Wednesday, August 26, 2015

BEYOND DENTISTRY AND STOPPING DEMENTIA

August seems to be a popular month for seminars. I attended three, and had to skip two as they clashed with other commitments. Some of the information I picked up from each of these seminars is of relevance to seniors. I am sharing these slides and images below in the hope that our blog readers will benefit from the information given by the distinguished speakers.

Sat 15 August - Seminar on "Beyond Dentistry: More Than Teeth" presented by Channel News Asia and Specialist Dental Group of Singapore

Who would want to pay S$10 and spend Saturday afternoon listening to a group of dental and medical specialists talk about tooth decay, gum disease, etcetera? The answer: 500 people! Dental talks can be most boring, but the six specialists certainly knew how to inform, impress and entertain the audience with their lively presentation of the latest advances in dental care. 

A packed ballroom at the dental seminar. (Image from Specialist Dental Group blog)

While every one of the six speakers had good advice to offer on how to maintain dental health and ensure our teeth last a lifetime, the talk that resonated most with me as a senior citizen was 'Better Teeth, Better Years' delivered by prosthodontist Dr Neo Tee Khin. 


Remember how we dreaded going to the dentist during our childhood days in the 1950s and 60s? Qualified dentists were a rare breed then, especially in the small towns. Those we had were men in white who had learned their trade from other men in white before them through a period of apprenticeship. The fastest remedy for a persistent toothache in those days was an immediate extraction. That's how many ended up losing good teeth and having them replaced with ill-fitting dentures.

Thank goodness dentistry today has gone far beyond those dark days of terror in the dentist's chair. Dentists, like doctors, are sworn to save our teeth. Extraction is always the last resort. If you have a choice and if you can afford it, go for implants rather than dentures. They fit better, function and look like natural teeth, and last a lifetime if you practise dental hygiene diligently.

The speakers. Very impressive qualifications and credentials.  Click here for their biodata. 

Poor dental hygiene can lead to health problems like diabetes, hypertension, heart disease/stroke, lung infections, stomach ulcers, cancer and even erectile dysfunction. To maintain strong teeth and healthy gums, visit your dentist every six months, brush your teeth twice a day (also after meals if you can), and FLOSS, FLOSS, FLOSS!

For more about each of the talks and the speakers, click here.

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Thurs 13 August - Symposium on "Ageing in Malaysia: From Molecules to Community" organized jointly by Universiti Kebangsaan Malaysia (UKM), Universiti Teknologi Mara (UiTM) and Universiti Putra Malaysia (UPM)

Sat 22 August - Seminar on "The Rising Tide - Dementia - Can we stop it?" organized by the Gerontological Society, Singapore

Both seminars focused on dementia and shared similar findings from the research studies done although the racial demographics differed. Some images of slides taken from the talks:

Both Malaysia and Singapore will have an ageing population by 2050. This will see a rise in the number of people with dementia. 

As the population ages, we are seeing a dramatic rise in cases of dementia among the elderly. What are the signs of dementia? Is it preventable? Curable? Inheritable? How can caregivers deal with the stress of looking after a dementia patient 24/7? What are the costs involved in dementia care? These were some of the questions that the three speakers addressed.

A/Prof Dr Rathi Mahendran reported on the Jurong Ageing Study (JAS), conducted to find out how interventions of mindfulness, art, tai chi and music reminiscence can help the elderly with mental health problems. Click here to view a video of Prof Kua Ee Heok taking about the study.
Pay heed to the risk factors. 
Immediate Past President of the Gerontological Society of Singapore, A/Prof Goh Lee Gan shared on the Dementia Prevention Program. He called for volunteers to be trained to assist with conducting the program. Click here to view related video of Prof Kua Ee Heok explaining the program.

A briefing session for volunteers on the components of the program. Interested? Please contact Ms Chan Hui Yu at chan_hui_yu@nuhs.edu.sg
The Health component of the program in detail
The same advice for both Malaysians and Singaporeans on how to reduce the risks of getting dementia
With Prof Kua Ee HeokWe hail from the same hometown of Batu Pahat, and share a common interest in dementia. An Oxford-Harvard graduate in psychiatry, Prof Kua has written many books on the subject and is a much sought after speaker on ageing and mental health issues. 

Monday, August 3, 2015

HOGEWEY - A PLACE LIKE HOME FOR THOSE WITH DEMENTIA

Thanks to an unexpected birthday gift of a return air ticket to Amsterdam, I had the opportunity to visit Hogewey Village. It has been on my wish list since I first read about the place two years ago, and watched CNN's Dr Sanjay Gupta's insightful documentary 'Dementia Village'. Now I can happily strike Hogewey off my wish list.

The prime mover behind this innovative concept is co-founder and former nurse Yvonne van Amerongen. I had emailed her earlier requesting permission to visit the facility with Marianne Abbink Lankhorst, my Dutch friend. She wrote back to say we were both welcomed to visit anytime. Excellent!

So there we were at Hogewey on a warm Thursday afternoon of 29 July 2015. Visitors enter and exit via the sliding door which is controlled by the receptionist. The door remains closed to the residents. They are not allowed out of the facility on their own.

We were given a map showing the layout of the place, and several information sheets about Hogewey. We had the freedom to move around and explore but were reminded to respect the privacy of the residents. In other words, no peering into their living quarters or taking their photos without their permission. But we were welcome to use the information and images provided on the Vivium website.

Front view of Hogewey
The homes and the courtyards. So much greenery and flowering shrubs, and benches everywhere.


The Indonesian lifestyle corner. Indonesia was once a Dutch colony.
As we had no access to the homes, this composite image is taken from internet sources. It gives you an idea of the different lifestyle settings. Residents are housed in groups according to the lifestyle they are familiar with. 

Hogewey is the world's first village built specifically for people in the advanced stage of dementia. The concept for it is based on the belief that dementia patients can still enjoy a relatively normal life if they live together with like-minded people in an environment that is familiar to them.

Residents share a common dining room and living room (Images: Daily Mail)

There are currently 152 residents at Hogewey, with six to seven housed in each of the 23 homes. grouped into seven distinct lifestyle settings: urban, homely, cultural, traditional, Gooi (well-to-do), Indonesian and Christian. Residents have their own bedrooms but share a common living room, dining room and kitchen. Each home has one or two staff to look after the residents and do the cooking.

Another view of the homes. 

The staff at Hogewey outnumber the residents 4:1. You will see them as housekeepers, shop assistants and minders, but you won't find them in staff uniform. Volunteers are identified by a nondescript badge they wear. Hogewey takes great pains to avoid any resemblance to a hospital or a nursing home. Instead, it strives to make Hogewey as close as possible to a small gated neighbourhood complete with its own supermarket, cafe, restaurant, beauty salon and theatre. There is a large central square and smaller ones or courtyards with benches and chairs where residents can sit and soak in the sunshine, weather permitting.

(When we were there, there was intermittent rain. That explains why you don't see any residents outdoors in the photos.)

Join me as I take you on a tour of Hogewey.


The main boulevard, with shops flanking both sides.
The cafe is the first outlet you see on your left as you walk along the boulevard.
This is probably where the residents go to work their muscles and limbs.
There's even a repair shop in case anything needs fixing.
Inside the beauty salon. We didn't get to enter so this image is taken from the Daily Mail.
This is The Passage - a spacious hall where the residents gather to enjoy group activities. There is always music playing in the background as the elderly love music from the old days. Expect to see some of them dancing too. We did.


That's Marianne at the door of the Rembrandt Room. This is where the residents enjoy art and craft activities.

The supermarket at Hogewey is well-stocked. Every item carries a price tag. The cashier issues a receipt for purchases but no cash changes hands. All transactions are covered in the residents' payment scheme.


There are no locks anywhere. Doors and elevators open and close as you step on the weight-sensitive floor panel. Residents have the freedom to move around and participate in the daily programme of activities if they wish to. The objective is to make life in Hogewey as normal as possible, and as close to what they are accustomed to.

No need to press any button or turn any door knob. Doors open when you step on the floor panel in front of it.

According to Yvonne in the CNN interview, the concept works. Residents do not need as much medication, they seem happier and are living longer. The Hogewey model has been replicated in Canada, Switzerland and the UK, and that's evidence of its success, aside from the awards it has won since 2010. Apparently those on the waiting list have to wait at least a year before there is a vacancy. That only happens when a resident has passed on. Hogewey is where those with severe dementia come to live out their remaining years in peace and with dignity.



The residents I met while strolling around Hogewey gave me friendly smiles and nods. Except for one resident in a wheelchair cuddling a doll, visitors would not know that the elderly folk enjoying activities in The Passage have Alzheimer's. A group was happily playing a board game, another was setting up pins for bowling.

To the outsider, Hogewey is a microcosm of a make-believe world. But to the residents, it is a reality that is a continuation of life as they know it, in a setting that they are familiar with.

Programme of activities in Dutch, of course.

The burning question readers might want to ask is: How much are the fees? Around USD3600 per resident per month. It's heavily subsidized by the Dutch government, otherwise it would cost upwards from USD8000 a month. At such figures, only the super rich with dementia in Malaysia and Singapore can afford to live out their final days in this utopia.