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Sunday Spotlight: Healthcare providers going hi-tech to help dementia patients tap into the past
 

Sunday Spotlight: Healthcare providers going hi-tech to help dementia patients tap into the past

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SINGAPORE – At the Ling Kwang Home for Senior Citizens, the furry therapeutic robot seal Paro serves as a companion to lonely or restless residents with dementia, reacting to their touch with life-like sounds and movements. For those with dementia at Sree Narayana Mission (Singapore), holograms may one day enable them to “stroll” through the colourful alleyways of Little India and bustling streets of Chinatown when they are no longer mobile. The methods are part of reminiscence therapy, offered by healthcare providers to trigger memories from the seniors’ pasts. The aim is to help those with dementia recall life events and spark conversations, to provide a grounding and calming effect and boost their self-esteem, said the Agency for Integrated Care (AIC). Dementia, a condition marked by symptoms such as memory loss and anxiety, anger or confusion about memory loss, is set to become more prevalent as the population here ages. Some nursing homes offer reminiscence therapy in the form of sensory gardens with rosemary and mint plants, or a room furnished to resemble a home. Others have rooms decorated with memorabilia and scents from the past – hair or aromatic oils from days of yore, kerosene lamps and red clogs. But with technology becoming increasingly affordable, healthcare providers are tapping modern tools to offer a wider range of reminiscence therapy, said the AIC. Tech gadgets make a wide array of photos, music and videos available, and virtual reality may be deployed in future. Sree Narayana is planning to embark on a mixed reality project, exploring technology options such as Microsoft’s Hololens to simulate festivals, cultural events and art exhibitions. “With this technology, I can bring places like Eu Tong Sen Street, Campbell Lane or Clive Street to (the seniors),” said its chief executive S Devendran. About 40 out of 65 attendees of the non-profit’s Woodlands senior care centre have dementia, while about 80 out of 224 residents at its nursing home have dementia. Holograms, or 3D images, can help overcome logistical and manpower constraints in taking seniors on outings. It will not be a substitute for real-life outings for mobile residents, but can serve those with limited mobility, said Mr Devendran. The project is being evaluated for the government’s Healthcare Productivity Fund. Singapore is increasingly catching up and recognising that holistic efforts are critical in tackling dementia, said Ling Kwang Home’s chief executive Dennis Tan. The home, which has 100 residents with dementia, began using Paro the robot in 2013. Residents also play fruit-slicing games on Samsung tablets, listen to Hokkien songs and even connect with long-lost family members through Skype. Physiotherapist Cecilia Llego recounted a resident with dementia in his late 70s who had constantly asked if he could see his mother. Staff members did not understand his ramblings initially. It was only later that they discovered his mother, in her 90s, was indeed residing in another home, and used a Skype video call to connect the duo. “During the conversation, both of them were crying. The son was saying ‘Mama’ and the mum was saying ‘You’re my son’, and they were (trying to) kiss (each other) on the tablet, and he was remembering (his past),” said Ms Llego. “Seeing that moment, we were all in tears.” The resident became more alert subsequently, she said. Reminiscence therapy works just as well in lower-tech forms. Residents of NTUC Health’s nursing home in Chai Chee listen to songs of their youth in a living-room environment, and staff members encourage them to think back to the past and to try recognising the singers and songs they used to love, said a spokesperson. Since 2009, the Salvation Army’s Peacehaven Nursing Home has worked with small groups of residents with mild to moderate dementia to compile their life stories into written autobiographies. The stories could feature themes like family, job, health and their thoughts on dying. This aids the resident’s sense of identity and boosts their social and communication skills when they share the stories with others, said the home’s social work manager Trina Tan. The stories also help staff members to provide more individualised care to residents. About 60 to 70 per cent of the home’s 360 residents have dementia. More traditional forms of reminiscence therapy also feature at Sree Narayana’s facilities and Ling Kwang Home. Attendees of Sree Narayana’s senior care centre take part in weekly movie screenings, where they receive coupons to “buy” snacks at a kacang puteh stall before watching a movie from their younger days. This year, it began taking nursing home residents to the Indian Heritage Centre to view artefacts on display, and aims to expand the outings to other museums and heritage buildings. Such spaces are “ready-made” for reminiscence therapy, said Mr Devendran. Singing clubs are a big affair at Ling Kwang Home, where residents and staff get dolled up in samfus or cheongsams to belt out well-loved opera or Cantonese songs. It also hosts Kopitiam Wednesdays, where its hall is transformed into a bustling marketplace filled with goodies like siew mai (dumplings) and you zha kueh (fried dough sticks). It also practises doll therapy, where residents with dementia are given life-like dolls. The dolls help the less communicative to start speaking or singing, and serves as a source of comfort to others by reminding them of their grandchildren. A challenge faced by healthcare providers is that foreign staff may lack knowledge of local customs and dialects, which are crucial for reminiscence therapy, said Ms Llego. Staff may also find themselves back to square one if the seniors with dementia regress. Some behavioural issues are hard to shake – such as the refusal to bathe, for instance, said Ms Llego. Mr Devendran said service providers would keep looking out for new ways of providing therapy to their clients. “We do whatever we can and push the envelope as far as we can to (delay the progression of dementia),” he said.
 
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9 Oct 2017 - General