Au adds that many Hong Kong people are busy and may leave their parents to domestic helpers. She says the problem is that some of these helpers may lack the relevant experience and training in looking after the elderly, let alone in taking care of their emotional needs.
However, Jess Leung Lam-ming, an experienced psychiatrist, emphasises that the signs of depression in the elderly are actually easy to spot. It just takes a person familiar with the elderly person to spend a good amount of time with them. “The daily activities of the elderly are in fact good indicators of mental problems, such as a change in sleeping habits, loss of appetite, weight and interest, negative thinking and a reluctance to leave home.”
Depression in the elderly can be triggered by both physiological and psychological factors. The former includes a sudden occurrence or onset of illness, such as a stroke or heart attack, and other illnesses that cause pain to the patient, while the latter includes the death of a lifelong partner or close relatives.
Leung recalls the case of one of her patients, a man in his 70s, who almost killed himself due to serious depression that was undetected. After his partner died, the old man lived alone and not with his children. He suffered from various physical ailments that left him in pain and affected his ability to take care of himself. One day, he suddenly stabbed his stomach with a knife, not just once but several times. Fortunately, he survived the incident, but it could have been avoided if his family members had paid more attention to his mental state.
In fact, Hong Kong has one of the highest elderly suicide rates in the world, with 25 cases per 100,000 old people in 2012 according to IMH, which is 25 per cent higher than that of Europe and the States. “The elderly are at higher risk of attempting suicide than other age groups, and the ratio of suicide completers is also higher,” says Leung.
Apart from depression, which has more to do with the state of mind, dementia is another prevalent mental disorder in the elderly and is linked to the deterioration of brain cells as they age. Figures from the Hong Kong Alzheimer’s Disease Association show that dementia affects one tenth of people aged 60 or above and the prevalence rate increases drastically to close to a third of the population aged 85 or above.
Dementia is a natural phenomenon in the elderly population. As life expectancy in Hong Kong continues to go up, the elderly population in 2039 is expected to reach some two million, more than double current figure. In other words, there could be a staggering 200,000 patients with dementia by then.
Given the scale of the problem, it should be easy to see the pressing need for a better understanding of the disease, yet many people are still unaware of the signs of dementia.
Danny Kam Wei-yao’s mother, who lived alone for 35 years, was diagnosed with dementia four years ago. But despite the diagnosis, her son was in denial. When she would occasionally shout that she had forgotten where she had put something, Kam would put it down to the stubbornness of an old person. It was not until a trip to the United States with his mother earlier this year, that he finally accepted the reality of her condition.