Helping dementia patients to help themselves

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A side view of the TEC at Trinity Methodist Church at Jalan Ellis.

A side view of the TEC at Trinity Methodist Church at Jalan Ellis.

ONCE a week, they are asked to prepare their own lunch with the help of the caregivers.

Some peel garlic, slice onions and vegetables while some prepare the other ingredients. Those with culinary skills will help the nurses and the care-staff with the cooking.

This is part of the therapy the elderly residents go through at the Trinity ElderlyCare Centre (TEC) at Ellis Road here.

“We prepare the lunch and cook together with the elderly only once a week while the rest of the day, we get their lunch from the caterer.

“We do this to give their hands and fingers some light exercise” TEC manager Lee Mee Ling said.

The Centre, which is affiliated to Trinity Methodist Church, provides a safe, nurturing, family  atmosphere that recognises the value of the individual.

It is an integrated day-care facility designed for the elderly who may require constant supervision due to their physical or cognitive limitations.

Situated on a half-acre land next to the Church, the Centre is a non-profit charity, accessible to people of all races and religions.

It is open to senior citizens 55 years old and above who are widows or widowers, convalescents, suffering from dementia and needing mobile assistance but not bedridden.

The Centre has well-rounded programmes with scheduled activities and exercises throughout the day.

Lee said the elderly residents would be provided with services such as nursing aid, physiotherapy and occupational rehabilitation.

They would also go through social activities that help foster mental and physical stimulation, she added.

These activities include interacting with the kindergarten pupils inside the compound and some games.

Every programme will be supervised by trained personnel comprising Lee herself, four staff nurses, two care-staff and one head nurse or sister.

“Our day care services include a lunch and two tea time breaks, scheduled rest period and personal hygiene,” Lee explained.

In addition to individualised supervision, she said, the Centre also provided assistance and daily activities for physical, psychological, social and spiritual development.

Lee shows exercise equipment for the use of residents at the Centre.

Lee shows exercise equipment for the use of residents at the Centre.

Reading news chat

She revealed that for mental or intellectual stimulation, the staff would lead and guide the residents in reading news chat to update them on the latest issues.

“Reading news chat is normally done in the morning. We also conduct learning sessions where they are asked to do some simple calculations to stimulate their minds.”

Lee said residents were also guided and supervised for light exercise such as morning walk and therapy through simple games.

The walk is normally held between 9.30am and 11am within the compound or the area along the Centre’s balcony.

The simple games involve passing the ball and throwing small sand bags bought from Taiwan.

“The physical exercise we give them is from the top to the bottom, depending on their ability, of course.

“Some are mobile, some independent, some moody and so on. So we have to convince them gently to join the exercise and games,” she added.

In between these activities, the residents may undergo vocal, foot, clay and art therapy as well as physiotherapy.

Lee said every programme was prepared to enable everyone to enjoy their stay and time at the Centre.

“Our main purpose of having the well-designed programmes is to refill the residents with new ideas, new memory — at the same time, allowing them to  enjoy the activities.”

Presently, 26 residents are registered at TEC on daily basis. They are between 60 and 93, and include four males. Most are sent to the Centre in the morning and picked up in the evening by their working family members.

No child’s play

Providing care to the elderly residents, however, is no child’s play, especially when they have dementia.

Lee said to help them, empathy, not patience, was needed.

It is generally believed one needs to be more patient when dealing with dementia patients, but for Lee, patience is not enough.

“There is a limit to patience – so the most important is empathy,” she stressed.

“If we have the ability to understand the person with dementia and share his or her feelings, then we know what to expect  from the person.

“For example, we cannot ask why a person with dementia cannot finish his food today but we can only encourage him to do so because it is important for him,” she explained.

Lee said apart from the challenges of looking after dementia patients, the caregivers normally did not have much problem taking care of the elderly.

Most of the residents at the Centre are dementia patients.

Meanwhile, studies have suggested almost all dementia patients show some changed behaviour because of various reasons.

Patients may react in an unusual way because they do not understand what is happening. They may have unmet needs.

They may be frustrated because they cannot communicate.

They may not be able to handle their emotions and may act in socially inappropriate ways.

Dementia patients face problems in understanding the environment, doing  things and communicating.

Patients are sometimes unable to explain what they want. In fact, they are not even clear about what they want, being overwhelmed and frustrated.

A folded-rest bed for the elderly to take a nap in.

A folded-rest bed for the elderly to take a nap in.

Aware of challenges

Lee said all TEC staff were well aware of the challenges involved in taking care from dementia patients.

She said at the Centre, the care-staff could  not expect more from the patients than what they were capable of otherwise the patients could be affected.

“That’s why I say empathy is most important. Here, we all try to understand the patients and use whatever knowledge and abilities we have  to empathise with their behaviour.

“We cannot expect residents with dementia to understand things like we do because they are already facing cognitive problems.”

Lee said when some potentially harmful behaviour was spotted, certain measures would be adopted to reduce it.

She admitted that while caring for dementia patients could be stressful and frustrating,  the caregivers, however, would not allow themselves to be affected by the behaviour of some residents.

“Yes, sometimes they can be very good but sometimes they can be angry and nasty over little things or when we want them to take part in various therapies.

“We cannot retaliate with anger but face it calmly and do the best to placate them,” she said.

Some of the art works the elderly did with the volunteers.

Some of the art works the elderly did with the volunteers.

Supportive and understanding

However, Lee said they were lucky in that all the family members of the elderly and dementia patients at the Centre were very supportive and understanding.

She added that she would inform family members of any negative behaviour so that they could help to advise the patients at home.

“So far, they (family members) have been very supportive, cooperative and happy with the positive development they see

in their parents (suffering from dementia.)

“From the feedback we got, these parents have become helpful at home, clearing the dustbins, washing the dishes and cleaning the tables since going through the programme at the Centre.”

She said family members were normally briefed on the programmes and activities before they registered their parents at TEC.

The residents, she added, were also given nap hours between 12 noon and 2pm every day.

One of the misconceptions some people have of elder-care venues is that they are places where nothing much happens beyond feeding the clients and helping them to the toilet.

It is not the case in TEC where patients are cared for mentally, physically and socially to slow down their deterioration in any of these areas.

Lee said the activities designed for the residents may give them confidence to try new things.

“We guide and supervise patients in doing photo frames with papers, flowers with clay and many other arts, including colouring.”

She noted that most of the residents were mobile and able to do creative work and mental stimulation exercises such as doing simple arithmetic and playing chess.

“Of course, there are some who appear to give up on life. They are reluctant to participate in this and that, saying they are just waiting for their time to come.

“Some feel they are being bullied but when persuaded and encouraged nicely, they usually cooperate and join in.”

Lee said volunteers and students were welcome to help in some of the social and mental stimulation therapies.

This, she added, was in line with TEC’s goal: Think of elders’ needs always and treat them with utmost respect and dignity; Establish continuously an atmosphere of warmth, comfort and security for the elderly; Concern for elders’ spiritual needs, growth and parent-child relationship.

A clean and safe balcony walkway for light exercise.

A clean and safe balcony walkway for light exercise.