AMID ALL THE pomp, ceremony and reminiscences surrounding the recent death of Ronald Reagan, not much attention was given to something special the former US president achieved in the last 10 years of his life: he lived out his last years with dignity, despite suffering Alzheimer's disease. This is something few people with Alzheimer's and the other dementias achieve. Many languish for years in institutions, often tied to their beds, or lie at home in soiled clothing and bedclothes because their relatives can't cope with their needs.
According to a survey by the department of psychiatry at the Chinese University of Hong Kong, 45 per cent of Hong Kong people with dementia are living in institutions. With our population rapidly ageing and moderate to severe dementia rates estimated at 4 per cent of people aged 65 or above (about 30,000 people at present), it doesn't take a statistician to work out we are going to run out of nursing home beds very quickly.
'We can't build all the hospitals and care centres needed. We have to train the caregivers,' says the department's head, Professor Helen Chiu Fung-kum.
Which is where the Jockey Club Centre for Positive Ageing comes in. Chiu, who is also the centre's director, feels the solution to quality elderly care lies in this revolutionary project. The centre appears to be a simple low-rise building in the grounds of Sha Tin Hospital. But once inside, it's wide corridors lead to large, bright and airy rooms with groups of elderly people chatting, playing mahjong and other games.
To a casual observer, it seems like a pleasant place to spend the day. But to anyone who has seen inside a typical Hong Kong aged care home, the differences are in the chalk and cheese category. In a standard home, residents suffering dementia are usually bedridden, tied to their beds by 'safety jackets'. If someone with dementia is allowed to walk around , it may well be because his or her condition has not been recognised. Many people, including those looking after the aged, think it is a normal part of ageing to lose your memory and become confused.
Alzheimer's and the other dementias are cruel diseases. The term dementia means out of one's mind - from the Latin 'mens' for mind and 'de' for out. While dementia is a gradual loss of mental functioning, it presents itself in a number of ways. People with dementia suffer loss of memory, loss of concentration, the ability to reason and to recognise places and people. But they may also suffer personality changes. Our ability to control strong emotions such as anger is lost as dementia progresses. Thus some people who were once happy and calm become angry and violent - particularly when frightened or confused. When this happens it's difficult for relatives to deal with this frightening 'stranger'. For many, the solution is to put their relative into an institution.