Thursday, December 26, 2019

HERE'S WHY THE 60+ DO NOT LIKE TO BE REFERRED TO AS 'THE ELDERLY'


The UN refers to people aged 60 and above as Older Persons. World Health Organisation uses the term 'older people'. Are these terms of reference preferable to 'senior citizens' or 'the elderly'? What is your opinion?

When I started this blog in May 2008, I had dozens of names in mind for the blog. Unfortunately all of them were already taken. In frustration I gave it one final attempt with 'SeniorsAloud'. The name had popped into my mind at that last minute. To my surprise, it was available and accepted.

I call this my 'passion card', rather than my business card or name card.
Both my daughters didn't like the name at all. They probably felt that with a name like SeniorsAloud, the blog would appeal only to old people. Of course, I went on the defensive. What did they mean by 'old'? I was about to turn 60 at the time, and didn't feel at all a day over 40! Neither was I frail, and definitely nowhere close to being senile. I am 71 now, still far from decrepit although admittedly my knees are starting to creak.

Let me ask my readers, do the words 'senior citizen' conjure up an image of a frail, wrinkly person bent over a walking stick or stuck in a wheelchair, suffering from hearing loss, poor vision and a host of chronic diseases like Alzheimer's? I have good friends who would cringe with horror at being referred to as a senior citizen, even though they are 60+ and retired. To them, that's as good as sounding the death knell!

Do you agree with these categories by age?
The problem with labels is they are generic. 'Old' people are painted with the same brush, and in the same grey colour. But there are so many different shades and hues of grey. If the 60+ are not quite ready to be called old, how then would you address them? In academic research old age can be divided into three stages: young old (55–65 years of age), middle old (66–85), and old old (85 and older). But that's chronological age, not biological age. I know of people who at 75 can outrun a 35 year old!

What other terms of reference do we have? The pre-war and post-war generations? Equally cumbersome and inadequate. Baby boomers? Well, we are long past our baby-producing age. How about 'perennials'? That is more fitting for trees and vegetation. And 'evergreens'? That sounds desperate, like trying too hard to remain young.
Some of our SeniorsAloud members at a photo shoot for The Star.
Quite often the media is guilty of mislabeling. "Elderly man victim of snatch thief", says one headline. You read the news report and find that the victim was only 63 years of age. Obviously the reporter had not heard that 60 is the new 40, and that people aged between 60 and 69 are called sexagenarians because they are still sexy and far from being over the hill and ready to be put out to pasture! But young reporters are incapable of making that age distinction. To those in their 20s, 63 is practically ancient, ready to be mummified and put on display in the museum.

So until we come up with more appropriate labels, I suppose we will have to forgive the young for addressing us as 'old' or 'elderly'. It could be worse, like describing us as cranky and smelling of mothballs and dead fish!


Which goes to show that it is an uphill battle to change the negative perception most people have of senior citizens. But change we must, and change must begin with us. We need to think positively of our age and of ourselves, because if we don't, we cannot expect others to view senior citizens as still active, healthy, productive, capable, wise, experienced, fun-loving, adventurous and bold. All the positives. In other words, we need to change the narrative of ageing and make 60+ truly the 'golden years' to look forward to.

For our Facebook followers, you will have noticed our postings of some really amazing and inspiring seniors who have defied the old image of ageing. From our own SeniorsAloud community, we have scores of members who look great, and are both physically and mentally in top form. Some of them are featured in our 2020 calendar and in the Star Lifestyle supplement dated 13 Dec 2019.

SeniorsAloud team - our ages range from 60 to 75. We aim to change public perception of ageing.
Postscript:The original article (above with minor revision) was written in 2011. Almost nine years have passed and I am glad to report that SeniorsAloud has grown in numbers and in outreach. We have gained a solid reputation for our noteworthy community initiatives.

What is my wish for the new year 2020? Well, I have always wanted to have a column in the newspaper to write about topics and issues of interest and relevance to senior citizens. If that ever happened, it would be a dream come true for me. Maybe I would call it 'Silver Threads'. It would also be a channel to share information and personal insights on matters that involve this demographic. There is growing interest in the field of ageing.

Other than writing letters to the newspapers, we make use of social media platforms e.g. facebook, to make our voices heard on a host of issues that affect us, including healthcare, cost of living, public transport, affordable housing, re-employment, age-friendly public facilities, retirement planning and end-of-life issues. At the same time, SeniorsAloud continues to promote active living as we believe that is the most effective way to enjoy longevity in good health.


Saturday, November 30, 2019

MY MOM HAS ALZHEIMER'S - AM I AT RISK?


My mother first showed signs of Alzheimer's Disease probably as early as 2008. She was 82 then. She couldn't remember dates, places and names of family members. She didn't know one day from another, and forgot what she just had for dinner or where she had left her purse.

That was 11 years ago. I had not heard of Alzheimer's Disease (AD) then. Like most people with elderly parents at home, I took these signs as part of the normal ageing process. It was commonly accepted that people turned senile (nyanyok) in their old age, so I wasn't too concerned about it.

My mom would repeatedly ask the same questions even though I had just given the answers. It was almost impossible to hold a simple conversation with her. Her attention would drift off to some distant places in her memory. It was as if a mist had clouded the clarity of the moment. She was there with me but yet not there. I didn't know then how to handle such a situation.


It took a fall at home and hip surgery for my mom before I learned about Alzheimer's. During the ten days my mom was in hospital, her doctor noticed signs of the disease in her behaviour. He suggested I take her to see a geriatrician for a proper examination. A visit to see a geriatrician at UMMC Specialist Hospital and some tests later confirmed my mom had AD.

Thus began my interest in reading up as much as I could about AD. In December 2013, I signed up for an online course on Living with Dementia: Impact on Individuals, Caregivers, Communities and Societies offered by Johns Hopkins University. In 2015, my passion to learn more about AD took me to Hogeweyk, the world's first dementia village in Amsterdam. In 2017, I enrolled for MSc in Applied Gerontology at NTU, Singapore. At 69, I was the oldest in the pioneer class. I attended numerous conferences to learn about the latest developments in AD research and treatment. As my mom's primary caregiver, I wanted to know how to better care for her. At the same time I could learn how to avoid ending up with AD. As a blogger and founder of a seniors' community, I could share what I have learned with others.


The statistics for Alzheimer's are alarming. According to the World Health Organisation Report (WHO) 2019, there are currently 50 million persons with dementia (PWDs). This number is expected to increase to over 150 million in 2050. The World Health Organisation (WHO) 2014 report put the number of people in Malaysia with dementia in 2015 at 123,000. This number was projected to be 261,000 by 2030 and would continue to increase to 590,000 people in 2050.

What's the difference between dementia and Alzheimer's Disease?


I have frequently been asked this question. Put simply, dementia is an umbrella term for a host of diseases that affect the normal functioning of the brain. Depending on which part of the brain is affected, diseases associated with dementia include Alzheimer's Disease, vascular dementia, Lewy bodies (DLB) and frontotemporal dementia. The most common of these is Alzheimer's Disease which affects mostly the elderly. However, early onset dementia affecting adults in their 40s and 50s is on the rise.

Is Alzheimer's Disease hereditary?

This is the golden question for me. My mom has AD. I believe my great grandmother had it too. When I was growing up in the 1950s I recall seeing her playing with a baby doll, and treating it as if it were her own child. Another time I saw her packing a few personal belongings in a sarong, and telling the family she was going to take a trishaw 'home', meaning China. These incidents are etched in my memory. I have at least four members in my extended family who were diagnosed with dementia (AD) in their final years.

Like my mom, one of my aunts also showed signs of behavioural changes in her old age. She would accuse everyone of conspiracy, of hiding her passport and stealing her money. All not true, of course. But when she told me so-and-so had stolen her valuables, I believed her. It was only later when she was diagnosed with AD that everything she said and did began to make sense.

Does that put me at risk? Yes, but at risk does not mean 100% or even 30% certainty. I may or may not develop AD. There are preventive measures I can take to reduce the risks, such as exercises and activities that promote brain health and cognitive functioning.


I am very forgetful. Is this a sign of early Alzheimer's Disease?

All of us are forgetful, some more than others. How often have we forgotten where we parked our car, the name of someone we have just been introduced to, or the lyrics of songs we used to sing? We refer to these lapses of memory as 'senior moments'. Red flags of AD include repeatedly forgetting recent events and confusion in retrieving them. This Mild Cognitive Impairment (MCI) or lapses in short-term memory may signal early Alzheimer's. Over time as the disease progresses, these memory lapses can potentially have serious consequences. My mom would forget to turn off the gas completely after cooking, forget to lock the front door when she left the house, or forget whether she had taken her medication. The latter could have resulted in a drug overdose. My mom also had mood swings, an obsession with collecting tissue paper and was prone to wandering around the house at wee hours of the morning.

My mom still enjoys browsing through newspapers and magazines. I bought this book for her in the hope the images would stir up fond memories.
We often read in the papers of a missing elderly who later turned out to have forgotten how to get home. There are no statistics on the number of such cases in Malaysia. The Japan Times (June 2019) reported that a record 16,927 dementia patients in Japan went missing in 2018. Alarming indeed. Do not leave an elderly unaccompanied especially in an unfamiliar place e.g. a busy hospital or a noisy mall. My mom had on several occasions stopped midway to our neighbourhood supermarket, unsure whether she was heading in the right direction despite having walked there countless times before. Confusion with directions is common in PWDs.

Can Alzheimer's be prevented?

Thanks to Google and the efforts of the Alzheimer's Disease Foundation of Malaysia (ADFM) over the years to educate the public, we now know more about AD. Not everyone develops the disease in their old age. There are people in their 80s and 90s whose minds continue to remain sharp. 

At present there is no cure for AD. Prescribed medicines for AD can only slow down the progress of the disease. Most of the drugs, e.g. memantine, have side effects. AD is a degenerative disease that can span many years, ultimately ending in death. I have watched my mom slowly change from a lively chatty woman to a shadow of her former self. After suffering a mini-stroke in February 2019, she has lost her ability to speak, and her memory has almost completely left her. She does not know who I am nor does she even ask. She sits in total silence, in a world of her own where no one can enter.

When my mom was discharged from hospital after her second surgery, she was prescribed expensive drugs by one doctor after another. After several years of seeing little improvement in my mom, and on the advice of a doctor friend, I decided to stop all the medication. My mom has been mostly drug-free since. She turned 93 in October 2019, still has a hearty appetite and sleeps well. That is good enough for me.


Preventive steps for dementia do not cost much money. Follow a regular exercise regime and adopt a healthy diet. Monitor your sugar level, blood pressure and weight. Keep your brain actively engaged with mental stimulation such as learning a new language or a new skill. Travelling broadens the mind, so go on trips whenever you can. Finally, build a network of close friends and avoid social isolation.

What preventive measures do I take?

As I am at higher risk than others of getting Alzheimer's, I make sure I stay active physically and mentally. I have always been active, interested in and curious about a lot of things. I read a lot, especially on ageing-related issues. I write a lot too. Curating for news and events to share on Facebook keeps me mentally busy daily. These activities stimulate the brain. That is why I enrolled for my second masters degree. I also took up singing, line dancing and learned to play the ukulele. Memorizing lyrics, dance steps and ukulele chords helps to stimulate my brain cells. I have been attending courses offered by the University of the Third Age (U3A) since 2011. Lifelong learning keeps the brain well-oiled and the social connections I make will hopefully keep AD at bay. 'Never too old to learn new things' has become my mantra for living life with a positive mindset.

KLSings' VoxPop choir performing at ADFM's 'Let's Talk About Alzheimer's' in conjunction with World Alzheimer's Day in September 2019.
If you are curious to know whether you or a family member has early AD, you could try taking the Mini-Mental State Examnation (MMSE). It is a popular test for cognitive functioning, and includes tests on memory recall, language and focus. There is even a Malay version. The scores will provide an indication of whether the person has any cognitive impairment. As it is only a simple diagnostic test, it should be followed up with a visit to the geriatrician for a full examination. 

Drop by at ADFM community corner at Wisma Atria, PJ, to find out more about AD. There are weekly group activities there for PWDs (persons with dementia) and their caregivers.