Related Links
Hong Kong Occupational Therapy Association

Write to us
Back to main

Mahjong
New way to cure disease

By Flora Chan

“Mahjong can cure hundreds of diseases” is a Chinese idiom that is often used by mahjong lovers. In fact, playing mahjong is seriously taken as a kind of treatment.

In 1993, mahjong therapy was introduced as a therapeutic treatment for patients at the Psychogeriatric Department in Kwai Chung Hospital.

Dr. Edwin Yu is a consultant psychogeriatrician in the Psychogeriatic Department.

In the Psychogeriatic Department, there are mahjong tables in every ward for patients to play as a leisure activity. But the setup was not originally tailored for demented patients.

Surprisingly, Dr. Yu found that more and more demented patients became better and stabler after playing mahjong.

“From then on, mahjong has been used as a therapeutic tool for treating dementia,” Dr. Yu said.

Mr. Simon Wong, an executive committee member of the Hong Kong Occupational Therapy Association, said playing mahjong trains body movements.

Before coming to the mahjong treatment, occupational therapists have to analyse patients’ conditions and decide which treatment to apply.

During the treatment, the role of therapists is to teach patients correct posture and movements.

Other than the postures, they do not teach them rules of mahjong.

Said Mr. Wong: “At the beginning, patients may not know how to move to get the tile from the other side of the table.

“Therefore, we teach them to move their bodies forward to get the tile.

“Later, they may try to straighten their arms to achieve the goal.”

Actually, playing mahjong makes treatment of illness easier in other areas.

If patients have problems in gross motor activity, such as in the shoulders or elbows, playing mahjong can train a range of muscles.

For example, it can train patients to pinch their fingers by piling up tiles, starting from three pieces, to six, 10 and so on.

This treatment can also help patients who cannot balance themselves properly.

Said Mr. Wong: “For patients with hand injuries, their sensations are poor. And every touch of a mahjong tile is a stimulation, which helps to re-train the sensations of patients.

Since mahjong tiles have different textures and designs, touching them  gives different degrees of stimulation to the brain.

Sometimes, Mr. Wong call this “sensory re-education”.

Besides, it can train the mind.

Mr. Wong said that alertness and concentration are prerequisites for patients to play mahjong since patients have to pay attention to what others are doing.

Dr. Yu said that playing mahjong requires patients to think. Once they think, it promotes blood circulation in the brain. This maintains and accelerates the metabolic rate of the brain.

It also enhances the brain cells to perform their functions and maintain a good neural network in the brain.

Dr. Yu said that about one-third of patients had better memory. Their intellectual deterioration was slowed by playing mahjong.

Ms. Cammie Lee (not her real name) is a 71-year-old demented patient who is receiving mahjong treatment at the Psychogeriatric Ambulatory Care Centre of Kwai Chung Hospital.

“At the beginning, when I came here, I had poor memory,” Ms. Lee said.

Ms. Lee had not played mahjong for 30 years, but after playing it as treatment, her memory has improved.

In the Mini-mental State Examination, the score of her was increased from 23 to 28  within 10 months.

The Mini-Mental State Examination is a simple test which acts as a preliminary indicator of the condition of patients. The maximum score is 30.

“My daughter had to bring me home from the hospital in the past, but now I can return home by myself,” she said.

Playing mahjong not only improved her memory, but also gave her a chance to make friends.

“Patients receive support from each other when playing mahjong. I am more active and happy now,” she said.

Mr. Wong said that through sharing of   feelings or experiences, patients felt under less pressure during the game.

Mr. Albert Chan (not his real name) is another patient receiving the treatment.

Said Mr. Chan: “I wanted to die when I knew that I had dementia.

“After receiving the treatment, I have become happier and have never thought about death or any unhappiness any more.

“Playing mahjong also trained my brain and hand to be more agile.”

Mahjong not only makes him happy, but also gives him confidence.

Both Dr. Yu and Mr. Wong emphasised that playing mahjong is only one of the activities in the treatment of patients.

“Playing mahjong is only a small part of patients’ daily activities in the centre.

“There are many different kinds of activities that also help patients to recover,” Dr. Yu said.

Dementia

Dementia is a kind of brain activity deterioration.

It is due to the reduction of brain cells and a neurotransmitter, acetylcholine.

Other causes are the lack of certain hormones, vitamin B12 or poisoning.

Older people tend to have dementia.

Acetylcholine is responsible for impulse and information transmission from nerve to nerve.

The lack of acetycholine thus results in poor memory.

At the same time, the density of connection between the brain cells will also be decreased.

Symptoms of dementia include poor memory, especially the recent ones, poor expression, orientation and judgment, strange temper and behaviour.

Demented patients may also become more passive.

There are three types of dementia: Alzheimer’s disease, multi-infract dementia and dementia caused by other medical or surgical diseases.

According to Dr. Edwin Yu of Kwai Chung Hospital, about 50 to 60 percent of demented patients have Alzheimer’s disease.

Dementia is divided into three stages: early, middle and later.

If demented patients do not receive proper treatment in the early stages, performance of brain will decline gradually.

Said Dr. Yu: “Without proper treatment, the score of the patients on the Mini-Mental State Examination will decrease by 3 points every year.

“When patients’ scores drop to about 14, their condition is already very serious.”

Patients may mix up day and night,   and they may be unable to recognise family members or take care of themselves.

“We can’t reproduce brain cells, but what we can do is to increase the connection of the brain cells or to maintain the level of acetylcholine,” explained Dr. Yu.

<<previous page

Flora Chan Playing mahjong helps patients recover from physical, mental and psychological problems.

Flora Chan

Besides playing mahjong, other activities can also help patients recover.