[100-Year Brain Health⑤] "Solving Quizzes and Doing Exercises"... Daily Life of Elderly in Early Dementia

Visiting Autonomous District Dementia Relief Center... Tablet App-Based Cognitive Training in Progress
Attending for 8 Years and Well Managed from Early Stage... Maintaining Daily Life Without Deterioration
Prejudice That One Must Stay Only at Home or Care Facilities Is Unwarranted

On the 17th, grandfather Choi Jong-chan is receiving training in 'self-care skills' necessary for daily life using an app installed on a tablet at the Seongbuk-gu Dementia Safety Center in Seoul.

At the Seongbuk-gu Dementia Safety Center, elderly individuals diagnosed with early-stage dementia or mild cognitive impairment are following the 'Himnoe Exercise,' developed for dementia prevention, in sync with the movements of an occupational therapist.

"Jiae and Ayoung agreed to meet in front of the movie theater at 12 o'clock. Jiae arrived on time, but Ayoung was 30 minutes late. Find and write down the title and screening time of the earliest movie they can watch."

On the morning of the 17th at the dementia relief center located in Seongbuk-gu Public Health Center, Seoul, Mr. Choi Jong-chan (82) quietly looked at the movie schedule on a tablet and slowly moved his finger to solve the problem. After choosing popcorn and cola at the theater concession stand and calculating the price according to the size, a notification saying "Correct answer" appeared on the screen. This application installed on the tablet helps seniors diagnosed with early-stage or mild cognitive impairment maintain their cognitive abilities by repeatedly training them through simulated daily life situations such as grocery shopping and payment, setting dishes on the table in order, and finding ways to use public transportation to reach a destination. There are also apps that use numbers or shapes for memory games or quizzes on health knowledge and vocabulary.

"On hot days like these, it's more comfortable and better to come to school and study. As soon as the center opens at 9 a.m., everyone comes early to play mole-catching games, measure blood pressure, watch TV news..." Mr. Choi called the dementia relief center a 'school.' Since being diagnosed with early-stage dementia last March, he visits here three times a week. After eating breakfast prepared by his wife, who is also in the early stage of dementia, he travels alone by bus for four stops. At the center, besides cognitive training, he also participates in occupational therapy activities using hands such as hanji craft or gardening, and follows exercises that train body flexibility and invigorate the body. During breaks, simple snacks like yogurt or snacks are provided at the center.

When returning home after the center program, he takes the subway. For several years, he has had weakness in one leg, so he moves as slowly as possible when using public transportation, but fortunately, he has never gotten lost. His child, Mr. Choi Jung-won (pseudonym), said, "Both my parents have been diagnosed with dementia, but so far, if we prepare soup and side dishes, they set the table themselves and take their medicine well morning and evening," adding, "We will watch over and care for them at home as long as possible without sending them to a nursing home."

Living without dementia worsening for 8 years

Mrs. Shin Young-hee (77) has been attending the center continuously for eight years since her first early dementia diagnosis in 2015. When the center was closed due to COVID-19 two years ago, she diligently participated in non-face-to-face programs connected via video at home. Although her retired husband helps with her meals and shares some household chores, she feels happy when her children frequently send food or when they occasionally dine out together. Mrs. Shin said, "The studies at the center are good, but the small frames made by attaching colored paper and cotton balls during craft time, and decorations made by threading beads on fishing lines, are treasures to me," adding, "I always take what I make here and decorate various places in my home." While talking about an outing (outdoor healing program) from the center, she said sadly, "I remember going to Children's Grand Park, but I don't know which mountain we went to far away."

Jeon Ayoung, an occupational therapist at Seongbuk-gu Dementia Relief Center, said, "In Mrs. Shin's case, dementia has not progressed and has been well maintained for several years since her initial diagnosis," emphasizing, "If dementia is detected early and well managed, one can live healthily for a long time."

Even if diagnosed with dementia, depending on the degree and health condition, it is possible to maintain existing daily life. Jeon, the team leader, added, "Some seniors we meet while using public transportation or shopping at the mart, like Mr. Choi or Mrs. Shin, may be patients with mild dementia," and stressed, "We should not have the prejudice that dementia patients must stay only at home."

Source) Ministry of Health and Welfare

From Dementia Prevention to Caregiver Education

Although the dementia population is increasing and social interest in dementia has grown, not all dementia patients are hospitalized or sent to care facilities. Until they reach severe stages where they get lost or cannot manage toileting independently, dementia patients can continue daily life with the help of family and those around them. This involves taking medication and maintaining brain function through cognitive training and exercise to slow dementia progression. For this, early diagnosis is essential. Based on the diagnosis, patients receive appropriate and systematic treatment and management to maintain quality of life and prepare in advance for various problems that may arise if dementia worsens.

The first place to visit when dementia is suspected is one of the 256 dementia relief centers located nationwide. Any Korean citizen can receive a free dementia screening test, and if the test shows suspicion of dementia, they are referred to affiliated hospitals for blood tests, brain imaging, and an accurate dementia diagnosis. Depending on the results, patients are prescribed medication to help maintain cognitive function as much as possible and may also receive medication to improve common symptoms such as depression and sleep disorders in dementia patients.

In the early stage of dementia (mild dementia), rather than withdrawing or staying only at home, it is better to use nearby dementia relief center rest areas and receive professional cognitive rehabilitation programs while continuing social interaction with family, acquaintances, and others. There is no additional cost to use the dementia relief center. Practical support that reassures families, such as dementia treatment management fee support, pre-registration of fingerprints for missing person prevention, and issuance of missing person identification tags, is also available. Dementia prevention classes for seniors not yet diagnosed with dementia and cognitive enhancement classes for seniors with cognitive decline or mild cognitive impairment are also operated. Counseling and education on the characteristics of dementia, caregiving methods, and managing caregiver stress are provided for families of dementia patients. Following the center's guidance, applying for long-term care services for the elderly through the National Health Insurance Service and receiving grade assessments allow dementia seniors to live at home while receiving day and night care services or home care services from care facilities. As of the end of last year, 488,967 dementia patients and 134,226 seniors with mild cognitive impairment were registered at dementia relief centers nationwide.

Meanwhile, for patients with severe dementia or those whose caregivers cannot care for them at home, or those requiring treatment for other diseases, help is provided by private elderly medical welfare facilities such as nursing homes and group homes, or patients are admitted to nursing hospitals. The government introduced the "Dementia Specialized Long-term Care Institution" system in 2016 and mandated the placement of professionally trained staff in dementia-specialized rooms within elderly care facilities, dementia-specialized group homes, and dementia-specialized rooms in day and night care facilities. Accordingly, the number of dementia-specialized long-term care institutions increased significantly from 54 at the end of 2017 to 220 in 2019 and 370 last year, and the number of residents increased from about 600 to 3,800 during the same period.