins Health Alert, Posted in Memory, 9 September 2013)


When you reach age 65, you have a one in 10 chance of developing dementia during your remaining lifetime. Clinicians are now making a concerted effort to diagnose dementia in the early stages, when patients may still have the capacity to understand the disease's course and to make important decisions about future care and interventions.

Being told you have an incurable disease that slowly robs intellectual functioning can take an emotional toll. Adjusting to a diagnosis at any stage of dementia is a complex, evolving process for the person diagnosed and his or her family. You may experience mixed feelings and a range of reactions, including:

A loss of Self
Dementia poses a threat to personality and character. Understandably, dementia's symptoms, such as forgetting faces and struggling to express yourself, can leave feelings of loss, uncertainty and frustration. Experiencing acute grief and mourning your loss of self-identity is common.

Most individuals with Alzheimer's disease aren't aware they have impaired memory and thinking. For others, unawareness increases as the disease progresses. This suggests that unawareness is part of the brain disease in some individuals. Arguing with them or repeatedly demonstrating to them that they're forgetful won't help and is likely to upset them more.

Other individuals outwardly deny or ignore the diagnosis of dementia but seem to be aware from their behavior that they have a problem. Research suggests that this reaction can sometimes be a self-monitoring strategy in an attempt to be seen by others as a person, not an object, and maintain self-esteem.

Certain individuals and their loved ones report feeling relief upon hearing the diagnosis of dementia. The anxiety of not knowing what's causing symptoms like forgetfulness can be a tremendous burden. A diagnosis can confirm suspicions that dementia is the cause and legitimizes the need for support and therapeutic interventions.

Secretiveness or Embarrassment
It's common for individuals to be reluctant to reveal their dementia diagnosis for fear of how others might perceive them. As a result, these individuals are often tempted to stop seeing friends or family members and become socially isolated - outcomes that are clearly undesirable, since studies show that maintaining social connectedness is key to coping with the psychological impact of a dementia diagnosis.

Anxiety, Anger, Sadness or Depression
These are all normal reactions. Demoralization is especially common in the disease's early stages the same way it is when grieving any other loss. Behavioral therapy or counseling may ease feelings of anxiety and depression if they interfere with everyday functioning.

(Source:  John Hopkins Health Alert, Posted Memory, 2 September 2013)