Kam recalls his mother was unable to recognise his brother and consistently refused to believe that she was in a foreign country. She once told Kam she could find her way back home and wandered around for two hours. Perhaps the truth was also too much for Kam’s mother to accept and she finally broke down crying in the middle of an unfamiliar street. “It was only then that I realised her condition was so serious,” says Kam with much regret in his voice.
Dementia is a syndrome rather than a single disease and it can have many different underlying causes. Sufferers may forget things easily, face difficulties in problem-solving and learning. Their personalities and behaviour can also change depending on the area of brain impairment.
Early-stage dementia patients look and behave very much like non-sufferers, as their physical condition remains sound. The bad news is their good physical condition is also a hindrance to the services they can receive.
Olive Sin Shuk-kan, a registered social worker and project officer of the self-financed Kin Chi Dementia Care Support Service Centre, explains how this is so. “[Dementia] only requires more nursing care in the advanced stages. Generally speaking, when a patient is adequate in mobility and has no other chronic diseases, there are few places where he could go to find treatment merely because he has a bad memory.”
By “few places”, she means government-run day care service centres. Dementia patients may be reluctant to use these centres because they are put together with less physically able patients with all sorts of chronic diseases.
The day care service centres supported by the Social Welfare Department (SWD) currently adopt an “integrated model”. All qualified patients are treated under the same roof, in spite of the different needs of the patients.
Legislator and registered social worker Bill Tang Ka-piu says: “Dementia patients require a tremendous amount of space for activities, they tend to talk a lot and argue with people easily. On the other hand, stroke and weaker patients are more aware of their behaviour and prefer a quieter environment.”
Tang explains that, as patients with dementia can make up 20 to 40 per cent of those using the services and the trend is on the rise, it is appropriate to set up a few specialised care centres solely for dementia patients.
Other than medical support, Tang also points out the flaws in welfare support for dementia patients. Before receiving services from SWD, an elderly person has to undertake the Standardised Care Need Assessment. Unfortunately for dementia patients, many of the services, such as the Community Care Service Voucher for the Elderly, require a participant to be assessed as having “impairment at moderate level”.