Saturday, December 25, 2010

Bombay High Court takes suo motu cognisance on News filed by Silver Inning Foundation for Senior Citizens Maintenance Act


It’s good that Honorable Bombay High Court had taken suo motu of the news story filed by Silver Inning Foundation on 13th June 2010 with Maharashtra Times, Maharashtra largest selling Marathi newspaper . The story was regarding long wait for Senior Citizens for implementation of Maintenance and Welfare of Parents and Senior Citizens Act, 2007. In this news we narrated the story of 80-year-old man, who was suffering from Alzheimer, was allegedly cheated by one of his sons over property worth Rs 1 crore. We tried to help the family by taking legal action but due to non implementation of said act the case was taken as normal legal matter and in two years the 80 year old victim died without justice. Had state government implemented the law there could have been speedy justice. The Bombay High Court took the note of The Front page news and converted it into public interest litigation. In this news we had warned government of nationwide protest by senior citizens on 16th august 2010.

This is big victor for Senior Citizens and Silver Inning Foundation. Hope now that the state will act faster to deliver justice to Senior Citizens and Parents who are being abused by their children’s and relative. But its still long way to go.

In June 2010 the State Govt. had framed the Rules and Tribunals have been constituted on 28th Sep 2010 (as informed by govt. to high court). But the state government had not informed the Formation of Tribunals to Senior Citizens, Organization/NGO working with Senior Citizens nor The Joint Action Committee formed on 16th August National Protest Day by all the NGO’s. It’s surprising to see continuous neglect and ignoring NGO’s and organization.


It’s to be seen how the Tribunals are been formed, who are the members, and implantation of the Act as whole.


We had demanded that Senior Citizens NGO’s/Organization and Joint Action Committee members be part of such Tribunals and State and District Council.The NGOS’ ahs to be taken in confidence before Framing, planning and implementation of any act /schemes for Senior Citizens.


This is perfect Christmas and New Year 2011 Gift to our Elders.


Following is the News covered by various News paper (Hindustan Times; DNA; The Times of India ) in Mumbai on 24th and 25th Dec 2010:


Give publicity to senior citizens' tribunals: Mumbai High Court to Maharashtra state:


The state government has been directed to give wide publicity to the special Tribunals and appellate Tribunals, which have been set up under the Maintenance and Welfare of Parents and Senior Citizens Act, 2007. A division bench of chief justice Mohit Shah and justice SJ Kathawalla of the Bombay

High Court directed the government to give wide publicity while hearing a public interest litigation.

The court had taken suo moto (on its own) cognisance of a news article in a Marathi daily on June 13th 2010, which said that an 80-year-old man, who was suffering from Alzheimer, was allegedly cheated by one of his sons over property worth Rs 1 crore. The news article also said the senior citizen would have benefited had the government implemented the provisions of the said Act.

Additional government pleader, Jyoti Pawar submitted an affidavit filed by JN Rathod, deputy secretary, social justice and special assistance department, in pursuant to an earlier high court directive.

The affidavit stated: “The Social Justice and Special Assistance Department is implementing the provisions of the said Act with the help of the Brihanmumbai Municipal Corporation and civic bodies across the state.”

The affidavit further stated that the tribunals and appellate tribunals have been constituted under the said Act on September 28, 2010.

The affidavit added: “The government has constituted a tribunal for each sub division of every district in the state and appointed the concerned sub divisional officers as the presiding officers in the tribunals. Also, appellate tribunals in each districts have been constituted and the concerned district magistrates have been appointed as the presiding officers for the said appellate tribunals.”

The Centre had enacted the Act in Dec 2007.

Hindustan Times:
http://www.hindustantimes.com/Give-publicity-to-senior-citizens-tribunals-HC-to-state/Article1-642569.aspx

DNA:
http://www.dnaindia.com/mumbai/report_publicise-maintenance-tribunals-bombay-high-court_1485405

The Times of India: http://lite.epaper.timesofindia.com/mobile.aspx?article=yes&pageid=5&edlabel=TOIM&mydateHid=24-12-2010&pubname=&edname=&articleid=Ar00507&format=&publabel=TOI

Thursday, December 23, 2010

Country versus city : older adults who live in rural areas feel safer

Older people residing in rural areas could outrank their city dweller peers when it comes to social connectedness because they reap the health and social benefits associated with living in a small, relaxed and connected country community.

A new report from National Seniors Australia suggests that older adults living in the country may be better off than those living in the big smoke, while the number of older people living in rural communities continues to rise.

The report, Getting Involved in the Country: Productive ageing in different types of rural communities, found that, in general, older adults who live in rural areas feel safer, have a high level of social connectedness, enjoy more social interaction and have a high sense of trust toward others.

The organisation’s general manager of policy, Peter Matwijiw, commented that the research findings challenge typical assumptions about older rural residents being socially isolated.

“What we’ve show here is that older people in country areas aren’t being left behind and, [as a generalisation], are far from being depressed and lonely, as a large proportion of older people say that they go out of their way to give something back to their community,” said Mr Matwijiw.

Community participation, he said, depends on an older person’s health status, lack of opportunities, or lack of time.

“If there are opportunities and the older person is quite well, they will actually choose to participate and enjoy the activities that have meaning for them.

“It is about recognising that older people are willing to participate in the community and will develop and maintain community connections because they enjoy doing it and are willing to do it.

Mr Matwijiw stressed how important it is for aged and community care providers to recognise what motivates an older person to get involved in their community activities, so that they can then supply the right balance of services for the socially isolated.

“If health does restrict a person from participating, can we do something to improve their health? Can we do something about improving their mobility by providing innovative transport options in country areas?

“With the broadband network, do we know whether the broadband network will increase a person’s ability to participate in the community?

“If people do want to give back to their community, are there many ways of assisting them to get involved.

The research aimed to develop a better understanding of productive ageing in three different types of rural communities in rural Victoria.

The report also found that older people were the real driving forces in rural communities.

“By participating they are also contributing to a very important part of their rural community in terms of giving it some heart and soul.

“We do underestimate their value very much. But the issue comes back to making sure that there are options and opportunities for older people in rural areas. It’s important to make sure that they can participate in their community if and when they choose to do so.”


Source: Country versus city - Australian Ageing Agenda: Aged Care and Retirement Industry News and Issues

Sunday, December 19, 2010

108-year-old raped by neighbour and then Victim starves self to death


One more case of Elder Abuse, there is increase in Atrocity against Senior Citizens in India -the country of so called ‘Joint Family’ & Culture and Tradition. See this way we treat our Elders. Its Abuse of Human Right. A Human Right Violation against Human Being, but our Government is mute spectator, NO LAW TO STOP ELDER ABUSE. NO organized mass civil society movement to STOP Abuse AND Neglect of Our Elders.

My Heart Bleeds whenever I come to know about Elder Abuse, REQUEST ALL SOCIAL ACTIVIST , SENIOR CITIZENS , ORGANISATION WORKING FOR & WITH SENIOR CITIZENS , HUMAN RIGHT ACTIVIST TO COME AHEAD and STOP ELDER ABUSE.


Government should take action on concern Police Station, SP Police , District Collector ;whenever there is any such incident occurred.

A bed-ridden 108-year-old woman was allegedly raped by her son’s friend at home in Jabalpur town when the rest of her family was out shopping on December 4. The crime was disclosed to HT on Friday by the president of the Jabalpur unit of the Mahila Congress after she took up the matter with Madhya Pradesh director general of police SK Rout in Bhopal.

The accused, Gopi Ahirwar, 45, a waiter in a hotel, lives in the same locality of Sita Pahad in Jabalpur cantonment and was a regular visitor to the victim’s home.

The victim, whose son is a daily wager, lives in the servant’s quarter of an army officer’s house. The victim’s granddaughter said, “As usual, we left the door open before leaving for the market that day as neighbours and relatives often visit our house to see my grandmother.”

The victim’s son said Ahirwar, who was drunk, bolted the door from inside. “As soon as he came out, our neighbours got suspicious and apprehended him.” The victim’s family rushed her a private hospital nearby but the doctors refused admission, claiming they wouldn’t be able to stop the excessive bleeding. She was then taken to a state government-run hospital, from where she was discharged on Monday.

Cantonment police station in-charge Mithlesh Sharma said the accused has been charged with rape and sent to jail.

Source: http://www.hindustantimes.com/108-year-old-raped-by-neighbour-in-Jabalpur/Article1-639769.aspx


108-yr-old rape victim starves self to death


The 108-year-old woman, who was raped by her son's friend at her home in Jabalpur, allegedly starved herself to death late on Friday night. Her son said since she had no medical complications before the assault, death must have come because "she stopped taking food and water since the incident took place".

Jabalpur district police chief Santosh Kumar Singh told HT that further action would be decided after getting the autopsy report. The police sent the body for autopsy on Saturday morning.

On December 4, Gopi Ahirwar (45), a waiter who lives in the same locality and was a regular visitor, entered the house while the family was out on shopping and raped her.The victim's daughter said the door to their home was always open as friends and neighbours often dropped in.

The victim's family initially did not want the autopsy done, but the police convinced them to get it done saying that it was necessary to find out whether she died because of the assault or prolonged illness.

A senior police official involved in the investigation said on condition of anonymity: "As she was discharged from the hospital on Monday, it is difficult to ascertain the actual cause of her death."

Source
: http://www.hindustantimes.com/108-yr-old-rape-victim-starves-self-to-death/Article1-640097.aspx

Saturday, December 18, 2010

Making difference to work with Dementia & Alzheimer's

Sailesh Mishra gave up his well paid marketing job in the corporate sector in 2004 to work full-time in the area of elder care, Alzheimer’s and development of less fortunate children. He is based in Mumbai. Because of his passion to work with elders he has started a social enterprise, Silver Innings, and later formed an NGO called Silver Inning Foundation, and also began a forum called People for Social Cause. Sailesh is actively involved with ARDSI and is Founder Sec. of ARDSI Greater Mumbai Chapter. He is also a consultant and advisor to other NGOs.

Sailesh utilizes his marketing and PR skill to market the issues of our elders through various forums and ICT /social Media. In this way he tries to reach the young and the old to sensitize and empower civil society with regards to elder care. As he works in elder care, he is very concerned about dementia and conducts regular awareness programs for it. He describes some of his experiences in the interview below.

For whom do you conduct these awareness programs?

Every year, in September, we go in for highly visible programs for a week to coincide with the World Alzheimer’s Day function. But this is not enough for the “Fight against Dementia.”

In addition to that, we try to arrange programs all through the year at various locations over Mumbai. Our target audience is mainly the elderly and their family members.

To effectively reach this audience, we work through local associations that have a sizable number of senior citizens, such as senior citizen clubs, bhajan mandals, and mahila samitis. Many of these associations are part of FESCOM (Federation of Maharashtra Senior Citizens), and our organization, Silver Inning Foundation, is also a member of this federation.

Many associations are very active and meet every week or every month. We volunteer to come for these meetings and present topics related to the elderly. We get audiences that range from 20 persons to as many as 120 persons.

Please describe the structure of your program.


Typically, our program spreads over two hours.

We use the first hour for an interesting audio-visual presentation where we explain Alzheimer’s and dementia to the audience. This includes showing them the excellent story prepared by Dr. Samuel which describes a case of an old lady who starts showing the symptoms of dementia.

The next hour is reserved for audience questions. If some of the persons present are interested, we also conduct a mini-screening for them. We also distribute reading material to the audience, and set up any further meetings for those who want them.

What are your observations regarding awareness of dementia?


The programs confirm the fact that awareness of dementia and Alzheimer’s is very low in India.

Some people do not understand what “Alzheimer’s” is. Given that the name does not sound Indian, they think that this is some problem/ disease found only in the Western countries and has nothing to do with India. Many have never even heard the name.

On the other hand, there are others who think that this is something really horrible, worse than AIDS, and they are very frightened of the name. Such people even hesitate to attend the talks. You know that there is stigma attached to anything people consider a mental disease.

Poor awareness is very unfortunate, because awareness is essential for early diagnosis, and this lack of awareness delays any help the patient or family can get.

As our focus is to reach out to as many elders as possible, we present dementia in the context of topics that concern elders, so that the audience is able to understand and participate effectively.

When you explain dementia to an audience of the elderly, do some of them get concerned that they may have dementia?

Yes, this is a common issue we address.

Everyone occasionally forgets things. Many members of the audience are concerned about whether their memory loss is a sign of dementia. We explain the difference between the memory loss that is normal, and the memory loss that is indicative of dementia. For example, many of us misplace our keys, but we are able to remember later where we put them, and such forgetting is normal. The memory loss found in dementia is more severe and affects the ability to do things. It is the behaviours and personality changes that make the situation worse.

While explaining the various warning signs of dementia, we also emphasize that we are not doctors. Our role in these programs is to spread awareness, and not to diagnose whether or not a member of the audience (or their relative) has dementia. Definitely, we are not authorised to label someone as a dementia patient. For people facing problems, we encourage them to contact the nearest psychiatrist if they (or their family members) display any of the symptoms we have discussed.

We are very clear that no one should assume that someone has dementia and “label” a person as a patient without proper diagnosis. We suggest that people consult a doctor, and maybe take a second opinion, to get a diagnosis. We have with us an area-wise list of Mumbai psychiatrists that people can use, depending on the locality where they stay.

We also caution people from consulting too many doctors, or changing doctors in the hope that there will be a cure. There is no cure for dementia.

How does the audience respond to the fact that there is no cure for dementia?


Most of our audience is in the age-group of 60 to 70, and when they hear dementia described, and also hear that there is no cure, this can be very frightening for them. In fact, we have seen many families even ignoring the problem. They don’t give medicine as it does not help, and many of them want to put the person with dementia into an old age home.

So they ask: how can dementia be prevented?

While there is no definitive way to prevent dementia, there are things that elders can do to remain active and healthy. We explain many such ways to the audience. Here are some of the suggestions we make:

* Do activities that keep the mind active, such as the puzzles and crosswords that come in the newspapers
* Continue to do things that you did earlier, before retirement. For example, if you were an accountant, continue to maintain your home accounts
* Do volunteer work to remain active and useful, and to meet people
* Have an active social life
* Maintain your health by exercise and healthy food habits

One very important way of stimulating the mind is to do something that is different from what one is used to doing. For example, if someone drinks tea every morning, that person can drink nimbu pani on a few days instead, or have coffee. If someone is used to climbing by putting the right foot on the step, he/ she can try using the left foot first instead. We also teach many small exercises, such as rubbing hands, to stimulate the brain. We also describe alternate therapies that elders find useful, such as music therapy, and reflexology. There are many such tips, and I suggest you attend a meeting to hear more about them. In fact, people are interested in music therapy specially the Indian spiritual one.

What are the other common concerns you encounter?

In some cases, some members of the audience already have a patient at home. Their questions are related on how to handle challenging behaviour. Common examples of behaviours that stress family members are when a patient repeatedly insists that he/ she wants to go to the toilet, or keeps asking the same question again and again.

We explain various caregiving methods for communication and for handling difficult behaviour.

One thing we make sure we tell people is that love and care is the only medicine for the person and the family. Also we try to explain to them that there is life after Alzheimer’s–because people can still sing, dance and enjoy life. This positive side was explained to us by Prof Cathy Greenblat.

You had mentioned that you also distribute material to the audience. Could you tell us about that?

Yes, we distribute material and also do various follow-up. Our awareness programs are not just talking about dementia for a couple of hours; we see our role as resource persons in this area.

The booklet we distribute explains the ten warning signs of dementia and has Mumbai specific resources, such as helpline numbers, and other resources that people may find useful.

In fact, in the next few months, we are launching India’s first Elder Resources Director – ‘Mapping Of Services’ for Elders for Mumbai MMRDA area. This will be a boon for many Senior Citizens and their family members.

Sometimes we also coordinate with other concerned organizations so that a one-minute screening is made available as part of the awareness program. While this is not sufficient or rigourous enough for a diagnosis, it helps the audience get a better understanding of what dementia symptoms are, and to decide whether to go to a doctor.

We also have a list of psychiatrists for each area that people can use to identify the doctor to consult.

Sometimes, some of the audience members are not comfortable talking to us in front of others. In case they want to discuss more about their specific concerns (or concerns related to someone else at home) we also do follow-up home-visits at a nominal cost.

One major need people have is that of trained attendants for patients at home. While we are not in a position to provide such attendants, we do give people the contact for various bureaus in Mumbai that supply attendants.

We also offer to train family members and attendants on caregiving for dementia patients.

We hope that with such programs, awareness of dementia will increase and people will be able to get diagnosed earlier and get help for both the patients and their families.

Silver Innings is working towards creating Elder Friendly World where Ageing becomes a Positive and Rewarding Experience.

Thank you, Sailesh.

Sailesh can be contacted at his e-mail:silverinnings@gmail.com and via Silver Innings and through his forum, People for Social Cause Blog (links: http://peopleforsocialcause.blogspot.com and http://silverinnings.blogspot.com/ ). He can also be approached via Facebook and Twitter.


By Swapna Kishore

Source: http://dementia-care-notes.in/sailesh-interview/

Monday, December 13, 2010

The Punjab government promised to set up a State Senior Citizens Council

The Punjab government will set up a State Senior Citizens Council to ensure social security of elderly persons, safeguarding their rights and help them lead a life with self-respect and dignity.

Punjab Chief Minister Parkash Singh Badal said this while inaugurating the Punjab Federation of Senior Citizens Association at Shivalik Public School auditorium in Phase VI, Badal, in Mohali on Saturday.

He said the proposed council will guide the government to prepare a comprehensive policy for the welfare of senior citizens, which was the most respectable section amongst the society.

Referring to the delayed payment of pensions, the CM said the government will soon create a dedicated fund of Rs 500 crore to enable the beneficiaries to get pension in time. He said the government has already initiated tie-ups with nationalised banks for disbursement of pension at the doorsteps of the beneficiaries.

Agreeing to the proposal of the Federation to depute a senior police officer of inspector general (IG) as a nodal officer at the state-level to look into the issues of senior citizens, especially related to their safety and personal security, the octogenarian CM ordered deputation of deputy inspector generals (DIGs) in their respective police ranges and superintendents of police (SPs) in the districts as nodal officers to ensure personal security of the elder persons.

He said Punjab was among the few states to adopt the Maintenance and Welfare of Parents and Senior Citizens Act, 2007, to ensure social security to the senior citizens, who had been neglected by their children in the old age. He said rules under this Act would be notified shortly and reiterated that the Act would be enforced strictly.

He also announced that senior citizens would be given due representation in the district committees constituted for implementation of various development projects and welfare schemes. Apart from this, Badal declared to set up a day-care home for senior citizens in Sector 68, Mohali, besides an old age home over a two acre plot already allotted by GMADA in the district.

The CM assured he would soon convene a meeting of the representatives of the Federation to chalk out a strategy to further streamline the welfare schemes for senior citizens. He called upon senior citizens based in urban area to come forward for social service, especially in rural areas in the field of education, health and sanitation, as they had a rich and vast experience, from which the society could be immensely benefited.

He said talked of the state-of-the-art old age home at his native village Badal and invited the Federation to hold its next meeting there.

On the occasion, he unveiled the logo of federation and released its maiden souvenir dedicated to the founder chairman of Punjab State Senior Citizens Association and former Chief Secretary of Punjab late.

By P S Vaishnav

Source: http://www.indianexpress.com/news/punjab-to-set-up-council-for-senior-citizens-soon-badal/573632/0



31st Jan 2010

Wednesday, December 1, 2010

South Korea declares "War on Dementia": Children Ease Alzheimer’s in Land of Aging


They were stooped, hobbled, disoriented, fumbling around the house. They got confused in the bathtub and struggled up stairs that seemed to swim before them.

“Oh, it hurts,” said Noh Hyun-ho, sinking to the ground.

“I thought I was going to die,” said Yook Seo-hyun.

There was surprisingly little giggling, considering that Hyun-ho, Seo-hyun and the others were actually perfectly healthy 11- to 13-year-old children. But they had strapped on splints, weighted harnesses and fogged-up glasses, and were given tasks like “Doorknob Experience” and “Bathroom Experience,” all to help them feel what it was like to be old, frail or demented.

“Even though they are smiling for us, every day, 24 hours, is difficult for them,” Jeong Jae-hee, 12, said she learned. “They lose their memory and go back to childhood.”

It is part of a remarkable South Korean campaign to cope with an exploding problem: Alzheimer’s disease and other dementia's. As one of the world’s fastest-aging countries, with nearly 9 percent of its population over 65 already afflicted, South Korea has opened a “War on Dementia,” spending money and shining floodlights on a disease that is, here as in many places, riddled with shame and fear.

South Korea is training thousands of people, including children, as “dementia supporters,” to recognize symptoms and care for patients. The 11- to 13-year-olds, for instance, were in the government’s “Aging-Friendly Comprehensive Experience Hall” outside Seoul. Besides the aging simulation exercise, they viewed a PowerPoint presentation defining dementia and were trained, in the hall’s Dementia Experience Center, to perform hand massage in nursing homes.

“ ‘What did I do with my phone? It’s in the refrigerator,’ ” said one instructor, explaining memory loss. “Have you seen someone like that? They may go missing and die on the street.”

In another striking move, South Korea is also pushing to make diagnoses early, despite there being scant treatment.

“This used to be hidden” and “there is still stigma and bias,” said Kim Hye-jin, director of senior policy for the Health and Welfare Ministry. But “we want to get them out of their shells, out of their homes and diagnosed” to help families adjust and give patients “a higher chance of being taken care of at home.”

Hundreds of neighborhood dementia diagnostic centers have been created. Nursing homes have nearly tripled since 2008. Other dementia programs, providing day care and home care, have increased fivefold since 2008, to nearly 20,000. Care is heavily subsidized.

And a government dementia database allows families to register relatives and receive iron-on identification numbers. Citizens encountering wanderers with dementia report their numbers to officials, who contact families.

To finance this, South Korea created a long-term-care insurance system, paid for with 6.6 percent increases in people’s national health insurance premiums. In 2009, about $1 billion of government and public insurance money was spent on dementia patients. Still, with the over-65 population jumping from 7 percent in 2000 to 14 percent in 2018 to 20 percent in 2026, dementia is straining the country, socially and economically.

“At least one family member has to give up work” to provide caregiving, said Kwak Young-soon, social welfare director for Mapo District, one of Seoul’s 25 geographic districts. Because South Korea encourages people to work well past retirement age, families may also lose dementia sufferers’ incomes.

Most families no longer have generations living together to help with caregiving, and some facilities have long waiting lists, but “we can’t keep building nursing homes,” Mr. Kwak said. “We call it a ghost. It’s basically eating up the whole house.”

Dementia Epidemic

South Korea is at the forefront of a worldwide eruption of dementia, from about 30 million estimated cases now to an estimated 100 million in 2050. And while South Korea’s approach is unusually extensive, even in the United States, the National Alzheimer’s Project Act was introduced this year to establish a separate Alzheimer’s office to create “an integrated national plan to overcome Alzheimer’s.” Supporters of the bill, currently in committee, include Sandra Day O’Connor, whose late husband had Alzheimer’s.

South Korea also worries that dementia, previously stigmatized as “ghost-seeing” or “one’s second childhood” could “dilute respect for elders,” Mr. Kwak said. “There’s a saying that even the most filial son or daughter will not be filial if they look after a parent for more than three years.”

So the authorities promote the notion that filial piety implies doing everything possible for elders with dementia, a condition now called chimae (pronounced chee-may): disease of knowledge and the brain which makes adults become babies. But South Korea’s low birth rate will make family caregiving tougher.

“I feel as if a tsunami’s coming,” said Lee Sung-hee, the South Korean Alzheimer’s Association president, who trains nursing home staff members, but also thousands who regularly interact with the elderly: bus drivers, tellers, hairstylists, postal workers. “Sometimes I think I want to run away,” she said. “But even the highest mountain, just worrying does not move anything, but if you choose one area and move stone by stone, you pave a way to move the whole mountain.”

South Korea is even trying to turn a crisis into a business opportunity. The Aging-Friendly hall, financed by the Ministry of Knowledge Economy, encourages businesses to enter “silver industries,” producing items for feeble elderly people, from chopsticks that are easier to pick up to automated harnesses that hoist people from bed, sliding along a ceiling track, and deposit them onto toilets or living room couches.

College students visit the hall and don blue 3-D glasses for “Dementia Experience” video journeys following people disoriented on streets or seeking bathrooms.

Throughout South Korea, Mrs. Lee leads “dementia supporter” training, arguing against longtime practices of chastising or neglecting patients, and advocating for preserving their skills and self-esteem.

One tip: give demented relatives “a washing pan and washboard” and say, “ ‘The washing machine’s terrible — we need your help’ ” washing clothes, she told 200 senior citizens interested in nursing home jobs or family caregiving advice. If patients say, “ ‘I’m good at making soy soup,’ but forget ingredients,” guide them step by step, she advised. Otherwise, “They may make it into salt soup, and everyone will say, ‘Oh, this is terrible, you stop doing it.’ ”

Even the youngest are enlisted. Mr. Kwak, the local government official, arranges for nursery school classes to play games with nursing home patients, saying that it destigmatizes dementia and that patients who “regress to earlier days” may “find it easier to relate to young children.”

And Dr. Yang Dong-won, who directs one of many government-run diagnostic centers in Seoul, has visited kindergartens, bringing tofu. “This is very soft, like the brain,” he said, letting it crash down. Now, “the brain is destroyed.”

“Dementia is very bad for you, so protect your brain,” he said, with exercise, “not drinking too much sugar,” and saying, “ ‘Daddy, don’t drink so much because it’s not good for dementia.’ ”

At a Dementia March outside the World Cup Soccer Stadium, children carried signs promoting Dr. Yang’s Mapo district center: “Make the Brain Smile!” and “How is Your Memory? Free diagnosis center in Mapo.”

The Mapo Center for Dementia perches at a busy crossroads of old and new, near a university and a shop selling naturopathic goat extracts. It has exercise machines out front and a van with pictures of smiling elderly people.

Even people without symptoms come, Dr. Yang said. They are “eased by hearing, ‘You do not have dementia and can visit two years later.’ ”

Cha Kyong-ho’s family was wary of getting him tested. “Dementia was a subject to hide,” said his daughter, Cha Jeong-eun. “I worried his pride would be hurt going through this kindergarten experience.”

But when “my mother asked him to get ingredients for curry rice, he came back with mayonnaise,” she said. And one day, Mr. Cha, 74, a retired subway official, could not find his way home. “I was like, ‘Where the hell am I?’ ” he said.

Ultimately, he visited Mapo’s center, finding the testing challenging.

“Sometimes I don’t remember what I read, or I can see it with my eyes and my brain is processing it, but I cannot say it out loud,” he said about the questions. “How can my brilliant brain remember everything? Jeez, it’s so headachy.”

Checking his ability to categorize items, Dr. Yang asked, “What do you call dog and tiger?”

“I call them dog and tiger.”

“Pencil and brush?”

“Oh, there’s a word for that.”

“Airplane and train?”

“I feel embarrassed I don’t know.”

“You have a lot of loss of memory,” Dr. Yang said. “This is the very beginning stages of Alzheimer’s disease.”

He suggested that Mr. Cha get a government-subsidized brain M.R.I. to confirm the diagnosis, and said drugs might delay symptoms slightly. He recommended Mapo’s free programs “to stimulate what brain cells he has.” These include rooftop garden “floral therapy,” art classes making realistic representations of everyday objects, music therapy with bongos sounding “like a heartbeat.”

Mr. Cha sighed.

“I think,” he said, gesturing toward his brain, “that something’s wrong with this, just a little bit.”

Students as Helpers

Schools offer community service credit, encouraging work with dementia patients, whom students call grandmas and grandpas. Teenage girls do foot massage at the Cheongam nursing home, which is run by Mrs. Lee, the Alzheimer’s Association president, for women without sons to care for them. (In South Korea, sons’ families traditionally shoulder caregiving responsibilities.) During one massage session, 16-year-old Oh Yu-mi rubbed a patient’s toes, saying: “I’m doing the heart. The heel is the reproductive system. It will help them excrete better.”

Another girl doing foot massage, Park Min-jung, 17, was shaken to realize that dementia could explain why her grandfather recently grabbed a taxi and circled his old neighborhood seeking his no-longer-existent house. “He used to be very scary to me,” she said, but training made her feel that “I can do things for him.”

A patient wept as the girls left, upsetting 16-year-old Kim Min-joon, the massage group’s leader. She said social workers suggested being less effusive to patients, so the girls’ leaving would be less traumatic: “If there is love or affection of 100 grams, cut it up into 1 gram each” and distribute it over “100 visits, not all at once.” But “I’m not good at controlling that,” Min-joon said. Even at school, “The feeling of their touch remains with me.”

A boys’ high school selects top students to help at Seobu Nursing Center, doing art therapy and attempting physical therapy with dances and “balloon badminton” (the racket is pantyhose stretched on a frame). The boys write observations to help Seobu adjust programs.

At school, they wrote questions on the blackboard: “Problems and solutions of communicating with the elderly. Ways to improve and execute exercise routine. How to make sure we’re all on time.”

“They don’t comprehend my words,” said Kim Su-hwan, 16.

“Maybe we should get closer to their ears,” suggested Kim Jae-kyeum.

Maybe “some of us could massage them,” said Su-hwan. “You do that, Su-hwan,” snickered Jae-kyeum.

“Smile at them more,” another student said. “Some of us look like we don’t want to do this.”

For Kim Han-bit, 16, the program is intensely personal. Han-bit was 13 when his grandmother, who practically raised him, got Alzheimer’s, and “I would just feel it was annoying and walk out of the room,” he said. “She would ask to do an activity, and I would say, ‘What business do you have doing that?’ It was my responsibility to feed her, give her drinks, wash her face. But I even resisted and fought back,” he said. When she died, he added, “I couldn’t let out tears.”

The dementia caregiving program had made him “wonder why I wasn’t able to do that with my own grandma, and I think I should do better in the future to compensate for all my wrongdoing,” he said. “I could have taken care of my grandmother with a grateful feeling. If only I could have.”

Recently, he worked to engage Lee Jeong-hee, a patient half his height with missing teeth who laughed, but spoke incoherently.

“When I come next time,” he said tenderly, “please remember me.”


Su-Hyun Lee contributed reporting from Seoul, South Korea.


This article has been revised to reflect the following correction:

Correction: November 25, 2010

An earlier version of a photo caption with this article misidentified the location where a student was bowing in a hallway. The photo was at the Seobu Nursing Center, not the Mapo Center for Dementia in Seoul.


Source: http://www.nytimes.com/2010/11/26/health/26alzheimers.html?_r=1&hp=&pagewanted=all

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