Dementia Posts Archive - DementiaHub.SG

Caring Through Vision Loss: Insights from Dementia Caregivers

shekinah — Wed, 06 May 2026 00:24:20 +0000

Listen

5 Min Read

https://www.dementiahub.sg/wp-content/uploads/speaker/post-83377.mp3?cb=1778049914.mp3

Visual loss is a common age-related condition. For people living with dementia, visual impairment can compound cognitive challenges, affecting independence, communication, and quality of life.

This article features how visual loss can impact persons living with dementia (PLWDs) and practical tips from care partners Lybea Lau and Rosalind Chan, on managing visual loss in PLWDs.

Health Promotion Board. (n.d.). Let’s talk about Vascular Dementia. HealthHub. https://www.healthhub.sg/programmes/mindsg/vascular-dementia
Chiew, H. J. (2021, July 5). Young-onset dementia: Improving outcomes with early recognition at Primary Care. SingHealth. https://www.singhealth.com.sg/news/defining-med/Young-Onset-Dementia
Ng, Z. X., Yang, W. R. E., Seet, E., Koh, K. M., Teo, K. J., Low, S. W., Chou, N., Yeo, T. T., & Venketasubramanian, N. (2015). Cerebellar strokes: A clinical outcome review of 79 cases. Singapore Medical Journal, 56(03), 145–149. https://doi.org/10.11622/smedj.2014195
Ioannides K, Tadi P, Naqvi IA. Cerebellar Infarct. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470416/
Huang, J., Qiu, Z., Zhou, P., Li, J., Chen, Y., Huang, R., Li, C., Ouyang, X., Feng, H., Xu, H., Liu, D., Dai, Z., Zhu, J., Liu, X., Chen, H., & Jiang, Y. (2019). Topographic location of unisolated pontine infarction. BMC Neurology, 19(1), 1-6. https://doi.org/10.1186/s12883-019-1411-6

Introduction

Visual loss is often characterised by specific patterns of sight degradation, mainly due to conditions like age-related visual loss (ARVL), cataracts, glaucoma, and diabetic retinopathy. A study by Singapore Eye Research Institute (SERI) found that about 43% of older adults in Singapore have visual impairment, often from treatable causes, while up to 90% of those with conditions such as age-related macular degeneration and diabetic retinopathy remain undiagnosed. ¹.

Understanding Visual Loss in Late Life

Most visual loss in older adults commonly arise from three categories:

Visual loss alone

Caused by a condition or disease of the eye. The most common eye diseases are age-related macular degeneration (AMD), glaucoma, and cataracts.²

Disease related visual loss

This is where another disease leads to someone developing vision loss e.g. diabetic retinopathy. Diabetes is also a risk factor for dementia.

Neurological visual loss

This is when loss of vision occurs due to neurological causes, such as problems with the nerve cells in the eye or the brain.

Dementia-Related Visual Difficulties

Persons living with dementia may develop visual difficulties during their diagnosis, particularly Alzheimer’s disease, which can directly affect vision.

For instance:

Visual Processing Impairment: A lesser-known symptom of Alzheimer’s disease is its effect on visual processing and depth perception. ³During one’s diagnosis, the brain regions responsible for interpreting and recognising visual stimuli may slowly start to deteriorate, leading to difficulties with visual perception (e.g., difficulty recognising faces, interpreting spatial information, or judging distances).

Cortical Blindness or Visual Agnosia: Certain types of dementia (like posterior cortical atrophy) can cause visual agnosia. This form of agnosia is an atypical non-memory form of Alzheimer’s disease. ⁴ This can cause individuals lose the ability to recognise objects, even though their eyes are functioning well.

How Visual Loss Impacts Persons Living with Dementia

Persons living with dementia who also experience visual loss face significant challenges in performing everyday tasks. Caregivers Lybea Lau and Rosalind Chan share how visual impairment can complicate everything from eating to walking.

Rosalind Chan, care partner to her husband Darren, who was diagnosed with Alzheimer’s disease and has experienced deteriorating vision.

Lybea Lau, care partner to her husband Andy, who is currently living with dementia and glaucoma.

Loss of Safety and independence

Early studies suggest persons living with dementia experiencing visual loss may experience a loss of safety and independence.⁵ The inability to compensate for poor memory with visual cues impaired their loved one’s ability to manage everyday tasks.

For Lybea, her husband Andy’s glaucoma has increased his need for assistance with basic activities, such as dressing, grooming, and even eating. This loss of autonomy led to frustration and a decrease in confidence, making it harder to carry out day-to-day tasks without help.

Similarly, Rosalind shared that visual loss has intensified her husband Darren’s fear of moving around alone safely.

Heightened Disorientation and Distress

Disorientation is another key impact of visual loss in persons living with dementia. Research suggests, when vision declines, it becomes harder to recognise familiar places and people, which can lead to anxiety and distress. ⁵ Lybea’s husband Andy tends to become increasingly anxious in public spaces, especially when surrounded by crowds.

Likewise, Rosalind notes that Darren’s difficulty with spatial awareness makes it harder for him to process instructions which increases his anxiety. This also makes Rosalind more cautious when guiding Darren.

Vulnerability to Isolation

Visual loss has also found to lead to isolation.⁵ Persons living with dementia may have reduced ability to engage in activities such as social outings, games or previous hobbies, resulting in withdrawing themselves from these social interactions. Both Lybea and Rosalind observe that their loved one’s struggle with confidence in social settings due to difficulty engaging in activities they once enjoyed.

Care Partner Perspectives: Real-Life Tips

Caregivers supporting a loved one through gradual visual loss can feel overwhelmed and deeply personal. Care partners, Lybea and Rosalind, share their experiences and tips in navigating this path.

Environmental Adjustments

Creating a safe, navigable environment helps maintain independence and reduce accidents:

Install grab bars in bathrooms and at main entrances.

Keep floors dry and walkways free of furniture, wires, and other obstacles.
If your loved one has glaucoma keeping lights on in key areas, such as hallways and bathrooms, especially at night.
Keep the bathroom floors dry to prevent falls and slips.
Use adaptive devices such as nightlights or motion sensor lights, strategically located for night-time safety.

Caregiver Insights

Keep the house brightly lit and minimise clutter, especially in areas your loved one frequents. It helps them feel more confident moving around. –Rosalind Chan, Care Partner

Carry a torch when going out at night and provide guidance in advance for steps or uneven terrain. – Lybea Lau, Care Partner

Daily Life and Routine Adjustments

Routine tasks may need additional support or modification:

Assist with tasks such as dressing, grooming, eating, and mobility, particularly when vision is limited.

Walk closely beside the person or hold their hand for reassurance and stability.

Provide clear, step-by-step directions and encourage trust in guidance to reduce anxiety and prevent disorientation.

Encourage your loved ones to engage in activities they enjoy while they still have usable vision.

For example, Rosalind shared that Darren enjoys singing, so she encouraged him to read song lyrics and follow lip movements while singing. Practising these activities early can help build familiarity and muscle memory as vision declines.

Tips from Rosalind, Care Partner

Encourage your loved one to touch and feel objects, which helps compensate for limited vision.

Instructions will not always be verbal. Sometimes caregivers must guide and steady them by holding their hand when using stairs or escalators.

Preventive and Supportive Measures

Encourage regular eye check-ups for early detection of eye diseases like glaucoma early.

You can self-check your vision with the EySEE application which simulates how a healthcare professional would check the Visual Acuity of a person. Click here for more information.

Individuals with diabetes are at higher risk of vision loss and eye diseases. Attend scheduled eye examinations diligently.

Tips from Lybea, Care Partner

Check for any known family history of eye diseases to anticipate potential challenges.

Key Takeaways for Caregivers

Reassure your loved ones and encourage them to trust your guidance.

Emotional reassurance reduces anxiety in unfamiliar or busy environments.

Environmental modifications significantly improve safety and independence.

Regular medical follow-ups can prevent or decelerate further vision loss.

Conclusion

For people living with dementia, visual impairment can compound cognitive challenges, affecting independence, communication, and quality of life. Lybea Lau and Rosalind Chan’s experiences show how combining practical strategies with emotional reassurance can preserve dignity, confidence, and connection for persons living with dementia experiencing visual loss.

Teo, J. (2026, February 24). Most older Singaporeans unaware of eye disease, study finds. The Straits Times. https://www.straitstimes.com/singapore/health/over-1-in-3-seniors-have-undiagnosed-eye-disease-1-in-5-have-serious-hearing-loss-study
Singapore Association of the Visually Handicapped. (n.d). Common Eye Diseases. SAVH. https://savh.org.sg/common-eye-diseases/
Rauch, K. (2022, July 26). Alzheimer’s Disease, Dementia and the Eye. American Academy of Ophthalmology. https://www.aao.org/eye-health/diseases/alzheimers-disease-dementia-eye
Murray, E., M. (2024, April 15). When Alzheimer’s Disease Begins with Vision Problems. Alzheimer’s Disease Research. https://www.brightfocus.org/resource/when-alzheimers-disease-begins-with-vision-problems/
Lawrence, V., Murray, J., Ffytche, D., & Banerjee, S. (2009). “Out of sight, out of mind”: A qualitative study of visual impairment and dementia from three perspectives. International Psychogeriatrics, 21(3), 511–518. https://doi.org/10.1017/S1041610209008424
Singapore National Eye Centre (n.d). EySEE- Self Check Eye Test. SNEC. https://www.snec.com.sg/patient-services/e-services/eysee

Counselling for Caregivers

Gabrielle Stacey Djuana — Fri, 20 Mar 2026 02:12:16 +0000

Listen

4 Min Read

https://www.dementiahub.sg/wp-content/uploads/speaker/post-80891.mp3?cb=1776045500.mp3

When caring for your loved one with dementia, you may come across counselling as a source of support. However, deciding to speak with a counsellor can feel challenging, especially if you are unsure of what to expect or how it might benefit you.

This article discusses how counselling can help caregivers in different stages of dementia, ways to approach counselling, and where to find counselling services in Singapore.

As dementia progresses, the needs of caregivers can bring feelings of uncertainty, grief and anger. With growing caregiving responsibilities, caregivers may find it harder to prioritise their wellbeing. Over time, this can potentially lead to adverse effects such as burnout, compassion fatigue or stress. Counselling can help caregivers maintain their wellbeing throughout the different stages of dementia by providing a listening ear and emotional support.¹

Counselling for Caregivers for Early-stage Dementia

Caregivers may feel stressed or concerned as they try to accept their loved ones’ diagnosis and to figure out how best to support them. This includes how to make their home dementia-friendly and sharing caregiving responsibilities with their family members.

At this stage, it is also common to start thinking about finances and work arrangements. Caregivers may also want to consider making a Lasting Power of Attorney (LPA). This ensures financial and healthcare decisions are made according to their loved ones’ wishes if they lose the ability to make decisions.

During this transition into their caregiving roles, counselling may help in understanding and processing unpleasant emotions as they come to terms with their loved ones’ diagnosis. Support may also be provided in the form of dementia education, which may be helpful for caregivers who are unfamiliar with dementia.²

Counselling for Caregivers for Middle-stage Dementia

Caring for one’s loved one with middle-stage dementia demands more responsibilities. The person with dementia may go through behavioural changes and further cognitive decline, thus requiring more support in handling daily activities such as showering, using the toilet, and getting dressed.³

Caregivers may need to set aside their own priorities to take care of their loved ones.⁴
At this stage, they may also consider bringing in a domestic helper for support.

With the increased responsibilities, caregivers may feel more stressed and struggle with their loved ones’ changing needs. Caregivers may also face a loss of boundaries and not having enough time for themselves to unwind. Counselling can help to develop personalised coping strategies, manage other forms of stress, make time for themselves, and seeing situations from a different perspective.

Counselling for Caregivers for Late-stage Dementia

Persons with late-stage dementia require their caregivers to continuously manage and supervise their daily needs, as their abilities decline further. These include extensive assistance in walking, verbal communication, and eating.⁵ They may also struggle with remembering familiar faces.⁶
As a result, connecting with their loved ones can be challenging, leaving caregivers feeling upset, discouraged or grief.

During this stage, caregivers often have to make difficult decisions, such as end-of-life matters.⁷
This may include discussions on palliative care and alternative living options, such as nursing homes or hospice care. Making these decisions can lead to guilt from thinking that caregivers are not doing enough for their loved ones. However, they may also feel relief at the same time.

These mixed feelings are often accompanied by grief as their loved ones’ life draws to a close. As such, counselling can provide a safe space for caregivers to process different forms of grief such as anticipatory grief, handle difficult decisions, and provide emotional reassurance, during this last lap of caregiving. Counselling also supports caregivers in looking towards the future after their loved ones pass on.

How to prepare for the first counselling session?

Think about what you want to talk about and to achieve from counselling beforehand.

Useful Prompts:

•Is there a specific event or incident you wish to bring up?

•Are there feelings and thoughts that have been bothering you?

•Are there any patterns of behaviours you have noticed about yourself that could be of concern?

•Are there any areas of your life that has been impacted?

Knowing what you want to achieve from counselling can help you in expressing your needs to your counsellor, making it a more fruitful and meaningful session.

To guide you along, especially during your first session, your counsellor may ask personal questions to get to know you better. This may include setting of counselling goals, counselling frequency, and questions about your family history.

Keep an Open Mind

It may take time for you to see progress in your counselling journey. It is important that you remain patient and approach each session with an open mind. One session may not resolve the issues you are facing, and it is helpful to remember that progress in counselling is rarely linear.

Approaching sessions with an open mind to new ideas, such as trying new coping strategies, can help you discover more effective selfcare or caregiving approaches.

Be Ready to Share Your Inner Feelings and Thoughts

Counselling can be a daunting experience for those who are not comfortable with sharing their emotional state with strangers or acquaintances. During your first counselling session, you may feel uneasy or struggle to speak about your experiences to your counsellor.

This is part of the counselling journey. As your rapport with your counsellor develops, it can become easier for you to open up to your counsellor.

Relaxing activities can help alleviate uncomfortable feelings that arise. You could make yourself some tea or read a book to relax and unwind.

Joining caregiver support groups can also give you a dedicated space to share your feelings and connect with other caregivers who can relate to your experiences.

Types of Counselling and Where to Find Them

Types of Counselling	Where to Find Them
Helplines	These helplines provide quick support for caregivers over the phone. This can be done in the comfort of your home in case you need to be home for the person living with dementia. Dementia Singapore (Mon-Fri: 9am-6pm, Sat: 9am-1pm): 6377 0700 Samaritans of Singapore (SOS) (24-hours): 1800-221-4444
CREST-CSN	Caregiver Support Network Community Outreach Team (CREST-CSN) specialises in providing support services for caregivers: mindline.sg \| Free Mental Health Resources & Mindfulness Tools in Singapore
COMIT	Community Intervention Team (COMIT) provides mental health support which include counselling for caregivers. There are over 100 teams in Singapore, making it accessible for caregivers: Community Intervention Team (COMIT) – SupportGoWhere

Conclusion

Caregiving for a loved one with dementia is a meaningful yet challenging journey, and your wellbeing matters just as much as that of your loved one. Seeking support from counsellors and other support services is a sign of strength. It is by taking care of your own wellbeing that you can continue to provide care for and preserve the dignity of your loved one. Regardless of where you are in your caregiving journey, you deserve the support, and counsellors are ready to support you every step of the way.

Additional Resources

Available Assistance- Dementia Singapore

Support and Services

Caregiver Support Singapore: From Overwhelm to Empowerment. (2025, October 27). In Focus. https://www.in-focus.com.sg/caregiver-support-singapore-mental-health-wellbeing/
Siow, D. (2008). Managing the caregiver from the general practitioner’s (GP’s) perspective. https://www.cfps.org.sg/publications/the-singapore-family-physician/article/376_pdf
Ali, S., & Bokharey, I. Z. (2016). Caregiving in dementia: Emotional and behavioral challenges. Educational Gerontology, 42(7), 455–464. https://doi.org/10.1080/03601277.2016.1156375
Alzheimer’s Society (2021). The middle stage of dementia. https://www.alzheimers.org.uk/about-dementia/stages-and-symptoms/middle-stage-dementia
Clifford, K., Moreno, M., & Kloske, C. M. (2024). Navigating late-stage dementia: A perspective from the Alzheimer’s Association. Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, 16(1). https://doi.org/10.1002/dad2.12530

The post Counselling for Caregivers appeared first on DementiaHub.SG.

Expressive Arts Therapy: An Introduction

Peter Cher — Tue, 16 Dec 2025 02:38:03 +0000

Listen

5 Min Read

https://www.dementiahub.sg/wp-content/uploads/speaker/post-76788.mp3?cb=1774604695.mp3

Rather than focusing on artistic skill, Expressive Arts Therapy emphasises the process of creating as a way to explore feelings, experiences, and inner conflicts that may be difficult to express verbally.

Guided by a trained therapist, persons living with dementia use multiple art forms to access insight, reduce stress, build resilience, and foster integration of mind, body, and emotions in a safe, supportive environment.

Expressive Arts Therapy or EXAT is a form of psychotherapy that integrates multiple art forms—such as visual art, music, dance/movement, drama, and writing—within a therapeutic process. It is grounded in person-centred and humanistic theories; and based on models like the Expressive Therapies Continuum (ETC) and principles of intermodal arts integration.

EXAT differs from traditional, single-modality art therapies, for example art therapy or music therapy, by intentionally combining diverse artistic forms to support emotional expression, self-exploration, cognitive stimulation, and psychological healing. It provides a non-verbal, sensory-rich pathway of communication for persons living with dementia, as verbal communication often becomes more challenging as dementia progresses.

The table below shows how different art forms can be used in EXAT with a specific intention:

Art Form	Examples of Use	Intention
Music	Listen to music, singing, or playing instruments.	To reduce agitation and anxiety; moderate mood; and support non-verbal communication.
Drama	Use movement, role-play, puppetry, mirroring, or improvisational storytelling.	To externalise inner conflicts and gain new perspectives in a safe and supported environment.
Dance/ Movement	Use body movements and gestures to express emotions, opinons, thoughts, and identity.	To promote mind-body sensitivity and awareness, emotional release and expression.
Poetry/ Storytelling	Journal down poetry, narrative storytelling, free writing.	Bridges the gap between visuals and feelings, allowing one to articulate unspoken thoughts, gain insights and construct meanings.
Visual Art	Create or engage with images through painting, drawing, sculpting or art appreciation.	To access, process and communicate complex emotions, thoughts, and trauma.

Differentiate Expressive Arts Therapy from Expressive Arts Programmes

EXAT is often misunderstood as or confused with Expressive Arts Programme. It is, therefore, essential to know the differences between these two approaches.

What Expressive Arts Therapy (EXAT) Is	What Expressive Arts Programme Is
A psychotherapy approach delivered by a trained mental health professional that integrates multiple art modalities within a therapeutic framework.	Recreational, educational, or social activities involving art, music, dance, or other creative forms without a formal therapeutic process.
Grounded in psychological and art-based theories, it aims to explore emotions, identity, cognitive stimulation, and psychological healing.	Focuses on enjoyment, reminiscence, cultural engagement, entertainment, or sensory stimulation.
Facilitated by trained expressive arts therapists.	Facilitated by activity staff, volunteers, or artists without clinical training.

Between the two, only EXAT is designed to cater for psychological and emotional needs through a structured therapeutic process.

Benefits of Expressive Arts Therapy (EXAT)

EXAT provides a safe, supportive, and flexible space for participants—including persons living with dementia and caregivers—who seek emotional and/or psychological support.

Benefits for Persons Living with Dementia

Bypasses verbal limitations by offering sensory, emotional, and embodied ways to express themselves.
Reconnects individuals to their sense of identity and life story.
Addresses unmet emotional and sensory needs, contributing to reduced agitation, anxiety, and wandering.
Enhances mood, confidence, and a sense of self-worth.

Benefits for Caregivers

Provides a safe space to process emotional stress and grief.
Strengthens self-awareness and reconnects caregivers to their own identity beyond the caregiving role.
Offers creative tools for stress relief and emotional release.
Builds resilience and emotional regulation skills to cope with daily challenges.

Getting Started

You may wish to consider any of these simple activities to help you get started:

Music and Rhythm

Visual Arts

Movement

Story Telling

Multi-sensory

Music and Rhythm

Visual Arts

Movement

Story Telling

Multi-sensory

Additional Tips

#1

Create space by clearing clutter and arranging chairs in a circle.
#2

Be a part of the activity to set the tone that you are not there to teach the activity.
#3

Use prompts that invite exploration, play and curiosity, such as: “Let’s see what happens if we do this,” rather than giving direct instructions.
#4

Be warm and supportive without slipping into “child-like” language.
#5

Speak with respect, using clear and simple phrasing while preserving the dignity of each person.
#6

Give participants some breathing space. There is no need to fill every minute with tasks. It is all right to experience moments of silence. If someone chooses not to take part in the activity, let him be — he may simply need more time to feel safe. Some participants may take a few sessions to settle in, so allow the pace to unfold naturally.

Conclusion

The use of diverse art modalities creates a relaxed, playful and engaging environment where participants can express their feelings and experiences.

For persons living with dementia, EXAT can help bypass cognitive limitations by tapping into sensorial, emotional, and embodied forms of communication. For caregivers, EXAT provides a safe outlet to express emotions, manage stress, reconnect with their inner selves, and improves overall well-being.

It nurtures curiosity, invites play, and supports a sense of identity and self-worth by offering opportunities for meaningful self-expression despite the changes dementia brings.

Author's Bio

Rachel Lim is a registered expressive arts therapist with ANZACATA and currently leads the development of Expressive Arts Therapy services at Dementia Singapore Ltd. With a master’s degree in Expressive Arts Therapy from the University of Hong Kong and a background in psychology, Rachel specialises in supporting persons living with dementia and their caregivers through creative, sensory-based approaches.

Lusebrink, V. B. (2010). Assessment and therapeutic application of the expressive therapies continuum: Implications for brain structures and functions. Art Therapy, 27(4), 168-177.

The post Expressive Arts Therapy: An Introduction appeared first on DementiaHub.SG.

Hearing Loss: A Hidden Risk Factor for Dementia

shekinah — Thu, 20 Nov 2025 00:34:34 +0000

Listen

6 Min Read

https://www.dementiahub.sg/wp-content/uploads/speaker/post-74890.mp3?cb=1770872395.mp3

Hearing Loss is a modifiable risk factor of dementia. This article explores the connection between the two and provides a deeper understanding of hearing loss, its signs and symptoms and what can be done to prevent and treat potential hearing loss.

Introduction

By 2050, nearly 2.5 billion people are projected to have some form of hearing loss.¹ According to the Lancet study (2020), hearing loss has been identified as a risk factor for dementia.² The Lancet study (2024), found that hearing loss is estimated to account for 7% of dementia-related cases globally.³ Although it is highly prevalent among seniors, hearing loss is not commonly or well diagnosed, making it an important issue in dementia prevention and care.

What is the Connection of Hearing Loss and Dementia

Hearing loss as a potential risk factor for dementia has gained more prominence in recent years. The 2017 Lancet report found that hearing loss had the highest Population Attributable Fraction (PAF) — a measure that estimates how many cases of a disease could be prevented if a specific risk factor were eliminated. In this case, hearing loss accounted for 23% of potentially preventable dementia cases, more than any other individual risk factor such as depression (10.1%), smoking (13.9%), social isolation (5.9%), high blood pressure (5.1%), or diabetes (3.2%). ⁴

Untreated hearing loss could lead to increased social isolation and changes in one’s brain structure. This is because two main regions of the brain are affected by hearing loss: the temporal lobe and the frontal cortex:

The temporal lobe: Involved with sound processing, and other functions.

The frontal cortex: Involved with attention and executive function, such as decision making and planning.

Hearing loss slows down these functions leading to a rapid deterioration of the brain’s cognitive function in these areas.

Increased Social Isolation

Older adults with hearing loss have trouble in communication, leading to withdrawal from social situations. ⁵ Other studies have also found that poorer social networks, reduced social support and loneliness can increase the risk of dementia in individuals who were initially disease-free, even after modifying other risk factors. ⁶

The link between hearing loss and social isolation reduces opportunities for cognitive stimulation. When individuals are less engaged in conversations they process less stimulating information, which can affect their brain function.

Over time, this reduced cognitive engagement, coupled with declining communication skills, may contribute to cognitive loss and ultimately lead to dementia.

Changes in Brain Structure

Hearing loss has also been related to lead to decreased stimulation of cognitive processing. ⁷ This results in a lack of speech and language input, which can negatively impact brain structure and function, ultimately causing brain tissue to shrink.

Additionally, hearing loss can accelerate subtle cognitive decline such as working memory by increasing the cognitive load on the brain. Specifically, it appears to weaken areas commonly associated with Alzheimer’s disease. ⁸

Types of Hearing Loss

Hearing loss is a condition that affects the way we hear sounds, and it can happen for many reasons.

There are three types of hearing loss (a) Conductive hearing loss and (b) Sensorineural hearing loss and (c) Mixed hearing loss.⁹

Conductive Hearing Loss

This type of hearing loss occurs when sound cannot travel efficiently through the outer and middle parts of the ear to reach the inner ear (the cochlea).

Common causes include:

Ear Blockage: Wax buildup, foreign objects, or infections (like otitis externa).

Perforated Eardrum: A hole or tear in the eardrum caused by trauma or chronic infections.

Damaged Middle Ear Bones (Ossicles): The bones in the middle ear may be dislocated, damaged, or fixed in place due to trauma or diseases like otosclerosis.

Middle Ear Infections (Otitis Media): Infection and fluid buildup in the middle ear space can interfere with sound transmission.

Sensorineural Hearing Loss

This occurs when there is damage to the inner ear (cochlea) or the auditory nerve that sends sound signals to the brain. It is usually permanent and more complex to treat.

Common causes include:

Ageing: Gradual hearing loss that occurs naturally as we age.

Noise Exposure: Prolonged exposure to loud sounds can damage the sensory cells in the cochlea.

Inner Ear Infections: Infections caused by viruses and bacteria, like mumps or flu.

Menière’s Disease: A condition that causes ringing in the ears (tinnitus), hearing loss, and dizziness.

Ototoxic Drugs: Certain medications can damage the hearing nerves or cochlea, including:

Antibiotics: Such as gentamicin and vancomycin

Cancer Drugs: Certain chemotherapy drugs

Mixed Hearing Loss

Mixed hearing loss occurs when a person has both conductive and sensorineural hearing loss, meaning there is a problem in both the middle ear (e.g., fluid or blockage) and the inner ear or nerve.

It can happen when someone with long-standing sensorineural hearing loss develops an ear infection or vice versa.

Common Causes:

Chronic ear infections plus age-related hearing loss

Head injury which can affect different parts of the ear

Long-term noise exposure

Early Signs of Hearing Loss

Hearing loss can occur suddenly or gradually, and it can affect one or both ears. Symptoms include:

Difficulty understanding speech in noisy environment

Feel like people are mumbling

Need to repeat themselves for you

Difficulty understanding someone if you are not looking at them

Withdrawal from conversations

Associated ear symptoms, such as earache and ear discharge due to ear infections

Tinnitus (ringing in the ears)

Vertigo (spinning sensations)

Do consult a doctor should you experience these symptoms.

Tips for Prevention and Intervention

The best way to reduce the risk of dementia from hearing loss is to have frequent and regular hearing checkups. It is recommended that seniors should attend a health screening every 1-2 years to stay proactive about their health. ¹²

Prevention

Health Hub functional screening platforms

Project Silver Screen is an affordable, nationwide functional screening programme for Singaporeans aged 60 and above. The Health Hub platform provides a comprehensive list of upcoming functional screenings.

Click on this link to sign up for your health screening: functional screening platforms

Practicing safe listening strategies can also reduce the risk of hearing loss.¹³

Here are some tips to prevent hearing loss:

Keep the volume down. Set your device’s volume level to no more than 60% of the maximum volume.
Use well-fitted and noise cancelling headphones/earpieces.
In noisy places, use ear protectors such as earplugs.
Always stay away from sources of loud sound, such as loudspeakers, noisy machinery etc.
Limit time spent engaged in noisy activities. Give your ears a break frequently from loud sounds. This helps the sensory cells inside the ears recover.
Monitor sound levels. Choose devices with built-in safe listening features that allow you to monitor your exposure.

Tip

Maintain a sound below 70dB as sounds above 70 dB can damage hearing over time.¹⁵

Intervention

Additionally, one can ensure that hearing loss is dealt with quickly through treatment.

These are some treatment and alternative options for managing hearing loss:

Hearing Aids: a small electronic device to wear in or behind your ear. It makes some sounds louder so that a person with hearing loss can listen, communicate, and participate fully in daily activities.

Cochlear Implants: a surgically implanted neuro-prosthetic that provides a person with moderate-to-severe sensorineural hearing loss with sound perception.

It is best to consult an audiologist to decide which is the best option for you or your loved one.

Conclusion

Addressing hearing loss can help reduce the risk of dementia. If you are concerned that someone you know or yourself may be at risk of developing hearing loss, please approach your GP (General Practitioner) or family doctor for a referral.

World Health Organization. (2025, 26 February). Deafness and hearing loss. https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., Orgeta, V., … K. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6
Livingston, G., Huntley, J., Liu, K. Y., Costafreda, S. G., Selbæk, G., Alladi, S., Ames, D., Banerjee, S., Burns, A., Brayne, C., Fox, N. C., Ferri, C. P., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Nakasujja, N., Rockwood, K., … Mukadam, N. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet Standing Commission. The Lancet, 403(10300), 1-40. https://doi.org/10.1016/S0140-6736(24)00345-6
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., … & Mukadam, N. (2017). Dementia prevention, intervention, and care. The lancet, 390(10113), 2673-2734.
Bott, A., & Saunders, G. (2021). A scoping review of studies investigating hearing loss, social isolation and/or loneliness in adults. International Journal of Audiology, 60(sup2), 30–46. https://doi.org/10.1080/14992027.2021.1915506
Chern, A., & Golub, J. S. (2019). Age-related Hearing Loss and Dementia. Alzheimer disease and associated disorders, 33(3), 285–290. https://doi.org/10.1097/WAD.0000000000000325
Griffiths, T. D., Lad, M., Kumar, S., Holmes, E., McMurray, B., Maguire, E. A., Billig, A. J., & Sedley, W. (2020). How Can Hearing Loss Cause Dementia?. Neuron, 108(3), 401–412. https://doi.org/10.1016/j.neuron.2020.08.003
Ford, H. A., Hankey. J. G., Yeap. B. B., Golledge, J., Flicker, L. & Almeida, P. O. (2018). Hearing loss and the risk of dementia in later life. Maturitas Vol (112), pg 1-11. https://doi.org/10.1016/j.maturitas.2018.03.004
Cleveland Clinic. (2023, August 24). Hearing loss: Types, symptoms, causes & treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17673-hearing-loss
NHS 24. (2024). What does tinnitus sound like? Ringing, crackling, buzzing examples [Video]. Youtube. https://www.youtube.com/watch?v=kgIrfiyK4x8
FreeMedEducation. (2017). What is Vertigo? [Video]. Youtube. https://www.youtube.com/watch?v=j04qNXaCm0Y
World Health Organization. (2025, 21 March). Deafness and hearing loss: Safe listening. https://www.who.int/news-room/questions-and-answers/item/deafness-and-hearing-loss-safe-listening
CPF Board. (2025, March 25). How often should you go for a health screening? CPF. https://www.cpf.gov.sg/member/infohub/educational-resources/how-often-should-you-go-for-a-health-screening
International Noise Awareness Day (n.d). Common Noise Levels- How Loud Is Too Loud?. https://noiseawareness.org/info-center/common-noise-levels/
Hearing Health Foundation. (n.d.). What are safe decibels? Hearing Health Foundation. https://hearinghealthfoundation.org/keeplistening/decibels

Was this article helpful?

Yes No

Making a Change by Using Person-Centred Language and Imagery for Dementia

Peter Cher — Fri, 31 Oct 2025 06:51:28 +0000

Listen

5 Min Read

https://www.dementiahub.sg/wp-content/uploads/speaker/post-74349.mp3?cb=1774604937.mp3

Using the right language consistently when talking about dementia or people living with dementia can go a long way in combatting negative societal attitudes and creating a truly inclusive society. Recognising this, Dementia Australia released a set of language guidelines in 2018. Since then, a growing number of organisations and social service agencies have advocated for the use of person-centred language when talking about people who live with dementia. However, perhaps due to insufficient public awareness or the inconvenience involved in using longer terms, adoption of person-centred language is still limited.

Language use has a significant impact on not just the way others view or treat people living with dementia, but also how people living with dementia perceive themselves and their relation to others. Many terms used to describe dementia and people with a dementia diagnosis are based on outdated or inaccurate understanding of the disease.

Common stigmatising local terms associated with dementia

Language frames our understanding of dementia as a disease and its root causes. Frequently using terms that describe its causes incorrectly or ascribe blame creates bias, which also fuels stigma. Cultural stigma is a set of “negative beliefs, prejudices and discriminatory structures” shared by a society (Link et al., 2001). The perception of dementia as something that needs to be hidden affects a person’s willingness to seek diagnosis, which limits their access to care options and support. This is concerning because early diagnosis and treatment can greatly improve outcomes for dementia.

People living with dementia may internalise stigma about their condition, which affects their self-esteem and well-being. This can cause them to withdraw from social interaction, which worsens dementia progression. Instead, using person-centred language encourages agency for persons living with dementia to manage their condition.

Stigmatising imagery used in the portrayal of dementia

A large-scale thematic analysis of books, films, television programmes, social media, and news items, conducted in December 2017 and updated in January 2019, revealed several common themes in depictions of dementia that may perpetuate cultural stigma.

There is often an emphasis on the biomedical framing of the disease and brain deterioration, compared to a holistic view of how dementia changes the lived experience of the person. The address “person living with dementia” is preferable to “Alzheimer’s patient” because dementia is a long-term condition. It is more helpful to focus on living well with dementia after their diagnosis than focusing on their status as a patient, since there is currently no known cure for dementia.

Dementia is also often likened to a natural disaster or epidemic, using metaphors like “rising tide” and other apocalyptic terms. This enforces the view that dementia should be feared and that people living with dementia are passive victims of the condition, when in fact progression can be prevented with social interaction and cognitive engagement. The term “epidemic” also implies that dementia is contagious, which encourages misperception of dementia and avoidance of persons living with dementia.

This not only causes undue public fear of persons living with dementia, but it also ascribes blame to the person and undermines public awareness efforts of dementia prevention.

Other terms often used include “victims” or “sufferers”. These terms limit our view of people living with dementia to that of requiring pity or compassion, rather than being able to contribute meaningfully. Images used to depict dementia often portray persons with dementia as an ‘empty shell’ or as a disembodied set of hands, which dehumanises the person living with dementia and decreases emotional connection to them.

In a survey of persons living with mild dementia, 46% were reluctant to share their diagnosis because of concerns that they would be “talked about like they were not there” (Burgener and Buckwalter, 2018). When people do not understand dementia, they are more likely to exclude persons living with dementia from conversations and instead speak directly only to caregivers. Hence, we can expect that increasing public awareness will increase the inclusion of people living with dementia. 65% of visitors to the “People of Dementia” blog, which published personal stories of people living with dementia and how life was like for them before and after the diagnosis, agreed that they felt more comfortable interacting with persons living with dementia after reading the blog (Jamieson et al., 2017).

Terms to Avoid	Preferred Terms	Why this term needs to be avoided and changed
Orang gila (“crazy person” in Malay)	Orang yang menghidapi demensia	Dementia is not a form of psychosis, although some forms of dementia may cause people to experience hallucinations.
Demented	Living with dementia
Gone case	Changed behaviours	It implies that the person living with dementia is beyond help, when symptoms can actually be managed with care.
Menggila (“out of control” in Malay)	Expressing unmet needs	Behavioural symptoms can often result from an inability to express unmet needs.
unpredictable
siao (“acting crazy” in Mandarin)
Senile	Diagnosed with dementia	This term inaccurately implies that dementia is because of old age.
痴呆症 (a derogatory term use to describe dementia in Mandarin）	Dementia	This term implies that people living with dementia are unintelligent and absent-minded. Especially in the early stage of dementia, disorientation is an occasional state rather than a characteristic.

How do we use appropriate language when referring to persons living with dementia?

Language used about persons living with dementia should be clear, normal, jargon-free, inclusive, and centred on the person, not the disease. In addition, language can be made more dementia-inclusive by:

Using first-person language
Eliminating pejorative terms that have negative connotations
Choosing inclusive language – acknowledging someone’s circumstances, but avoiding disempowering narratives (e.g. uses a wheelchair vs. wheelchair-bound)
Avoiding labels
Avoid leading with social identifiers (e.g. race or language)
Avoiding language that attributes responsibility to persons for their condition
Avoiding verbs that undermine the person’s experience of the disease

(Adapted from Healy et al., 2022)

In the long term, using person-centred language instead of stigmatising language will correct public perception of dementia and reinforce that persons living with dementia should be treated with respect. This includes their inclusion in medical discussions, designing care treatment plans and programmes, and co-participation in research.

Being mindful of the words and imagery we use to talk about dementia and people with dementia, is one of the most important steps we can take as individuals to build a dementia-inclusive society.

Additional Resource

Dementia Language Guidebook

Dementia Singapore and the Lien Foundation collaborated to produce a dementia language guidebook titled Changing Words, Touching Lives, which was inspired by Dementia Australia’s Dementia Language Guidelines. It lists the preferred words and phrases for describing dementia in Singapore’s context, as well as terms to avoid which are applicable in all situations. This ranges from casual conversation to publicity materials relating to dementia as a disease and persons living with dementia.

Healy, M., Richard, A., & Kidia, K. (2022). How to Reduce Stigma and Bias in Clinical Communication: a Narrative Review. Journal of general internal medicine, 37(10), 2533–2540. https://doi.org/10.1007/s11606-022-07609-y
Dementia Australia. (2018). Dementia language guidelines. https://www.dementia.org.au/media/2018-dementia-language-guidelines
Lien Foundation. (2018). Changing words, touching lives: A guide to dementia-inclusive language.
Swaffer, K. (2014). Dementia: Stigma, language, and dementia-friendly. Dementia: The International Journal of Social Research and Practice, 13(6), 709–716. https://doi.org/10.1177/1471301214548143
Tan, W. J., Hong, S. I., Luo, N., Lo, T. J., & Yap, P. (2012). The Lay Public’s Understanding and Perception of Dementia in a Developed Asian Nation. Dementia and geriatric cognitive disorders extra, 2(1), 433–444. https://doi.org/10.1159/000343079
Dementia Australia. (2018). Dementia language guidelines. https://www.dementia.org.au/media/2018-dementia-language-guidelines
Young, J. A., Lind, C., Orange, J. B., & Savundranayagam, M. Y. (2019). Expanding current understandings of epistemic injustice and dementia: Learning from stigma theory. Journal of Aging Studies, 48, 76–84. https://doi.org/10.1016/j.jaging.2019.01.003
Low, L. F., & Purwaningrum, F. (2020). Negative stereotypes, fear and social distance: A systematic review of depictions of dementia in popular culture in the context of stigma. BMC Geriatrics, 20(1), 477. https://doi.org/10.1186/s12877-020-01754-x researchgate.net+6

The post Making a Change by Using Person-Centred Language and Imagery for Dementia appeared first on DementiaHub.SG.

Shaping Dementia Landscape in Singapore

shekinah — Fri, 10 Oct 2025 07:38:09 +0000

For the best viewing of the timeline, please switch your desktop to 75% zoom.

Listen

14 Min Read

https://www.dementiahub.sg/wp-content/uploads/speaker/post-73314.mp3?cb=1770872635.mp3

Introduction

In the heart of Southeast Asia lies a city-state known for its progress and innovation – Singapore. But before the early 1990s, a quiet struggle unfolded. There was little to no formal support for persons living with dementia. Back then, dementia was often misunderstood, hidden away in silence. Yet change was on the horizon. From government agencies to grassroots volunteers, a growing network of support began to take root, laying the foundation for what would become Singapore’s evolving dementia care landscape.

There are currently about 100,000 people living with dementia and this number is expected to increase to about 152,000 in 2030 as reported by the Ministry of Health. Currently, there are many support programmes and services available for those living with this condition. However, many of these support programmes and services available for those living with dementia are unsuitable for persons with Young Onset Dementia (65 years old and below). This is a concern as there has been a growth in Young Onset Dementia (YOD) diagnosis in Singapore. Recognizing this gap and the need for greater awareness and understanding, Singapore focused on ensuring that resources and information on dementia became accessible. These efforts are crucial in addressing the challenges ahead and raising awareness.

To fully appreciate how far we’ve come, it’s important to reflect on the key turning points and tireless champions who have shaped this journey. This is the story of how Singapore has come together to build a society that uplifts, empowers, and supports those living with dementia.

Laying the Foundations

Alzheimer's Disease Association Established

In 1988, a series of missing persons reports in The Straits Times caught the attention of Dr Ang Peng Chye, a practicing psychiatrist at that time. At first glance, the cases appeared to be isolated incidents of elder neglect or abandonment, but Dr Ang saw a deeper pattern and a growing challenge. Driven by concern, he assembled a small task force under the Singapore Council of Social Services (SCSS), now known as the National Council of Social Service (NCSS). What they uncovered was striking across nursing homes and general practitioners. There was a profound lack of understanding about dementia; what it was, how it was diagnosed, and, most importantly, how care was given.

With these early insights, the team moved quickly. In 1989, they established the New Horizon Centre in Toa Payoh, the first dementia day care centre in Singapore, which paved the way for centre-based care for persons living with dementia to provide respite to caregivers. A year later, they founded the Alzheimer’s Disease Association, known today as Dementia Singapore Their mission was simple, yet impactful: to uplift, support, and empower families and individuals affected by dementia.

Image Caption: Dr Ang Pye Chye at ADA Staff and Volunteer Day

First Memory Clinic in Asia Established

Around the same time, another milestone emerged. Professor Kua Ee Heok, a leading psychiatrist from the National University of Singapore, was invited by the World Health Organisation (WHO) to join the Global study of dementia. This opportunity led to a landmark achievement. In November 1993, Singapore became home to Asia’s very first memory clinic, marking a pivotal step forward in both research and care.

By 1997, the clinic introduced the Elderly Cognitive Assessment Questionnaire (ECAQ), Singapore’s first dementia screening tool tailored for use by general practitioners. Thoughtfully localised, the ECAQ included familiar imagery like traditional local snacks to make the process more intuitive for seniors. It was a simple idea to bring dementia detection closer to everyday life.

The 1990s continued to pave the way for specialised care. In 1992, St. Andrew’s Community Hospital opened as the first hospital to offer subsidised, intermediate care for the elderly, including those living with dementia. Then, in 1999, Apex Harmony Lodge was established as the only purpose-built dementia residential care facility in Singapore. It is a place designed not just for treatment, but for dignity by creating a resort-like experience for persons living with dementia at all stages.

Together, these early efforts laid the groundwork for what would become a nationwide movement, one rooted in knowledge and compassion. This made room for the next wave in building dementia awareness and capability in Singapore.

Growth of Dementia Capability and Safeguards in Singapore

As Singapore entered the new millennium, the foundation laid for dementia awareness in the previous decade began to grow into a more structured and coordinated approach. The focus shifted from awareness to training professionals, family caregivers, and domestic helpers to meet the complex needs of those living with dementia.

Training courses for Dementia Care

In 2005, Singapore began offering training courses for healthcare and social service professionals at ADA, leading up to the official launch of its first dedicated dementia training center, the ADA Resource and Training Centre (ARTC), in 2013, with funding from the Singapore Ireland Fund. Today, the center is known as Dementia Singapore Academy. The current training provides essential skills to care professionals, family caregivers, Migrant Domestic Workers (MDW), and community members, enabling them to support individuals living with dementia in a meaningful and informed way.

This marked the beginning of a broader shift from professionalised care to community empowerment. It is not just about building expertise within clinics and institutions, but extending knowledge into homes, neighbourhoods, and families.

To reinforce this, the Caregiver Training Grant (CTG) was introduced by Ministry of Health to enable families to access affordable, personalised training to care for their loved ones with conditions including dementia. For many, this support was not just financial, it was an emotional reassurance that they were not alone.

This began the shift of not just empowering care professionals and social workers in being effective, but also equipping caregivers and members of the public with the skills needed to create a safe and inclusive environment for persons living with dementia.

In 2008, dementia advocacy reached a new height in public discourse. That year, The Straits Times published a six-page special feature to commemorate World Alzheimer’s Month, signalling that dementia was no longer a taboo topic, but a national priority that required support from the whole community.

As awareness grew, so did the need for legal safeguards.

In 2010, Singapore passed the Mental Capacity Act (MCA), a watershed moment in upholding the rights and dignity of individuals with cognitive impairment. For the first time, adults could appoint future decision makers, ensuring their wishes would be respected even if they lost their mental capacity later in life. This was done through the Lasting Power of Attorney (LPA), a legal tool that helps families plan.

For these protections to be truly inclusive, equity had to be built into the system.

Financial assistance schemes like the Seniors’ Mobility and Enabling Fund and the Pioneer Generation Package were subsequently introduced. These ensured access to assistive devices, medical care, and daily support that were not limited by socioeconomic status. More importantly, these initiatives helped make ageing with dignity not just an ideal, but a reality.

To support these initiatives, many parts of society came together in building a dementia-inclusive Singapore.

Expanding Advocacy and Community Engagement

Nationwide Campaigns

By the mid-2010s, dementia advocacy in Singapore had evolved from clinical care and legislation into something deeper: a movement rooted in the community.

It began in the heartlands, where the everyday met the extraordinary. In Yishun, Khoo Teck Puat Hospital launched a powerful ground-up campaign with Alzheimer’s Disease Association now known as Dementia Singapore called “Forget Us Not” funded by Lien Foundation. The title was more than a campaign slogan. It was a call to action extended to the nation to recognise the invisible struggles of those living with dementia and to respond with empathy.

At the same time, the Ministry of Health (MOH) and Agency for Integrated Care (AIC) drove the Dementia-Friendly Singapore (DFSG) Initiative in collaboration with community partners and corporates.

The vision was clear: to build a society where persons living with dementia are understood, accepted, and supported not just in healthcare settings, but in everyday life.

In 2017, this vision was translated into a real-world impact. Singapore’s first 24/7 Dementia Go-To Point (GTP) was launched at Sree Narayan Mission Nursing Home in Yishun. These GTPs are safe return points (community touchpoints) where members of the public can bring individuals who appear lost or confused to a safe place where trained staff can offer help.

Launch of CARA Application

In 2021, CARA was launched as a free dementia membership programme by Dementia Singapore, supported by the National Council of Social Service (NCSS) and the Agency for Integrated Care (AIC). Accessible through a mobile application, it offers a single platform for members to connect to services and resources relevant to dementia care, including key safety features such as Safe Return and Report Missing Person.

CARA does not require a formal dementia diagnosis, enabling access to support and resources early in the caregiving journey, while also providing rewards and benefits from partner organisations.

Among its features, the Dementia Go-to Point Locator helps members of the public identify nearby safe return points in the community, where persons with dementia can be guided to receive timely assistance.

Pioneering Peer Support for Persons Living with Dementia

Advocacy was also coming from within starting from the very people living with dementia themselves.

In the early 2020s, a new chapter began amidst the isolation of the COVID-19 pandemic. Individuals with dementia began stepping into the spotlight, using their voices to educate and uplift families and friends.

One of them was George Chong, one of Singapore’s earliest dementia advocates, who was diagnosed with Young Onset Alzheimer’s Disease in 2017. Through initiatives like the Voices for Hope (VFH) programme, persons living with dementia and their caregivers were equipped to share their journeys, reduce stigma, and build peer support networks. 

One of these changemakers was Emily Ong, who was diagnosed with MCI and founded the “La Kopi Peer Support Group” in 2021. She played an active role in numerous national and international conferences, advocating for greater inclusivity for those living with dementia. Initially meeting virtually due to pandemic restrictions, the group became an essential source of connection for individuals with young-onset or mild dementia, as well as their families.

In a time of lockdowns and social distancing, these virtual gatherings became lifeline proof that even when physically apart, a community as such could still grow.

These stories, told in their own words, signaled a powerful shift from care being given to persons with dementia to action being taken by them.

Source: Giffy Dementia-Friendly Singapore (DFSG) Mascot, Agency for Integrated Care.

Source: Voices For Hope Alumni on a Cruise in July 2024, Dementia Singapore.

The first national survey with over 5,600 participants across Singapore was conducted in 2019. The aim was to understand how stigma around dementia affects people in Singapore and promote greater understanding and acceptance for persons living with dementia and caregivers. The survey identified key areas of concern such as rejection, loneliness, and shame. This led to a concentrated effort in enhancing support for persons living with dementia and their caregivers within the community.

Growth of Community and Ageing in Place Initiative

As Singapore moves toward becoming a super-aged society, one guiding principle began to take hold: seniors, including those living with dementia, should be able to age in place; not in isolation or institutions, but in the familiarity of their own homes and in communities that understand and support them.

This idea, while once aspirational, soon became a national priority. Taking shape in the following ways:

Age Well SG

Led by the Ministries of Health, National Development, and Transport, the Age Well SG programme was launched to bring this vision to life. It was a coordinated effort to transform the urban environment into a supportive ecosystem for the ageing—one that enables safety, independence, and dignity.

New active ageing infrastructures began to emerge:

Therapeutic gardens designed to soothe and engage the senses.

Fitness trails tailored to seniors’ abilities.

Wayfinding aids and dementia-friendly signages were installed to help improve navigation.

The shift toward ageing in place also extended beyond the built environment. Community networks, neighbours, volunteers, and support groups played a vital role in helping seniors remain anchored in their neighborhoods. These local care systems provided daily reassurance to both persons with dementia and their caregivers.

Kebun Baru (Wayfinding Murals)

To create an inclusive Dementia-Friendly Community (iDFC) in Kebun Baru (KB), a group of students from NUS Chua Thian Poh Community Leadership Centre partnered with Dementia Singapore (formerly known as Alzheimer’s Disease Association) to conduct a ground-sensing study to:

Understand KB residents’ knowledge of and attitudes toward dementia;
• Uncover what a DFC means to them; and
• Explore what can be done to make KB dementia friendly.

From late 2019 to March 2020, a collaborative project between Dementia Singapore, grassroots leaders, and community partners was conducted in the community of Kebun Baru, Ang Mo Kio. One of the initiatives in this project was the Wayfinding Project, which aimed to make wayfinding, that is, navigation of physical surroundings, easier for persons living with dementia in this community.

Discussions were held with two persons living with young-onset dementia, participants from Dementia Singapore’s Voices for Hope programme for persons living with dementia and their caregivers, and Mr Henry Kwek (Member of Parliament and Advisor for Kebun Baru Constituency). Following this, murals of familiar retro items were painted on strategically located walls at void decks of HDB blocks in two Residents’ Committees. In effect, these murals can function as landmarks that differentiate buildings and corridors from each other, making it easier for person living with dementia to orientate themselves while moving through this vicinity.

National Gallery

The National Gallery of Singapore (NGS) collaborated with Dementia Singapore to host the first-ever art exhibition specifically dedicated to individuals living with dementia. Before NGS launched the Art With You program, the 2013 Arts and Dementia project had already inspired cultural heritage centers, artists, and art facilitators to create participatory arts programs in community spaces. This initiative provided opportunities for people with dementia and their caregivers to engage in meaningful social activities outside of institutional care settings.

Building a Dementia-Friendly Future in Yio Chu Kang

In 2019, a pioneering collaboration between the Agency for Integrated Care (AIC), the Centre for Liveable Cities (CLC), and the Singapore University of Technology and Design (SUTD) launched the Dementia Friendly Neighbourhood (DFN) study. This initiative introduced infrastructure prototypes across three precincts in Yio Chu Kang, aimed at creating environments that better support people living with dementia.

On December 2, 2023, Senior Minister Lee Hsien Loong (then Prime Minister) and Mr. Yip Hon Weng, Adviser to YCK Grassroots Organisations (GROs), officially unveiled the DFN study and prototypes. This event marked a significant step forward in Singapore’s effort to build more inclusive communities that cater to the needs of individuals with dementia and their families.

These efforts highlight the community’s dedication to creating an environment where persons with dementia can thrive.

Singapore’s dementia journey was about continuity preserving the rhythm of life while enhancing the support structures that surround them. At its core was a simple but powerful belief: the best place to grow old, for most people, is home.

Innovation as the Future of Dementia Care

In recent years, Artificial Intelligence (AI) has emerged as a powerful tool in the early detection of cognitive decline. Two groundbreaking examples highlight this shift toward more proactive dementia care.

AI Tools for Early Detection

One is Pensieve-AI, a locally developed app that identifies early memory problems or pre-dementia in seniors in under five minutes, with an accuracy rate of up to 93%. Using a tablet and stylus, patients complete drawing tasks, which the app analyzes for signs of cognitive issues. This AI tool is set to replace traditional screening methods like drawing a clock or recalling random words. In a nationwide study completed in September 2024, Pensieve-AI demonstrated 93% accuracy, matching the gold standard of cognitive testing. Developed by Singapore General Hospital (SGH) and GovTech, it is scheduled for rollout in 2026.

Another innovation is ReCOGnAIze, an AI-powered screening tool created by Gray Matter Solutions, a spin-off from Nanyang Technological University (NTU), in collaboration with the Osler Health Group. Unlike traditional paper-based tests or lengthy interviews, ReCOGnAIze uses neuroscientific games to detect Mild Cognitive Impairment (MCI), which can increase the risk of dementia. The process is quick—taking no more than 15 minutes—and offers a non-invasive, engaging way to identify early signs of cognitive decline.

Both technologies reflect a broader shift from reactive care to proactive prevention, aiming to intervene earlier, provide better support, and help individuals maintain their independence for as long as possible.

AI in shaping Art Therapy

At Jurong Community Hospital, a programme called PortrAIts: Small Things that Matter combines AI and art therapy to help persons with dementia express their memories visually. One patient used AI to recreate a vivid scene from his childhood, a moment long buried, now reimagined through digital art.

These creative breakthroughs are not just novel; they are deeply restorative. They give voice to experiences that dementia tries to erase. By merging art and technology, persons living with dementia are empowered, fostering autonomy and enhancing their quality of life in ways unimagined.

Peacehaven Jade Circle Dementia Care Facility

Meanwhile, in residential care, robots are redefining caregiving experience.

At Peacehaven Jade Circle, a next-generation dementia care facility developed by The Salvation Army, the Lien Foundation, and the Khoo Chwee Neo Foundation, residents are offered choices daily from joining group activities to enjoying breakfast on their own terms. The environment is person-centered, but supported by smart technology including Dexie, a dementia-specific humanoid robot designed to engage, stimulate, and comfort.

This blend of warmth and technology does not replace caregivers, it helps them by ensuring care is consistent, respectful, and personalised. However, it must be used appropriately to reap the best possible benefits as persons living with dementia do require an empathetic and human touch in their care.

Yishun Community Hospital’s dementia ward features a bus shelter, offering patients comfort, familiarity, and a sense of home. Inspired by gerontology training, staff use the shelter to ease anxiety, spark memories, and encourage physical activity showcasing a forward-thinking approach to dementia care in Singapore.

Each of these innovations, whether in clinics, hospitals, or homes, points to a future where dementia care is not just efficient, but empathetic; where technology does not overshadow human experience but amplifies its most compassionate parts.

What began decades ago as scattered seeds sowed by doctors, caregivers, and concerned communities has grown into a vibrant and evolving ecosystem of support. Along the way, Singapore has nurtured a dementia care landscape rooted in compassion, strengthened by science, and shaped by community.

While the path ahead remains challenging, the ground has been prepared. New seeds are still being sown through innovative therapies, inclusive design, and voices of lived experience. With continual care, these seeds will grow into a future where persons living with dementia and family caregivers are not only supported but truly seen and valued.

Abdullah, Z. (2025, February 4). NTU launches AI-powered screening tool to detect pre-dementia in 15 minutes. The Straits Times. https://www.straitstimes.com/singapore/health/ntu-launches-new-ai-powered-screening-tool-to-detect-pre-dementia-in-15-minutes
Agency for integrated care. (n.d.). Caregivers Training Grant (CTG). aic.sg. https://www.aic.sg/financial-assistance/caregivers-training-grant-ctg/
Agency for integrated care. (n.d.). Seniors’ Mobility and Enabling Fund (SMF). aic.sg. https://www.aic.sg/financial-assistance/caregivers-training-grant-ctg/
Age Well SG. (n.d). What is Age Well SG. Age Well SG. https://www.agewellsg.gov.sg/
Apex Harmony Lodge. (n.d.) Who We Are. Apex Harmony Lodge. https://www.apexharmony.org.sg/about/our-story
CARA. (n.d). A Lifestyle and Community Digital Platform. CARA. https://cara.sg/
Caregiving and Community Mental Health Divison, Agency for Integrated Care, & Centre for Libeable Cities. (2019). Creating a Dementia-Friendly Neighbourhood: A Yio Chu Kang Pilot Project. Dementia Friendly Singapore. https://www.dementiahub.sg/wp-content/uploads/2025/02/Dementia-Friendly-Neighbourhood-Research-Report.pdf
Dementia Friendly Singapore. (n.d). About Dementia-Friendly Singapore (DFSG) initiative. DementiaHub.SG. https://www.dementiahub.sg/dfsg-initiative/
DementiaHub.SG. (n.d.). Dementia-friendly neighbourhoods. DementiaHub.SG. https://www.dementiahub.sg/i-want-to-play-a-part/dementia-friendly-neighbourhoods/
Dementia Singapore (2019, May 6). 3 in 4 persons with dementia feel rejection and loneliness, national survey on dementia finds. Dementia Singapore. https://dementia.org.sg/2019/05/06/smu-ada-survey-2019/
Dementia Singapore. (n.d.). Milestones. Dementia Singapore. https://dementia.org.sg/milestones/
Dementia Singapore (n.d). Voices for Hope. Dementia Singapore. https://dementia.org.sg/voices/
Dementia Singapore. (2020, September 25). Up Close And Personal With Dr Ang Peng Chye. dementia.org.sg. https://dementia.org.sg/2020/09/25/up-close-and-personal-with-dr-ang-peng-chye/#:~:text=What%20motivated%20you%20to%20establish,as%20%E2%80%9CAlzheimer’s%20Disease%20Association%E2%80%9D
Dementia Singapore. (2024, September 4). Young onset dementia cases on the rise, even as overall dementia cases in Singapore drop [Press release]. Dementia Singapore. https://dementia.org.sg/wp-content/uploads/2024/10/Media-Release-Young-onset-dementia-cases-on-the-rise-even-as-overall-dementia-cases-in-Singapore-drop.pdf
Forget Us Not. (n.d). Forget Us Not, Building a Dementia Friendly Community. https://forgetusnot.sg/
Hong, J. (2017, September 10). First 24-hour dementia go-to point launched in Yishun. The Straits Times. https://www.straitstimes.com/singapore/first-24-hour-dementia-go-to-point-launched-in-yishun
Kaur, A. (25 March, 2025). What’s a bus shelter doing in a dementia ward in Singapore?. The Straits Times. https://www.straitstimes.com/life/whats-a-bus-shelter-doing-in-a-dementia-ward-in-singapore
Kua, E. H., Tan, S. L., Lee, K. S., Ko, S. M., & Tan, C. H. (1997). The NUH Memory Clinic. National University Hospital, Singapore. Singapore medical journal, 38(3), 112–115. https://pubmed.ncbi.nlm.nih.gov/9269377/
Kua, E.H. (n.d). Prof Kua Ee Heok, faculty profile [Faculty profile]. Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore. https://medicine.nus.edu.sg/pcm/faculty-staff/expert-team-physicianspsychologist/physicians/prof-kua-ee-heok/
Lee, Y, L. (2023, September 23). Tapping artificial intelligence in art therapy for dementia patients. The Straits Times. https://www.straitstimes.com/singapore/tapping-artificial-intelligence-in-art-therapy-for-dementia-patients
Mahzam, R. (2023, June 9). Speech By Mdm Rahayu Mahzam, Senior Parliamentary Secretary, Ministry of Health, At the Launch of “Inclusive Customer Experience– Making a Difference for Persons Living With Dementia” Training Programme, on 9 June 2023 [Speech]. ‘’Inclusive Customer Experience–Making a Difference for Persons Living With Dementia” Training Programme. https://www.moh.gov.sg/newsroom/speech-by-mdm-rahayu-mahzam-senior-parliamentary-secretary-ministry-of-health-at-the-launch-of-inclusive-customer-experience-making-a-difference-for-persons-living-with-dementia-training-programme-on-9-june-2023
Mental Capacity Act (Cap. 177A, 2008). Singapore Statutes Online. https://sso.agc.gov.sg
Ministry of Health Singapore. (2025, September 10). Pioneer Generation Package. Moh.gov.sg. https://www.moh.gov.sg/managing-expenses/schemes-and-subsidies/pioneer-generation-package
National Gallery Singapore. (n.d). Art with You. National Gallery Singapore. https://www.nationalgallery.sg/sg/en/about/our-initiatives-and-collaborations/art-wellness/art-with-you.html
Raman, R. (2025, January 14). Singapore is turning to AI to care for its rapidly aging population. Rest of World. https://restofworld.org/2025/singapore-ai-eldercare-tools/
St. Andrew’s Mission Hospital. (2020). Milestones. St. Andrew’s Mission Hospital. https://www.samh.org.sg/milestones/
Tan, J. (2025, July 21). AI-powered app accurately identifies pre-dementia seniors, to be available in 2026. The Straits Times. https://www.straitstimes.com/singapore/ai-powered-app-accurately-identifies-pre-dementia-seniors-to-be-available-in-2026
Young Dementia Network. (n.d.). Emily Ong: Advocate for young people with dementia. Young Dementia Network. https://www.youngdementianetwork.org/about-the-network/our-members/member-and-service-showcase/emily-ong/

Was this article helpful?

Yes No

Using the Pool Activity Level (PAL) Tool to Engage Persons Living with Dementia

shekinah — Wed, 03 Sep 2025 05:40:12 +0000

Listen

5 Min Read

https://www.dementiahub.sg/wp-content/uploads/speaker/post-72242.mp3?cb=1778725176.mp3

The Pool Activity Level (PAL) Instrumental Tool⁴ is a framework designed to support persons living with dementia. Developed by Dr. Jackie Pool, PAL focuses on tailoring activities to match the cognitive and functional abilities of each person, fostering meaningful engagement.

This article is the first of four installments that discusses the benefits of PAL and how one can use it informally for persons living with dementia.

Health Promotion Board. (n.d.). Let’s talk about Vascular Dementia. HealthHub. https://www.healthhub.sg/programmes/mindsg/vascular-dementia
Chiew, H. J. (2021, July 5). Young-onset dementia: Improving outcomes with early recognition at Primary Care. SingHealth. https://www.singhealth.com.sg/news/defining-med/Young-Onset-Dementia
Ng, Z. X., Yang, W. R. E., Seet, E., Koh, K. M., Teo, K. J., Low, S. W., Chou, N., Yeo, T. T., & Venketasubramanian, N. (2015). Cerebellar strokes: A clinical outcome review of 79 cases. Singapore Medical Journal, 56(03), 145–149. https://doi.org/10.11622/smedj.2014195
Ioannides K, Tadi P, Naqvi IA. Cerebellar Infarct. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470416/
Huang, J., Qiu, Z., Zhou, P., Li, J., Chen, Y., Huang, R., Li, C., Ouyang, X., Feng, H., Xu, H., Liu, D., Dai, Z., Zhu, J., Liu, X., Chen, H., & Jiang, Y. (2019). Topographic location of unisolated pontine infarction. BMC Neurology, 19(1), 1-6. https://doi.org/10.1186/s12883-019-1411-6

What is Pool Activity Level Instrumental Tool (PAL)

The Pool Activity Level, or PAL in short, is an evidence-based tool for persons living with dementia. It was developed by Dr. Jackie Pool in 1999 to personalise activities for persons living with dementia.

PAL is widely used across the community care sector in Singapore ¹, such as dementia day care centers and nursing homes. It helps community care providers tailor activities to enhance the well-being and quality of life for persons with dementia, but it can also be used by individuals caring for their loved ones with dementia to scale activities for daily living and recreation.

How is PAL Used?

Occupational therapists (OTs) often use the Pool Activity Level (PAL) Instrument to support persons living with dementia, by assessing their functional abilities and tailoring meaningful activities accordingly.

The following describes how one can use the PAL tool in practice:

Tips

One may observe whether a person can pick up a toothbrush and start brushing without being told, or if he needs help to get started.

1. Determine the PAL Level

There are four levels of PAL. To tailor the best activity for your loved one, you should know which level they fall under.

Level

Planned Level

Persons Living with Dementia Characteristics

Plan and carry out familiar tasks independently.

Examples (Getting Dressed)

Plans what to wear selects own clothing from cupboard; dresses in correct order.

Caregiver Role

Encourage autonomy with minimal guidance.

Exploratory Level

Can follow simple instructions and learn by doing.

Needs help to plan what to wear but recognises items and how to wear them.

Use hands-on, step-by-step prompts.

Sensory Level

Responds mainly to sensory stimuli (i.e music)

Needs help to plan, and with order of, dressing, but can carry out small tasks if someone directs each step.

Offer tactile, auditory or visual input.

Reflex Level

Reflexive, mostly involuntary responses (i.e massage)

Totally dependent on someone to plan, sequence and complete dressing; may move limbs to assist.

Focus on comfort, position, and routine.

2. Activity Planning and Grading

Based on the person’s PAL level, one should:

Ensure activities are something the person enjoys (cooking, painting etc).

Design or adapt activities to match cognitive ability.

Ensure activities are safe, engaging, and doable.

Adjusts task complexity, environment, and instructions.

Tips

Example one:

For someone at the Exploratory Level, introduce a familiar baking task but break it down into single steps with demonstration.

Tips

Example two:

For a person at the Exploratory level, offer hand-over-hand assistance to get the person to water the plants at a garden.

Tips

Example three:

For a person at the Planned level, encourage full participation from planning to execution of a simple cooking task

i.e. cooking fried rice, providing verbal promptings when required.

3. Review and Reassessment

It is advisable to continually:

monitor for changes in function or cognitive status;

adjust the PAL level and revise activity plans as needed; and

use PAL as a dynamic tool, not just a one-time assessment.

Tips

When someone who was at the Exploratory level is now unable to perform a painting task with guidance, consider getting the person to run his or her fingers over textured surfaces.

These simple actions provide a strong foundation of understanding persons living with dementia. One can also speak to an OT and care staff to better understand their loved one’s abilities.

Benefits of PAL for Persons living with Dementia

Research has supported the following areas where PAL can influence meaningful engagement and improve the quality of life (QoL) for persons living with dementia.

Promotes Person-Centered Care

The PAL tool focuses on what the person can do, rather than their limitations. Activities are tailored to match a persons living with dementia’s current cognitive and functional abilities, making them feel respected, understood, and valued.² This will boost their self-esteem and emotional well-being.

Supports Cognitive Engagement

Activities designed at the appropriate PAL level help to stimulate the brain without overwhelming the person living with dementia. It helps to maintain cognitive function for as long as possible by promoting participation in structured, familiar, or sensory-rich tasks.

Improves Emotional and Psychological Well-being

When tasks are too complex, persons living with dementia may feel distressed, agitated, or helpless.⁶ PAL ensures tasks are matched to ability, reducing the risk of behavioural challenges and increasing cooperation. This can lead to smoother caregiving interactions.

Maintains Independence and Functional Skills

PAL preserves daily living skills. It empowers individuals to do as much as they can, with just the right level of support. It also encourages autonomy in personal care, mobility, and leisure where possible.

Even simple tasks like folding towels or sorting items can reinforce purpose and control for persons living with dementia.

Enhances Quality of Life Through Meaningful Activity

Activities under the PAL framework are emotionally and socially meaningful, tailored to personal preferences and history.³ PAL promotes occupational engagement based on the interest of the persons living with dementia. Individuals often display improved mood, better sleep, and more stable routines.

For example: A person living with dementia who was previously a teacher may find familiarity and engagement in grading papers or word searches compared to other activities.

Improves Safety

PAL helps therapists and caregivers identify risks based on cognitive level (e.g., poor problem-solving skills, impulsion). Activities and environments can be modified (e.g., simplifying tasks, removing hazards) to prevent injuries.

Supports Relationships and Communication

Caregivers who understand how PAL works can interact more effectively with persons living with dementia by using appropriate prompts and managing expectations. It reduces miscommunication and preserves the emotional bond between the caregiver and their loved ones.

Additionally, the PAL tool is effective for persons living with dementia with hearing or visual impairment.⁵ This helps caregivers adapt activities for sensory loss, making it easier for their loved ones to stay engaged.

Track Progress or Decline

PAL can be re-administered over time to monitor changes in abilities. This supports timely adjustments to care plans and interventions.

Conclusion

The PAL tool is beneficial in enhancing the quality of life for persons living with dementia. Using a structured approach to understanding a person’s activity level, the PAL tool enables caregivers to tailor care that is meaningful and engaging. It contributes to a greater sense of well-being for persons with dementia.

Agency for Integrated Care (2016). Dementia Care Competency Framework 2016. Agency for Integrated Care. https://www.aic.sg/wp-content/uploads/2023/06/Dementia-Competency-Framework-Assessment-Criteria.pdf
Groenendaal, M., Smaling, H. J. A., Achterberg, W. P., & Caljouw, M. A. A. (2022). Maintaining meaningful activities for persons with dementia during transitions of care: A systematic review. Geriatric Nursing, 44, 176–183. https://doi.org/10.1016/j.gerinurse.2022.01.017
Han, A., Radel, J., McDowd, J. M., & Sabata, D. (2015). Perspectives of people with dementia about meaningful activities: A synthesis. American Journal of Alzheimer’s Disease & Other Dementias®, 31(2), 115–123. https://doi.org/10.1177/1533317515598857
Pool, J. (2012). The Pool Activity Level (PAL) Instrument. Jessica Kingsley publishers, London. https://www.dailysparkle.co.uk/wp-content/uploads/2022/04/PAL-Guide-for-Activity-Provision.pdf
Wenborn, J., Challis, D., Pool, J., Burgess, J., Elliott, N., & Orrell, M. (2008). Assessing the validity and reliability of the Pool Activity Level (PAL) Checklist for use with older people with dementia. Aging & mental health, 12(2), 202–211. https://doi.org/10.1080/13607860801984375

Was this article helpful?

Yes No

Music Therapy – a Symptomatic Treatment of Dementia

Peter Cher — Mon, 25 Aug 2025 07:27:39 +0000

Listen

4 Min Read

https://www.dementiahub.sg/wp-content/uploads/speaker/post-72339.mp3?cb=1774605077.mp3

Music is a complex composition of melody, harmony, rhythm, timbre, tempo, dynamics, form, texture, and words or lyrics. These elements, when put together, have a profound effect on the listener’s emotions, behaviour, and memory. When used appropriately, music can be a useful and effective tool to optimise the quality of life for persons living with dementia.

With these unique qualities, music has been widely used as a potentially beneficial intervention to improve moods, cognitive function, memory, and communication. This is commonly known as music therapy. Music therapy can also provide opportunities for socialisation and connection between individuals with dementia and people around them in both personal sphere and group setting.

In this article, we explore the use of music therapy as a non-pharmacological intervention to improve cognitive and behavioural symptoms in persons living with dementia, the possible effects and benefits of music therapy, and how music therapy is used in Singapore to better or enhance the quality of life of those living with dementia.

Benefits of Music Therapy for Persons Living with Dementia

Non-pharmacological approaches like music-based interventions are regarded as low-risk, accessible and inclusive as an approach to managing behavioural psychological symptoms of dementia or BPSDs, compared to pharmacological interventions.

Based on recent studies, music therapy has gained worldwide popularity in managing symptoms of dementia over the years. It is found that musical training can help mitigate effects of cognitive impairments and increase the capacity of persons to remember music.

In a study on persons living with Alzheimer’s Disease (AD), researchers found that persons with AD showed improvement in word fluency, biographical memory, and memory of the lyrics after participating in music therapy sessions.

Here are some of the benefits music therapy can have on persons living with dementia, as supported by several studies:

	Potential Benefits of Music Therapy for Persons Living with Dementia
1.	Improves mood and reduces agitation	Music can evoke positive emotions and memories. This can help alleviate depressive symptoms and other negative emotions such as anxiety and agitation which are common behavioural and psychological symptoms of dementia.
2.	Enhances cognitive function	Music can improve certain cognitive and executive functions such as verbal fluency, recollection of lyrics/memories, and assists in Activities of Daily Living (ADLs).
3.	Enhances communication	Music can serve as a non-verbal communication tool that helps persons living with dementia to express their thoughts.
4.	Improves socialisation and connection with people	Group music activities can eliminate isolation and loneliness.
5.	Improves quality of life	All the benefits can lead to improved quality of life. It is especially beneficial to those who are battling with emotional symptoms, such as anxiety.

Supported Evidence of Music Therapy

The use of customised music playlist in medical setting has been proven effective in combating (disinhibited) behavioural symptoms of people living with dementia. Studies reported a rise in positive results in recent years.

Here are some evidence-based statistics that support the effectiveness of music therapy in managing BPSDs or behavioural and psychological symptoms of dementia, including agitation, aggression depression, anxiety and apathy, particularly in moderate stage of dementia:

A meta-analysis of 17 randomised controlled trials (RCTs) by Zhang et al. (2017) found out that music therapy significantly reduced disruptive behaviours of persons living with dementia.
An RCT conducted by Raglio et. al. (2010) revealed that individualised music therapy had a 30 per cent reduction in disruptive behaviours compared to control group.
A Cochrane review (2018) that analysed 22 trials with over 1,097 participants saw music-based intervention resulted in significant reduction in depressive symptoms.

“Music Therapy is a person-centered, non-pharmacological approach that supports emotional well-being, cognitive function, and social interaction. It also provides opportunities for caregiver participation, strengthening emotional bonds and offering shared joyful experiences. The structured yet flexible format makes it accessible and highly beneficial for persons with dementia, including those in moderate stages. It is also listed as a recommended intervention for BPSD as part of the clinical guidelines for dementia by Singapore’s Ministry of Health.”

R. S. Chandraajothi, Senior Centre Manager, Care Services - New Horizon Centre Bukit Batok & Jurong Point, Dementia Singapore

Music has the power to evoke emotions and help persons living with dementia recall and share their life stories with their caregivers and vice versa. Furthermore, music therapy activities can easily and effectively be incorporated into other forms of therapy such as reminiscence therapy and art therapy.

Here are some practical, meaningful, and evidenced-based activities (and their benefits) you can incorporate into the lives of persons living with dementia:

Create a personalised playlist that includes your loved one’s favourite songs from his youth/era or culture. This can trigger fond memories and facilitate conversation.
Encourage your loved ones to sway along or clap to the rhythm and tempo of the music. This can improve movements and functional abilities.
Play soothing and familiar music to help your loved one manage emotions, moods, and relieve anxiety and pain.
Encourage your loved one with dementia to sing along to his favourite songs. This will improve speech articulation and fluency over time.
Combine music with visual art such as painting to encourage self-expression and enhance creativity.

Conclusion

As research continues to validate the effectiveness and benefits of music therapy, integrating music therapy into dementia care not only honours the personhood of persons living with dementia, but it is also an accessible and meaningful way to connect them with their loved ones. In the gentle rhythm of familiar melodies, many find joy, comfort and more importantly a renewed sense of identity and dignity that enhance their quality of life.

Bleibel, M., El Cheikh, A., Sadier, N.S. et al. The effect of music therapy on cognitive functions in patients with Alzheimer’s disease: a systematic review of randomized controlled trials. Alz Res Therapy 15, 65 (2023). https://doi.org/10.1186/s13195-023-01214-9
Shirsat A, Jha RK, Verma P. Music Therapy in the Treatment of Dementia: A Review Article. Cureus. 2023 Mar 31;15(3):e36954. doi: 10.7759/cureus.36954. PMID: 37139292; PMCID: PMC10151115.
Zhang, Y., Cai, J., An, L., Hui, F., Ren, T., Ma, H., Zhao, Q. (2017). Does music therapy enhance behavioural and cognitive function in elderly dementia patients? A systematic review and meta-analysis. Ageing Research Reviews, 35, 1–11. DOI: 10.1016/j.arr.2016.12.003
Van der Steen, J. T., Smaling, H. J. A., van der Wouden, J. C., Bruinsma, M. S., Scholten, R. J. P. M., & Vink, A. C. (2018). Music-based therapeutic interventions for people with dementia. Cochrane Database of Systematic Reviews, 2018(7), CD003477. DOI: 10.1002/14651858.CD003477.pub4
Raglio, A., Bellelli, G., Traficante, D., Gianotti, M., Ubezio, M. C., Gentile, S., Villani, D., & Trabucchi, M. (2010). Efficacy of music therapy treatment based on cycles of sessions: A randomised controlled trial. Ageing & Mental Health, 14(8), 900–904.

The post Music Therapy – a Symptomatic Treatment of Dementia appeared first on DementiaHub.SG.

FINGER Model – Prevention of Cognitive Decline

Peter Cher — Mon, 04 Aug 2025 03:59:10 +0000

Listen

3 Min Read

https://www.dementiahub.sg/wp-content/uploads/speaker/post-71612.mp3?cb=1774605416.mp3

The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) model is a holistic approach that focuses on lifestyle changes rather than medication. It has gained prominence as a proactive measure against cognitive impairment, underlining the significance of lifestyle interventions in maintaining brain health. Its development has paved the way for a shift in how we perceive and address cognitive decline, embracing a more integrated and preventive strategy.

Understanding Cognitive Decline

Cognitive decline refers to the gradual loss of cognitive abilities, which can affect one’s memory, reasoning, and problem-solving skills. Some cognitive decline is expected with age, but significant cognitive decline can indicate mild cognitive impairment or more severely, Neurocognitive disorders (Dementia). The symptoms often start subtly, like forgetting appointments or struggling with problem solving, but can eventually impact one’s daily life and independence.

It is crucial to prevent cognitive decline to maintain quality of life, allowing individuals to engage fully in personal and social activities. By focusing on prevention, we can delay or even avoid the onset of severe cognitive impairments, ensuring a more vibrant life as we age.

Core Principles of the FINGER Model

The FINGER model is built upon five core components:

Nutrition: A balanced diet that is rich in fruits, vegetables, whole grains, and lean proteins, which supports cognitive function.
Physical Activity: Regular activities, such as walking, can improve blood flow to the brain and the growth of new neural connections.
Cognitive Training: Activities like puzzles and memory games can keep the brain active and engaged.
Social Engagement: Such engagement provides mental stimulation and emotional support, which are essential for maintaining cognitive health.
Monitoring Risk Factors Related to Cardiovascular Disorders: Controlling of cardiovascular risk factors like blood pressure, cholesterol, blood glucose, and body weight is also important for brain health.

Each of the above components play a vital role in promoting brain health and preventing cognitive decline.

Implementing Lifestyle Measures to Maintain Social Relationships and Keeping the Brain Actively Engaged

Integrating the FINGER model into daily life does not have to be daunting or reinventing one’s daily routine. One can start with small, manageable changes. For instance, including more fruits and vegetables into meals, or frequent brisk walks. These simple steps can make a significant difference over time.

In addition to mental and social activities, integrating physical exercise into one’s routine is crucial in maintaining overall wellbeing. Regular physical activity does not only improve cardiovascular health it also enhances cognitive function by increasing blood flow to the brain.

Whether it is a brisk walk in a park, a yoga session, or a dance class, find an activity that you enjoy and commit to it regularly. Exercise releases endorphins, which can improve mood and reduce stress level, further supports cognitive health. One should aim for at least 150 minutes of moderate aerobic activity each week, as recommended by health experts.

A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats provides essential nutrients your brain needs to function optimally. Foods high in antioxidants, like berries, and omega-3 fatty acids found in fish, such as salmon, are particularly beneficial.

Staying hydrated is equally important, as mild dehydration can affect your concentration and cognitive abilities. One should consider consulting a nutritionist to tailor a diet plan that meets one’s specific needs and preferences, fuelling both your body and mind effectively.

Integrating these lifestyle changes lays a strong foundation for long-term cognitive vitality.

A Promising Approach for Local Dementia Care

Although the FINGER model emerged from Finland, it has been implemented in various studies worldwide, including Singapore. Its adaptation signifies an encouraging trend, highlighting its potential to enhance Cognitive support care for individuals and families locally.

Author’s Bio

Hovi Care provides elderly and elderly and cognitive support care services designed to support seniors in achieving a high quality of life through active ageing and holistic wellness programmes. They combine cognitive, social and physical rehabilitation, to support and to meet individual’s needs.

Website: http://www.hovicare.sg/

Alzheimer’s Society (2025). Anxiety and Dementia. https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/anxiety-dementia.
Barrell, A. (2020). Stress vs. anxiety: How to tell the difference. Medical News Today. https://www.medicalnewstoday.com/articles/stress-vs-anxiety
Dementia UK. (October, 2022). Managing anxiety and depression in a person living with dementia. https://www.dementiauk.org/information-and-support/health-advice/managing-anxiety-and-depression-in-a-person-living-with-dementia/

Was this article helpful?

Yes No

Dementia Posts Archive - DementiaHub.SG

Caring Through Vision Loss: Insights from Dementia Caregivers

In this Article

Introduction ​

Understanding Visual Loss in Late Life ​

Dementia-Related Visual Difficulties ​

How Visual Loss Impacts Persons Living with Dementia ​

Care Partner Perspectives: Real-Life Tips ​​

Caregiver Insights

Tips from Rosalind, Care Partner

Tips from Lybea, Care Partner

Conclusion

Read Next

Counselling for Caregivers

In this Article

How Counselling Supports the Dementia Caregiving Journey

Counselling for Caregivers for Early-stage Dementia

Counselling for Caregivers for Middle-stage Dementia

Counselling for Caregivers for Late-stage Dementia

How to prepare for the first counselling session?

Think about what you want to talk about and to achieve from counselling beforehand.

Keep an Open Mind

Be Ready to Share Your Inner Feelings and Thoughts

Types of Counselling and Where to Find Them

Conclusion

Additional Resources

Expressive Arts Therapy: An Introduction

In this Article

What Expressive Arts Therapy Is

Differentiate Expressive Arts Therapy from Expressive Arts Programmes

Benefits of Expressive Arts Therapy (EXAT)

Getting Started

Additional Tips

Conclusion

Author's Bio

Hearing Loss: A Hidden Risk Factor for Dementia

In this Article

Introduction

What is the Connection of Hearing Loss and Dementia

Types of Hearing Loss

Early Signs of Hearing Loss

Tips for Prevention and Intervention

Prevention

Tip

Intervention

Conclusion

Was this article helpful?

What went wrong?

Tell us how we can improve?

Thank you for your feedback!

Follow us on social media:

Read Next

Making a Change by Using Person-Centred Language and Imagery for Dementia

In this Article

Why does using person-centred language matter?

Common stigmatising local terms associated with dementia

Stigmatising imagery used in the portrayal of dementia

How do we use appropriate language when referring to persons living with dementia?

Additional Resource

Shaping Dementia Landscape in Singapore

In this Article

Introduction

Laying the Foundations

Image Caption: Dr Ang Pye Chye at ADA Staff and Volunteer Day

Growth of Dementia Capability and Safeguards in Singapore

Expanding Advocacy and Community Engagement

Nationwide Campaigns

Growth of Community and Ageing in Place Initiative

Innovation as the Future of Dementia Care

Was this article helpful?

What went wrong?

Tell us how we can improve?

Thank you for your feedback!

Follow us on social media:

Read Next

Using the Pool Activity Level (PAL) Tool to Engage Persons Living with Dementia

In this Article

What is Pool Activity Level Instrumental Tool (PAL)

How is PAL Used?

Tips

Introduction

Understanding Visual Loss in Late Life

Dementia-Related Visual Difficulties

How Visual Loss Impacts Persons Living with Dementia

Care Partner Perspectives: Real-Life Tips