More therapists 'may ease negative impact of dementia'

(Above, from left) Mr Taib Sany, 82, Madam Kwek Lee Khoon, 84, Madam Wendy Ow and her mother, Madam Chia Yin Peng, 88, during a music session at SACH last month. (Left) Ms Anna Lee made a patient an overcoat full of things like buttons and strings that he could fiddle with instead of pinching himself.

With 300 to 400 more occupational therapists, Singapore might be able to "significantly" reduce the negative effects of dementia in its rapidly ageing population.

Dr May Lim, who lectures on occupational therapy at the Singapore Institute of Technology (SIT), said international figures show that four in five people suffering from mild cognitive impairment progress to dementia in six years.

But stimulation and exercises designed by an occupational therapist to suit the individual's needs could delay the progression by as much as five years.

The SIT will be introducing Singapore's first degree courses for occupational therapists and physiotherapists next year in a move to raise preventive care standards and keep more people out of hospitals.

Occupational therapists could also help dementia sufferers retain their ability to function even while their brains degenerate.

Dr Lim says patients can be taught how to cope with their failing memories, such as by labelling cupboards for people who have difficulty remembering where they store things.

There are also helpful devices that occupational therapists can prescribe for different purposes, such as for cutting off gas supplies, or playing a family member's voice telling them it is still night and to go back to sleep should they wake up confused in the middle of the night.

Getting dementia patients to carry on doing things helps them maintain their ability to function, so Dr Lim said that having a maid do everything for them could result in a more rapid decline.

Instead, patients with mild dementia should be encouraged to plan and even cook meals with the help of the maid.

"Don't stop them from doing things just because they are old and forgetful," she said.

Occupational therapists are trained to assess and recommend what is best for a particular patient as the solution may be different in each case.

Dr Lim said they first find out what is important to the person, then try to help them achieve their goal.

They can also help people with more severe dementia so that they are easier to care for.

It is not uncommon for a dementia sufferer to become agitated. But they might do so for different reasons.

Dr Lim recalled how a patient would get agitated about 30 minutes before lunch every day due to her low blood sugar levels. The therapist suggested giving her lunch earlier, which solved the problem.

A patient at Saint Andrew's Community Hospital's (SACH) dementia centre would spend a lot of time pinching himself to the point where his arm was full of scabs.

Ms Anna Lee, SACH's principal occupational therapist, made him an overcoat full of little things like buttons and strings that he could spend his time fiddling with instead.

SACH also has puzzles, interactive games and pictures of old Singapore that help such patients connect or be entertained.

It has a 35-minute interactive video - in English, Malay and three Chinese dialects - that takes the form of a visitor having a chat with the patient, with nods, pauses and singing of simple old songs together, which reduces frustration among older patients.

Madam Wendy Ow, 59, said her mother, who has dementia, enjoys her weekly session at SACH's dementia clinic, adding that it is the only time she is active and connected.

"She is really happy doing things here," said Madam Ow.

This article was first published on May 04, 2015.
Get a copy of The Straits Times or go to for more stories.