I Live With Dementia Archives - DementiaHub.SG

FINGER Model – Prevention of Cognitive Decline

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

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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/

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Vascular Dementia

Peter Cher — Thu, 14 Dec 2023 04:41:02 +0000

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Vascular dementia is one of the most common types of dementia in Singapore. In fact, 45.5% or almost half of those with dementia in Singapore have this condition. ¹ Read on to find out more about what it is, its symptoms and risk factors, and how to reduce the risk of developing this type of dementia.

What is Vascular Dementia?

Vascular dementia is a type of dementia caused by blood-flow-related brain damage. The word ‘vascular’ refers to blood vessels.

How Common is Vascular Dementia?

In many parts of the world including Singapore, vascular dementia is the second most common type of dementia after Alzheimer’s disease. According to the National Neuroscience Institute (NNI), 16% of the patients seen at NNI from 2013-2017 who developed dementia when they were above 65 years of age had vascular dementia, while those who had developed dementia below 65 years of age seen at NNI in the same period accounted for 19% of cases. ²

Main Symptoms of Vascular Dementia

The symptoms of vascular dementia are similar to those experienced in other types of dementia. Typical symptoms include:

Slow thought
Difficulty with planning
Trouble understanding
Issues with concentration
Mood and/or behaviour changes
Memory and language issues
Problems with movement and/or balance

The symptoms experienced depend on the specific brain areas that have been damaged. For example, if brain areas that are needed to understand language are damaged, a person with this kind of brain damage may have trouble understanding what they hear others saying, or what they read.

Read more about causes of vascular dementia in the sections below for more information of more specific groups of symptoms that can occur.

How quickly do symptoms develop?

The speed of symptom development depends on the cause, type, and severity of the vascular dementia.

Symptoms of vascular dementia can develop slowly over time, which typically happens when the dementia is caused by chronic, slow-developing blood vessel damage.

On the other hand, symptoms can appear or worsen suddenly after a stroke: after both the first stroke and any subsequent strokes.

Do symptoms differ from symptoms of other types of dementia, such as Alzheimer’s disease?

Symptoms of vascular dementia tend to be characterised more by speed of thought and problem-solving ability.
Some symptoms, like memory loss and language issues, tend to be more prominent in dementia caused by Alzheimer’s disease than in vascular dementia, although persons living with vascular dementia may experience them too.

The differences between the symptoms of vascular dementia and those of other kinds of dementia may be more obvious at the milder stages of dementia. As dementia progresses, the kinds of symptoms experienced may broaden in scope, and the differences between the symptoms of vascular dementia and other kinds of dementia may become less apparent.

Mixed dementia: More than one type of dementia

A person can also develop mixed dementia, which happens when a person has more than one type of dementia. Most cases of mixed dementia happen with Alzheimer’s and vascular dementia since they are the two most common types of dementia. Persons with mixed dementia will show signs of both types of dementia, with one type of dementia often being predominant.

Causes

Blood carries nutrients and oxygen that our body’s cells need to work and be alive. When blood cannot reach certain brain tissues because of problems with blood flow, these tissues cannot receive the oxygen and nutrients they need and become damaged. If this lack of blood flow happens for too long, these tissues can die, causing irreversible damage.

Some of the more common vascular issues that can cause vascular dementia include:

Ischemic stroke

The word ‘ischemia’ means ‘lack of blood flow’. An ischemic stroke is a blockage in a blood vessel in the brain. A single ischemic stroke or multiple strokes can prevent blood from reaching brain tissues.

Haemorrhagic stroke

The word ‘haemorrhage’ means bleeding. Haemorrhaging in the brain, or a haemorrhagic stroke, can happen in the brain’s blood vessels, and it is life-threatening when this happens. There are many possible causes of bleeding in the brain, including head trauma, high blood pressure that weakens blood vessels’ walls, and aneurysms (abnormal bulging in the walls of blood vessels).

Chronic blood vessel damage

Chronic blood vessel damage means damage to blood vessels that continues for a long time.

Damage to blood vessels, such as the narrowing of blood vessels, can, when it is severe, obstruct blood from flowing to brain tissues. Over time, this obstruction can develop into vascular dementia.

Types of Vascular Dementia

The symptoms of vascular dementia, and their order of development as dementia progresses, depend on the type of vascular dementia a person develops. The types of dementia are defined by different causes.

Below are the main types of vascular dementia: 

Subcortical vascular dementia

Subcortical vascular dementia happens when tiny blood vessels deep inside the brain become damaged.
Most tissues damaged in this type of dementia happen in an area deep within the brain called the subcortex.

Stroke-related dementia

Stroke-related dementia happens when a stroke or multiple strokes happen in the brain. A stroke prevents blood from reaching brain tissues, leading to tissue death. The place where there is dead tissue due to low blood supply is called an ‘infarct’.

Strategic-infarct dementia

- Strategic-infarct dementia happens when dementia is caused by one large stroke
- In this kind of dementia, there is a sudden and drastic change in thinking and behaviour, although with appropriate support, symptoms can be stabilised.

Multi-infarct dementia
- Multi-infarct dementia happens when dementia is caused by a series of strokes which progressively damages brain tissue.
- Some strokes can be small and have minor symptoms. They can even happen without noticeable symptoms, in which case they are called ‘silent’ strokes.
- Smaller strokes are also called ministrokes or transient ischemic attacks (TIAs).
- Ministrokes can last for a few minutes each, and their more obvious symptoms can last for an hour to a day.
- As more strokes happen over time, symptoms of dementia can develop and worsen. The worsening of symptoms may be more noticeable immediately after each small stroke, after which the symptoms may tend to stabilise.

Stroke Syndromes

For both strategic-infarct and multi-infarct dementia, the parts of the brain that the stroke damages affects the syndrome (a group of symptoms) that a person experiences will differ. Knowing what stroke syndromes you or your loved one with vascular dementia may have can help you to better manage the symptoms of vascular dementia and get the appropriate support.

Many strokes will occur with hallmark stroke symptoms:
Facial drooping of one side of the face
Hemiparesis: weakness on one side of the body
Numbness, usually on one side of the body
Dysarthria: difficulty with speaking and/or slurred speech
Dysphasia, or language impairment: an impaired ability to understand spoken and written language
Confusion: trouble speaking and understanding speech
Sight issues in either or both eyes
Movement issues: trouble with walking; dizziness; difficulties with balance and coordination
Severe headache without a known cause

These hallmark symptoms may not always happen in a stroke, or may happen with other syndromes depending on the type of stroke. The type of stroke itself depends on the area of the brain affected, including the side of the brain (right or left).

Some symptoms happen immediately when the stroke first happens, while others may develop after some time. In addition, some symptoms are long-lasting, while some symptoms involving the loss of abilities (for example. speech, sight) can sometimes be partially recovered.

More information about stroke syndromes can be found in the section Additional Information: Stroke Syndromes at the end of the article.

Treatment and Support

As vascular dementia is highly linked to vascular health issues, persons living with vascular dementia may be advised to take steps to improve their overall cardiovascular health, such as by improving their diet and level of physical activity.

Treating and supporting dementia-related health conditions

Treatment and support after the diagnosis of vascular dementia may be done alongside treatment of health conditions that caused the dementia. For example, if a person has had a stroke that has led to the development of vascular dementia, this person may take medications for post-stroke treatment while undergoing rehabilitation therapies, such as physical therapy, speech therapy, and occupational therapy, to work on post-stroke issues.

Practical, psychosocial, and emotional support

Experiencing and adapting to vascular dementia are not easy for both the person experiencing the condition and their family and friends. It is, therefore, important to get support. Apart from the support from your community, support services are also available. For example, there are post-diagnostic support programmes that help to guide persons diagnosed with dementia and family caregivers through a period of time after diagnosis.

For more information on the support services available, contact a Community Outreach Team (CREST).

Risks

The risk of developing vascular dementia is closely linked to what affects one’s vascular health. Some risk factors for developing vascular dementia include:

High blood pressure
High blood cholesterol
Diabetes
Obesity
Smoking
Older age

How can I reduce my risk of developing vascular dementia?

In general, keeping one’s vascular system healthy and maintaining a healthy lifestyle helps to reduce the risk of developing vascular dementia.

Ways to keep one’s vascular system healthy:

Have a balanced diet

Moderate salt, sugar, and fat intake
Eat sufficient fruits and vegetables
Consume more wholegrain instead of refined carbohydrates like white rice or white bread
Consume more protein-rich foods with healthy fats such as fish meat and beans over red meats

Stay physically active

It is recommended to have 150 minutes of moderate-intensity physical activity per week
Do a good mix of aerobic exercise (exercise that speeds up your heart rate and breathing), strength-training exercise (exercise that maintains and builds muscle mass), stretching, and balance exercises

Get enough sleep

In general, getting enough sleep lowers the risk for serious health problems

Manage stress

Managing stress, especially long-term stress can improve heart health and mood, which in turn lowers the risk of developing vascular dementia

Avoid or reduce smoking

Smoking damages blood vessels, which may make developing vascular dementia more likely

Stay socially engaged and connected

Staying connected with others helps to regulate stress levels, which is good for vascular health
Some ways you could keep connected could include: visiting Active Ageing Centres, volunteering in your community with others, organising occasions to eat together, or asking friends and/or family to do leisure activities together

Stay mentally active

Keep yourself engaged in activities that challenge yourself mentally. For example:

Doing things that exercise your creativity (art activities, gardening, etc.)
Learning new skills
Playing games
Having discussions with others

Watch this video by the Health Promotion Board to learn more about reducing the risk of developing vascular dementia.

Find out more about reducing the risk of developing dementia here.

How to get help:
If you or someone you know may have vascular dementia and need support or information, contact a Community Outreach Team (CREST) to find out more about getting support, or call Dementia Singapore’s helpline at 6377 0700.

Additional Information: Stroke Syndromes

A stroke syndrome is a group of symptoms that happens because of a stroke.

Cerebellar Stroke Syndrome

Cerebellar strokes happen when blood vessel blockage or bleeding prevents blood flow to a part of the cerebellum.
Cerebellar strokes are rare, and make up less than 10% of strokes.³
Cerebellar stroke symptoms include:
- Dizziness and vertigo, with a feeling of falling to one side (occurs in 75% of cases of cerebellar stroke)⁴
- Nausea and vomiting (occurs in 50% of cases) ⁴
- Difficulty with walking
- Difficulties with coordination
- Tremors
- Headache
- Slurred speech
- Trouble with speech
- Double vision

Pontine Stroke Syndrome

A pontine stroke happens when blood vessel blockage or bleeding prevents blood flow to a part of the brain stem called the pons.
Pontine strokes are common, accounting for about 7% of strokes.⁵
Pons and brain stem stroke symptoms may differ from the hallmark stroke symptoms, and may include:
- Dizziness, vertigo, and severe balance issues
- Double vision
- Slurred speech
- Swallowing difficulties
- Reduced alertness
- Motor and/or sensory impairment
- Hemiparesis: weakness and clumsiness in the face, arms, and legs on one side of the body

Frontal Lobe Stroke Syndrome

A frontal lobe stroke happens when blood vessel blockage or bleeding prevents blood flow to the frontal lobes of the brain’s cerebral cortex.
Frontal stroke symptoms include:
- Hemiparesis
- Speech issues
- Swallowing difficulties
- Incontinence
- Difficulties with spatial reasoning
- Changes in behaviour and personality
- Difficulties with executive functioning skills, such as reasoning, judgement, decision making, and problem solving

Temporal Lobe Stroke Syndrome

A temporal lobe stroke happens when blood vessel blockage or bleeding prevents blood flow to the temporal lobes of the brain’s cerebral cortex.
Temporal lobe stroke symptoms include:
- Speech issues
  - Wernicke’s aphasia: a condition where a person is unable to understand the meaning of language spoken to them, or to produce meaningful language
- Hearing issues
  - Hearing impairment may range from mild hearing loss to complete loss of hearing, which is rare
  - Difficulties with processing sounds
  - Auditory hallucinations
- Emotional changes such as fits of anger or aggression, or a lack of interest
- Difficulties with memory

Parietal Lobe Stroke Syndrome

A parietal lobe stroke happens when blood vessel blockage or bleeding prevents blood flow to the parietal lobes of the brain’s cerebral cortex.
The symptoms of a parietal lobe stroke depend on whether the left or right parietal lobe is affected, and which side of the individual’s brain is more dominant for certain functions (e.g. language, mental calculations).
In most cases, a right-sided parietal lobe stroke leads to:
- Paresthesia, or abnormal sensations, on the left side of the body
- Weakness on the left side of the body
- Hemispatial neglect: a decreased awareness of the left side of the body and the environment on the left side
- Impaired spatial awareness of the environment on the left side of the body
- Difficulties with copying drawings
- Difficulties with sense of direction, and for visual and spatial memory
- Anosognosia: A lack of awareness of stroke symptoms, or that the stroke has even occurred
In most cases, a left-sided parietal lobe stroke leads to:
- Paresthesia, weakness, hemispatial neglect, and/or impaired spatial awareness on the left side of the body
- Right-left confusion: difficulty with orientating the self to the left or right sides of one’s body or environment
- Agnosia: difficulties with recognising objects
- Acalculia: difficulty with counting
- Aphasia: speech and language issues; parietal lobe damage may also result in the inability to repeat others’ speech
- Agraphia: difficulty with writing

Occipital Lobe Stroke Syndrome

An occipital lobe stroke happens when blood vessel blockage or bleeding prevents blood flow to the occipital lobes of the brain’s cerebral cortex.
Occipital lobe strokes happen less often than strokes in the other cerebral lobes (temporal, parietal, and frontal lobes).
Because the occipital lobes serve important functions in a person’s ability to perceive, process, and remember visual and spatial information, strokes that affect this brain area may strongly affect these abilities
- Occipital lobe stroke symptoms include:
- Vision loss:
  - Heianopia: blindness on one side of the person’s field of vision
    - A stroke that affects one side of the occipital lobe will affect the field of vision opposite to the affected brain area; for example damage to the left occipital lobe causes vision loss in the right half of the field of vision.

- - Quadrantanopia: blindness in one quadrant of the person’s field of vision
  - Central vision loss: loss of sight in the centre (middle) of your field of vision
  - Complete cortical blindness: Cortical blindness means total loss of sight due to damage in the brain’s cortex; this sight loss is not due to changes to the eyes.
    - Anton syndrome: In some rare cases, persons with cortical blindness may be unaware that they are blind despite being shown evidence that that is the case
- Visual agnosia: an ability to recognise objects by sight
- Prosopagnosia, or face blindness: an ability to recognise the faces of people
  - Word blindness: some people may be able to recognise letters and spell words, but not recognise words
- Visual hallucinations: though rare, persons may see images that do not originate from actual visual stimuli in their environment like sparks and lights
- Alexia without agraphia: an inability to read without difficulties with writing ability
- Difficulty with eye movement
  - Nystagmus: Uncontrollable, constant, and rapid eye movements
  - Control of eye movements: the nerves controlling the muscles that manage movements of different eye parts may be affected, which may cause eye misalignment and double vision, difficulties in tracking objects, difficulties with adapting to changes in light intensity, and eyelid drooping.

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Books for Your Journey with Dementia

aleene.chow — Wed, 29 May 2024 04:43:40 +0000

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The personal stories of others can provide affirmation and perspective for our own lives. This article lists free books available on loan that can support you in your journey with dementia.

If you have recently been diagnosed with dementia, you may wonder what changes the diagnosis might bring to your life. Many persons with dementia have written books on their lives, which have inspired others as stories of resilience.

All of these books are free to loan in the E-book format from the National Library Board, and you can read them almost immediately at your own time online.

Book Recommendations for Persons living with Dementia

Non-Fiction: Memoirs written by Persons Living with Dementia

Memoirs offer the insight of persons living with dementia who have walked the journey with their friends and family. It can help provide some assurance that you are not alone in your experience, and prepare you for some changes you might observe.

Somebody I used to Know

by Wendy Mitchell (Available as e-book)

A powerful memoir that chronicles the journey of by Wendy Mitchell, a former NHS manager diagnosed with early-onset dementia, and how she adapted to life with the condition and the challenges she faced along the way.

Dancing with Dementia: My Story of Living Positively with Dementia

by Christine Bryden (Available as e-book)

This is an inspiring memoir by Christine Bryden, a dementia advocate and survivor. Christine shares her personal journey of living positively with the condition and offers practical advice on how to maintain a fulfilling life despite the challenges of dementia.

What I Wish People Knew about dementia : From Someone who Knows

by Wendy Mitchell (Available as e-book and audiobook)

This heartfelt book by Wendy Mitchell, a person living with dementia, sheds light on the realities of the condition and provides valuable insights on how to support and care for those affected by it.

Memory's Last Breath: Field Notes on My Dementia

by Gerda Saunders (Available as e-book)

“Memory’s Last Breath” is a beautifully written memoir that offers an intimate and revealing account of living with dementia. Gerda Saunders shares her personal experiences of coping with the complications of losing short-term memory, while also embarking on a personal investigation of the brain and its mysteries.

The First Survivors of Alzheimer's: How Patients Recovered Life and Hope in Their Own Words

by Dale Bredesen (Available as e-book)

For persons receiving treatment for Alzheimer’s Disease as well as their family members, this book offers hope and comfort. It features first-person stories of patients who recovered life from Alzheimer’s Disease and how they did it, with commentary from Dr. Dale Bredesen to help readers find tips and tricks that might help them as well.

Non-Fiction: Guides on Living Well with Dementia

Written by care professionals who work with people living with dementia, these guides are written to provide advice for some questions you might have about your symptoms, relationships, and how to live a life well-lived despite dementia.

Living Your Best with Early-Stage Alzheimer's: An Essential Guide

by Lisa Snyder (Available as e-book)

This book provides a practical guide on coping with the diagnosis of Alzheimer’s, managing symptoms, finding meaningful activity, planning for the future, maintaining relationships, and participating in research. It empowers the person with Alzheimer’s to move forward in life despite the challenges of the diagnosis.

Dealing with Dementia: A Guide to Alzheimer's Disease and Other Dementias

by Brian Draper (Available as e-book)

This comprehensive guide offers practical advice on drug treatments, complementary therapies, and care options for those struggling with a diagnosis of dementia, particularly Alzheimer’s disease. With a down-to-earth approach, it’s an invaluable resource for anyone worried about the effects of aging on the mind.

Fiction: Stories about Dementia

These books are not based on real persons or events, but have been well-received by members of public and caregivers for their portrayal of life with dementia and the message of hope they promote. These books have been adapted into films and may serve as an introduction for family of persons living with dementia to understand the condition.

Still Alice

by Lisa Genova (Available as e-book)

Alice Howland, a successful Harvard professor with a happy family life, begins to experience forgetfulness and confusion. She is diagnosed with early onset Alzheimer’s disease, and as her memory fades, she fights to maintain her independence and sense of self. This New York Times bestseller is a poignant and detailed portrayal of the experience of losing one’s mind, and has been adapted into a major motion picture.

The Leisure Seeker

by Michael Zadoorian (Available as e-book and audiobook)

“The Leisure Seeker” by Michael Zadoorian is a heartwarming tale of an elderly couple, Ella and John Robinas, who embark on a cross-country journey in their RV, determined to live their final days on their own terms. Despite Ella’s cancer and John’s Alzheimer’s, they set out on a forbidden vacation, leaving behind their adult children and doctors. This unforgettable journey of rediscovery has been adapted into a major motion picture starring Helen Mirren and Donald Sutherland.

Special thanks to the National Library Board (NLB) for contributing to the book list.

Additional Resources

Archives Unlocked: Oral History and Reminiscence Work By Irene Lim and Patricia Lee
Source: National Archives of Singapore

During the COVID-19 pandemic, the Oral History Centre of Singapore, together with the Singapore University of Social Sciences and Dementia Singapore, embarked on a meaningful journey to document the stories of eight persons living with dementia and their caregivers. The act of reminiscing is used to promote the wellbeing of the seniors. Through adapting oral history methodology, these seniors are given the space to recollect, reflect, tell and record their days of growing up in Singapore.

Spark Conversations: A Journal of Shared Memories
Source: Agency for Integrated Care

This journal can serve as a starting point for you to share your life story and memories with younger members in your family. It includes questions and cards for a meaningful conversation between youths and seniors.

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Programmes and Services

Peter Cher — Thu, 09 Apr 2026 02:45:47 +0000

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There are numerous programmes and services available in the community, owing to the Integrated Mental Health Network. This network brings together health, social, and community care providers who serve various clients, including persons living with dementia and their care partners.

If you are just starting out on your journey with dementia and don’t quite know where to start, this article is for you. Read on to find out about the various programmes and services available, how they can help you, and requirements you might need to take note of before applying.

CARE & SUPPORT SERVICES

Care & Support services involve the provision of practical (i.e., support with daily activities, linking clients up to relevant care services), emotional and financial support for persons living with dementia and their caregivers. These services may be rendered at home, a day care centre, or a nursing home for clients who require care and support that cannot be provided at home.

Dementia Helpline

CREST

CREST-CSN

COMIT

CREST-PDS

Meals on Wheels

Medical Escort and Transport

Home Personal Care

Eldersit Services

Maintenance Day Care

Dementia Day Care

Weekend Day Care

Social Service Office

Nursing Home Respite Care

Family Service Centres (FSCs)

Dementia Helpline

CREST

CREST-CSN

COMIT

CREST-PDS

Meals on Wheels

Medical Escort and Transport

Home Personal Care

Eldersit Services

Maintenance Day Care

Dementia Day Care

Weekend Day Care

Social Service Office

Nursing Home Respite Care

Family Service Centres (FSCs)

SOCIAL ACTIVITIES/PROGRAMMES

Social activities and programmes create opportunities for interaction with others in the community, which is especially pertinent for persons living with dementia who may become more withdrawn over time as they socialise or communicate less. These activities and programmes are aimed at slowing down the progress of dementia, providing a structured schedule, and improving the mood of persons living with dementia.

Active Ageing Centres/Active Ageing Centres (Care)

Volunteer Centres/Programmes

Community Centres (CC)

Gym Tonic

Voices for Hope

Active Ageing Centres/Active Ageing Centres (Care)

Volunteer Centres/Programmes

Community Centres (CC)

Gym Tonic

Voices for Hope

MEDICAL AND HEALTHCARE SERVICES

Medical and healthcare services for persons living with dementia may include medical assessments, rehabilitation care, prescription of medications to aid with behaviour, memory and mood, as well as nutritional assessments. These services may be rendered in various settings, including the care recipient’s home, centres, hospitals or nursing homes.

Memory Clinics

Centre-based Nursing

Day Rehabilitation Centres

Home Therapy

Home Medical

Home Nursing

Nursing Home

Memory Clinics

Centre-based Nursing

Day Rehabilitation Centres

Home Therapy

Home Medical

Home Nursing

Nursing Home

ADDITIONAL RESOURCE

Directory Listing of Dementia Support and Services

This resource details a comprehensive list of the various programmes and services in the community, divided by the 4 main regions in Singapore so you can easily find a service provider near you.

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A Guide to Setting Up a Trust for Persons with Dementia

aleene.chow — Wed, 29 May 2024 07:45:36 +0000

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Dementia presents unique challenges, not only for those directly affected by the condition but also for their caregivers. As cognitive abilities decline, managing finances can become increasingly difficult, leading to potential vulnerabilities and financial insecurity. In such circumstances, establishing a special needs trust can provide invaluable protection and peace of mind.

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

Read on for insights into the importance of a special needs trust, a step-by-step guide to setting it up, and resources available to help caregivers like yourself navigate the complexities of financial management for your loved one with dementia.

A special needs trust is a legal arrangement designed to manage assets on behalf of individuals with disabilities, including dementia. By placing assets into a special needs trust, individuals can ensure that their financial resources are protected and used appropriately to support their care needs.

What is the Importance of a Special Needs Trust?

A special needs trust provides a level of protection against financial exploitation and mismanagement. As cognitive decline progresses, persons living with dementia become increasingly vulnerable to scams, fraud, and undue influence. By entrusting their finances to a trustee, often a trusted family member or professional, persons living with dementia can mitigate the risk of financial abuse and ensure that their resources are used for their benefit.

Setting Up a Special Needs Trust

1. First Appointment with Case Manager

Upon reaching out to the Special Needs Trust Company (SNTC) to schedule an appointment, you will proceed to the initial assessment stage. Here, you will meet with a case manager, who is trained in social work. They will then conduct a comprehensive needs assessment, covering various expenses for your loved one with dementia, including:

Housing
Healthcare
Transportation
Nutrition
Personal Care
Miscellaneous expenses

Following this, the case manager will work with you to create a personalised care plan. This care plan is like a form of budgeting exercise and it will help determine the necessary trust funds to ensure your loved one’s long-term care needs are met, particularly in times when you are no longer able or around to provide care. This plan can be developed with caregivers or with persons living with dementia who are in the mild stage of their condition and are able to understand the benefit of setting up a trust for themselves.

2. Trust Set-up and Pre-activation

The case manager will help you with setting up the trust and identify future assets to be injected that will be used to support the beneficiaries. Sponsorship opportunities are offered to eligible lower-income families. The case manager will assist you, should you meet the eligibility criteria, in applying for the appropriate sponsorship schemes as part of the trust setup process.

For more information on the available sponsorship schemes, click here.

3. Trust Activation

When the trust is activated, the money will be used to fund the beneficiary. The case manager will continue to support the family through ongoing case reviews and periodic visits.

For more information on what happens upon activation, click here.

Future Care Planning – Spouse with Dementia
Source: Special Needs Trust Company

This video offers a step-by-step guide to caregivers of persons living with dementia when setting up a Special Needs Trust.

Tools for Financial Care Planning

In addition to establishing a special needs trust, caregivers and persons living with dementia now have access to technological tools to aid in financial care planning.

One such example is the Financial Care Plan (FCP) application by SNTC. This application allows caregivers to answer 17 questions pertaining to their family situations, special needs and future care arrangements. Based on this input, the app generates a customised plan, including an estimation of how much your loved one with dementia will require in their lifetime. This estimation is derived from factors such as the year of birth of yourself and your loved one, the special needs condition of your loved one, your loved one’s future care arrangement, and the income level of the family.

This development offers a more accessible and efficient approach to managing finances and creating long-term care plans.

For more information, visit SNTC’s website.

Conclusion

Managing finances can be a daunting task, especially for persons living with dementia and their caregivers. However, the combination of a special needs trust and innovative financial planning tools offers caregivers of persons living with dementia a streamlined approach to managing finances and securing long-term care. By utilising these resources, caregivers can provide essential support while ensuring peace of mind for themselves and their loved ones.

AUTHOR BIO

Special needs trust company

The Special Needs Trust Company (“SNTC”) was set up in 2008 to provide trust management services to persons with special needs (with physical, developmental or mental disability) and are unable to manage their own affairs. SNTC is the only non-profit trust company in Singapore fully supported by Ministry of Social and Family Development and commissioned to provide affordable trust services to meet the needs of caregivers to ensure the financial security of their special needs dependents.

Website | Facebook

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When to Consider Moving into a Nursing Home

aleene.chow — Mon, 11 Mar 2024 00:17:03 +0000

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Caregivers want their loved ones to live in the environment most comfortable to them, which is usually home. However, circumstances might call for a person living with dementia to move into a nursing home if their needs cannot be met at home. Find out more about when you might need to consider having your loved one move, and how you can support them throughout the process.

If the primary caregiver can no longer provide care that the person needs to live well
If the person with dementia lives alone, but requires additional care that is too costly or difficult to access from home because they are wheelchair or bed-bound
If community services are unable to meet their needs adequately
Safety concerns when the caregiver is unable to cope with severe behavioural and psychological symptoms of dementia (BPSDs) or sundowning experienced by the person living with dementia

Allied healthcare professionals may advise a change of living arrangement with the following considerations, in order of priority:

1. Medical health of the person living with dementia
2. Psychoemotional needs of the caregiver (whether the caregiver’s ability to cope with stress, maintain personal relationships and quality of life is impacted by the current caregiving arrangement)
3. Functional status (ability to carry out activities of daily living) and the safety of the person living with dementia
4. Socio-economic considerations

Sudden changes in the person with dementia or the caregiver’s health may require the person living with dementia to change living arrangements. It is hence best to prepare for these situations ahead of time and select the best nursing home for your loved one’s needs by discussing their long-term care plans with them while they still retain mental capacity.

Who makes the decision to move?

The decision should always be left to the person living with dementia, as long as they have been assessed to retain mental capacity. This means that they are judged to still be capable of making important decisions. They must be able to understand information and weigh options, as well as communicate their decision. However, if the person living with dementia has lost the mental capacity required to make this decision, the Lasting Power of Attorney (LPA) donee can make this decision on their behalf. If the person living with dementia has not appointed anyone as their LPA donee, health and social service professionals can advise their next-of-kin on this decision. If a person living with dementia no longer has mental capacity and has lost contact with their next-of-kin, then a professional body may be appointed as the donee. They are then referred to as a public trustee.

For more information about the Mental Capacity Act, please refer to the Code of Practice.

Code Of Practice – Mental Capacity Act
Source: Office of the Public Guardian

The code of practice elaborates on the Mental Capacity Act, especially in how it is applied to actual situations. It helps professionals, paid caregivers, informal caregivers, family and friends of the person understand their roles and responsibilities under the act to safeguard the interests of the person lacking mental capacity.

It is common for caregivers to feel worried about the changes that living with a loved one with dementia may bring. Many also feel guilt over the decision to move their loved one into a nursing home, even when it is in their loved one’s best interests.

How should the move to a nursing home be carried out?

Your loved one will go through a period of adjustment when they enter the nursing home. Nursing Home Respite Care is a service which offers short-term care for persons living with dementia, and can range in duration from several days up to a maximum duration of one month. Although this is mainly meant to provide respite for caregivers when they are temporarily unable to provide care, it may be a good way to see how your loved one responds to the care environment in a nursing home and for families to ease into the change. To be eligible for respite care options, your loved one must meet some minimum criteria:

- Has moderate to high nursing care needs
- Must have a discharge care plan after the end of the respite care period (they must have a permanent place of stay they can return to)
- Application requires medical records

Often, the application to a nursing home is done through communication with a social worker. As part of the application, a needs assessment will be conducted to assess your loved one’s fit for respite or nursing home programmes, as well as a family conference to hear the opinion of everyone involved. You can find out more about the application criteria here.

You or any authorised caregiver also needs to provide your loved one’s recent (dated no earlier than six months from submission of the application) medical report, which must include the following:

Diagnosis

Clinical History

Current functional status

Required nursing procedures

Drug allergy history (including list of currently prescribed medications)

Cognitive and behavioural symptoms (if applicable)

Results from a chest X-Ray (negative for infectious disease)

COVID-19 vaccination information (full vaccination status required)

You can also use your loved one’s hospital discharge summary if they were discharged within the past six months of application. All of these documents can be provided by your loved one’s primary physician.

Nursing homes will prioritise applications based on your loved one’s fit for criteria. Some nursing homes have specialised dementia wards for those who are mobile but may have behaviours that make them unsuitable for general wards. Priority is usually given to wheelchair- or bed-bound seniors for public nursing homes. For private nursing homes, anyone can apply.

You can speak to a care consultant at AIC Links to find more information about making the change in living arrangement. Alternatively, you can speak to a medical social worker at a polyclinic during your loved one’s scheduled doctor’s visits.

Addressing your loved one's needs during the move

Your loved one will be quite limited in the number of personal possessions they are able to bring into the nursing home when admitted. Often, they are only allotted one wardrobe, or even simply a drawer for personal clothing. They are also not able to bring pets with them, which is another consideration if your loved one is very attached to a family pet. Wherever possible, you should also consider whether the faith and language preferences of your loved one match the nursing home you are applying to. There are several nursing homes affiliated with faith-based organisations.

After the move, speak to the person living with dementia to find out how they feel about the move as early as possible. Many seniors experience relocation stress when moving into a nursing home, although the adjustment period is different for everyone. Some nursing homes also have support groups for family and friends of the home’s residents, which may help if you are feeling anxious over the decision. Talk to the care home nurses/staff about your loved one’s life history and interests. You can still remain actively involved in your loved one’s care even after they move into a nursing home.

Moving from the Nursing Home back to home
You or any authorised caregiver also needs to provide your loved one’s recent (dated no earlier than six months from submission of the application) medical report, which must include the following:It is uncommon for persons living with dementia to transfer from the nursing home back to the home setting. In the case that occurs, the caregiver/guardian should have a conversation with the care team at the nursing home as part of discharge care planning. You may also arrange for an occupational therapist to make a home visit and recommend necessary changes to make the home safer for your loved one. If you are considering moving your loved one back home, you may apply for home leave from the nursing home so they can adapt to the change. Under home leave, residents from a nursing home are temporarily discharged to stay at home.

For more information on the support services available, contact a Community Outreach Team (CREST).

Financial support for application to nursing homes

Nursing homes can be very expensive. Before subsidies, the average cost per month is $4,000 for public nursing homes. Singaporean citizens and Permanent Residents are eligible for between 10-75% subsidy for nursing homes depending on monthly household income per person. A table of subsidy levels can be found on the Ministry of Health’s website.

Other Financial Support

- Moderate/mild disability: Pioneer Generation Disability Scheme
- Severe disability: Interim Disability Assistance Programme for the Elderly/ElderFund, MediSave Care, Pioneer Generation Disability Scheme

You can find a more detailed list of financial schemes here.

Other options

It is always best for persons living with dementia to age in place whenever possible. If your loved one does not require nursing care but have high care needs, there are several services that can offer the support they need for daily activities of living, including:

If they have difficulty with a few ADLs, You can apply for an Integrated Home and Day Care (IHDC) package, which combines different home-based and centre-based care services suited to your loved one’s needs. If you provide care for your loved one at home with the aid of a domestic worker, you are also eligible for the Home Caregiving Grant and Migrant Domestic Worker (MDW) Levy Concession in addition to the schemes listed under Other Financial Support above.

You may also consider assisted living facilities, such as St. Bernadette’s Lifestyle Village or Red Crowns Assisted Living. These facilities are communal living spaces that offer the services mentioned above including housekeeping. It is intended for those who require assistance with ADLs but not nursing or medical care, and can offer residents more independence and privacy compared to a nursing home.

If your loved one is living alone and prefers to continue to do so, you can arrange for befriending services or for a community nurse to make regular visits. You can also get your loved one connected to a Community Case Management Service (CCMS) team for care coordination. The CCMS provider depends on the region of your loved one’s residence, so you can speak to an AIC care consultant to find out more or get a referral from your loved one’s GP.

You can also apply for the Home Monitoring System (HoME+) by the Singapore Red Cross, which is a non-invasive system that uses motion sensors and a panic button to monitor your loved one’s safety and assist them in cases of emergency. However, this service requires you to have a Wi-Fi network set up in your home. Wait time from the point of application for HoME+ can take up to six months.

Singapore Red Cross HoME+

HoME+ helps seniors living on their own, through a helpline and a monitoring, alert and response system for home safety. It offers 100% privacy (no CCTV), and empowers the elderly with greater freedom and security in their own homes. The system features 2 motion sensors, 1 door sensor, 1 gateway and 1 duress button, entirely supported by a call center, community responders and Red Cross’ ambulance services.

Additional Resources

FINDING A NURSING HOME | Connecting Caregiver Tips

For those caring for persons living with dementia, choosing a nursing home may become an eventual necessity.

Patsy Chia was a caregiver to her mother for more than 10 years. She narrows down the factors in finding a nursing home for your loved one, and how families can provide care and concern even if their loved one is not living at home.

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Location-tracking Technology in Dementia Caregiving

Peter Cher — Mon, 27 Nov 2023 06:42:30 +0000

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When a person living with dementia is still able to run errands such as grocery shopping or manage their personal appointments independently, caregivers should encourage them to continue to do so. These activities, when safely carried out, can help persons living with dementia feel integrated into the community and increase physical and cognitive stimulations that can improve their overall well-being.

Adopting location-tracking technology is one way to empower persons living with dementia to continue to enjoy their routines and outdoor activities, while allowing their caregivers to be involved by keeping watch from a safe distance.

This article explores the use of location-tracking technology* in dementia caregiving, how it works, and some of the consideration factors caregivers should take note of when deciding on a tracking device for their loved ones living with dementia.

*Location-tracking technology allows caregivers to know where a person living with dementia is by showing them the location on a portable device.

Role of Location-tracking Devices in Dementia

As dementia progresses, memory impairment, confusion, and disorientation in a person living with dementia may become a serious concern for caregivers who worry that their loved ones may lose their way while navigating the community or places on their own. Wet weather and unsafe road conditions may also expose a person living with dementia to an increased risk of accidents, falls, and other injuries. The fear and anxiety for their loved one’s safety may lead caregivers to limit outdoor activities of their loved ones living with dementia¹ and, inadvertently, the loss of independence and social interaction.

Whilst safety remains a top priority, it is also important that caregivers strike a balance between the need for safety and their loved ones’ need for autonomy and independence. One of the ways in which caregivers can achieve this is to include a location-tracking solution in their caregiving. This will enhance safety and traceability of their loved ones, and provide peace of mind for caregivers.

How Location-tracking Technology Can Help

1. Enabling Independence and Autonomy

Studies have shown that maintaining a person’s independence, freedom to participate in activities, and the autonomy to make choices for social interactions can contribute positively to improving one’s quality of life. ² Location trackers can enable persons living with dementia to continue their daily outdoor routines, such as strolling, shopping or engaging in social activities with confidence, while providing caregivers with assurance that they can effectively locate their loved ones.

2. Peace of Mind for Caregivers

Location-tracking devices can provide caregivers with information on where their loved ones are at any point in time and help them quickly locate their loved ones in situations where they are lost or require assistance to go home. This can help caregivers to alleviate anxiety and constant worrying.

3. Joint Caregiving

Some location-tracking devices allow multiple caregivers or family members to access tracking information or receive location alerts and updates. This enables a more collaborative approach to care coordination, where family members can be involved in the caregiving process for their loved ones living with dementia.

4. Understanding Daily Routines

When a person living with dementia carries a location-tracking device, the device can store a record of commonly visited places. Such information offers caregivers valuable insights into understanding their loved one’s daily routines, frequently visited locations, as well as behavioural and travel patterns. This provides an in-depth understanding of your loved one’s individual needs, which can be used when tailoring a more effective and person-centred care plan.

Types of Tracking Device Technologies

Location-tracking device or location tracker, as the name suggests, provides real-time or near real-time updates on location information of the person living with dementia who carries it. A location tracker typically consists of a small personal device that is worn or carried by the person living with dementia. This device can send location updates to a designated app or web portal accessible by one or more caregivers via a mobile phone or the web. Depending on the type of technology, location updates may either be in real-time or delayed. These updates also normally include the current location, historical locations, and battery status.

There are different types of technologies used in location trackers that are suitable for persons living with dementia. The more common ones are:

Bluetooth Low Energy (B.L.E.): This leverages Radio Frequency (RF) and Bluetooth technology for wireless communication. It uses Bluetooth signals to interact with nearby devices, such as mobile phones, connected to the Internet to locate a transmitter.³ It covers much shorter distances of between 30-40 meters.⁴ Once outside this range, it may be difficult to gather precise location data. Such a tracker is typically lower in cost, lightweight, and does not require frequent charging.

Global Positioning System (GPS): GPS location tracker uses data from satellites, mobile phones, and Wi-Fi signal networks to determine the location of the GPS receiver. Such a tracker is suited for wider radius and outdoor positioning, but it is less effective in small, indoor spaces. GPS location tracker comes with a built-in GPS receiver that provides tracker’s position in real time; hence, it requires frequent charging. Devices with GPS function typically cost more and may require data SIM cards or monthly data subscription.

Additional Useful Features

Newer locations-tracking devices also come with new functionalities that can further enhance monitoring.

Geofencing

Geofencing feature allows caregivers to create virtual geographical boundaries or safe zones for their loved ones living with dementia. Instant alerts are sent to caregivers’ mobile phones when their loved ones venture outside these virtual boundaries, allowing caregivers to be more vigilant. For example, caregivers can set up alerts when their loved ones leave home at night.

Emergency Call Features

Some location trackers come with built-in telecommunication features, such as an emergency button that notifies caregivers when their loved ones living with dementia require urgent assistance. Such a feature on the location tracker can be useful for a person living with dementia to connect with family members and caregivers when using a mobile phone becomes a challenge.

Fall Detection

Some models of location trackers have in-built motion sensors that trigger an automated alert to caregivers when it detects that the person living with dementia has fallen. This allows caregivers to attend to the person living with dementia immediately.

Caregiver Tips for Selecting Tracking Devices

Selecting the right location-tracking device that is effective and suited to your loved one’s preference is an important decision. There are various factors that caregivers can consider when selecting a device that ensures safety which is also suitable as dementia progresses.

We have listed some helpful tips and considerations to help caregivers to make the right choice.

1. Physical Activity Level

A good starting point is to consider the current physical activity level of your loved one with dementia: What does the daily routine look like? Their specific preferences such as time of day when going about certain activities or their preference for more outdoor or indoor activities. This gives you a sense of the kind of places your loved one frequents, as well as safety precautions to take note of.

For example, if your loved one prefers to go outdoors, selecting devices that offer more precise location tracking with a longer battery life, water resistant, and have more robust features such as fall detection can be considered.

2. Lifestyle Preferences

Caregivers can also consider how location-tracking devices can help their loved ones maintain their routines and interests for as long a period as possible. Understanding lifestyle preferences can also help caregivers determine if the devices should be carried or worn, how discreet these devices are, and whether incorporating alerts and prompts at appropriate times can help support their lifestyles.

Location-tracking devices come in a variety of shapes and sizes. Many of these devices are small, which can be placed on keyrings or wearable items, such as watches, jewelry and even shoes’ in-soles. Caregivers can choose from a range of designs based on preferences of their loved ones.

As dementia progresses, your loved one may gradually forget to use the tracking device. It is advisable for you to talk about these interventions early to give your loved one time to get used to using the device as part of the daily routine.

3. Upkeep & Maintenance

Just like a mobile phone, location-tracking devices need to be charged to be effective for outdoors use. GPS trackers typically require more frequent charging, which is an important factor to consider.

4. Compatibility

Check that the device is compatible with the caregiver’s smartphones and other portable devices. Some location-tracking solutions allow for more than one caregiver to view location information and receive alerts. It is, thus, helpful to select devices that can work across the various mobile operating platforms to maximise effectiveness.

5. Be Ready to Improvise

Caregivers can also consider using different solutions at different stages of dementia to ensure the technology can supplement the abilities of their loved ones.

For example, at the mild stage of dementia where persons living with dementia may still be able to manage their mobile phones, it is possible for the mobile phone to serve as a tracking device with installed maps such as Google Maps or OneMap that generally helps with wayfinding and can be improvised to help with remote monitoring. As dementia progresses, caregivers can then consider GPS-location trackers with other features such as fall detection and geofencing.

Read our article on 10 Ideas for Outdoor Monitoring to find out more about alternative solutions.

6. Contingency Planning

Caregivers and other family members should always discuss implementing an appropriate backup plan in cases where location-tracking devices fail to work or if the person living with dementia removes or misplaces the device. Technology is never 100% failproof and early planning for sources of support available to the caregiver would be a worthwhile exercise for the family to be able to intervene when situations escalate.

Conclusion

Helping persons living with dementia to maintain their sense of freedom, independence and autonomy is an essential part of caregiving. Caregivers may not always be available to accompany their loved ones as they go about their daily activities. Including location-tracking technology into caregiving toolkits can help caregivers balance the need for safety and their loved ones’ need for freedom.

It is advisable to have an open and honest discussion to understand how your loved one feels about introducing technologies. Caregivers should consult healthcare professionals to select a solution that is tailored to their loved one’s unique needs.

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10 Ideas for Outdoor Monitoring

dementiahub — Wed, 15 Nov 2023 09:17:13 +0000

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Looking for a solution to help your loved ones living with dementia to safely enjoy their activities outside the home while offering caregivers the ability to monitor movements from afar?

Below is a list of outdoor tracker solutions and alternatives that may be helpful for caregivers to explore with their loved ones.

*Note: This list is not an endorsement of products. Interested caregivers may wish to contact the respective sellers for more information.

1. Tracker with SOS and Geofencing Capabilities
2. Tracker with Call-and-Fall Detection Capabilities
3. Adapting Bluetooth Trackers
4. Adapting Tracking Through “Find My Device” Apps
5. CARA – Engaging the Community
6. Hyperlocal Dementia Search Networks
7. Tracking Public Transport History
8. Google Maps and Timeline
9. Location Sharing Through Chat Apps
10. Activating Family & Friends

1. Tracker with SOS and Geofencing Capabilities

The Tack GPS offers a small and lightweight personal GPS tracker for real-time tracking (both indoors and outdoors). This device comes with SOS notifications and geofencing capabilities and 30-day battery life. Additional subscription package is required.

For more information: Visit Tack GPS.

2. Tracker with Call-and-Fall Detection Capabilities

The iHelp 2 is a GPS tracker with built-in motion sensors for fall detection. It can auto-trigger SMSes and calls in emergencies. This tracker is equipped with an SOS call button to communicate with family members.

For more information: Visit OMG Solutions.

3. Adapting Bluetooth Trackers

Bluetooth trackers are an option for caregivers to explore. However, these trackers come with limitations to take into consideration when assessing their suitability. This range of trackers are readily available and are less costly than GPS trackers. They are great for indoor tracking to help pinpoint users’ general location. They require little installation, come with extended battery life, and are easy to use.

As these devices rely on Bluetooth signals paired with devices, these trackers typically have a limited radius of about 30 meters. Bluetooth signals may also weaken in indoor spaces due to walls and other obstructions, making it difficult for trackers to accurately provide location data outside of the signal range.

These trackers are best suited for loved ones who are mostly accompanied and tend to stay close to their caregivers.

Bluetooth trackers are readily found on all online marketplaces.

4. Adapting Tracking Through “Find My Device” Apps

Smart phones are natural GPS receivers. If your loved ones living with dementia is carrying a smartphone or wearables such as smart watches, you will be able to track the location of your loved ones through the native “Find My Device” feature.

These apps are free for use. The devices of your loved ones can be added to the device list to provide general location of your loved ones’ whereabouts.

The “Find My Device” app is a good option if you loved ones are actively carrying their charged mobile devices.

5. CARA – Engaging the Community

Developed by Dementia Singapore with the support of AIC and the Dementia-Friendly Singapore movement, the CARA mobile app is a lifestyle and community digital platform created specifically for the dementia community.

CARA is an alternative to provide caregivers with a peace of mind while their loved ones actively engage in the community.

Membership is open to persons living with dementia, caregivers, and the general public. Sign-up is currently free. Verified caregivers will receive an electronic membership card and verified persons living with dementia members are issued a physical card with a unique QR code identifier. This card can be shown to members of the public if your loved ones require assistance, and the member of public will be able to scan the unique identifier and call the registered caregiver(s).

Persons living with dementia and caregivers can also access a range of specially curated benefits to encourage persons living with dementia to continue their participation in community activities. This mobile app is also integrated with Vintage Radio, enabling access to music from the yesteryears.

Although it is not classified specifically as a tracking device, CARA leverages technology and the community to help keep a lookout for persons living with dementia who may be distressed while outside their home.

Caregivers will also be able to notify the CARA community when their loved ones are found to be missing, enabling caregivers to enlist help from members of the CARA community to search for their loved ones.

These notifications have also been integrated with the Municipal Services Office’s OneService App, amplifying the broadcast of notifications to a larger search network.

Read more about CARA:

Visit cara.sg to download the app
CARA: A Pioneering Membership Programme

Dementia care: OneService app broadcasts missing person reports to its 500,000-plus users

Source: ChannelNewsAsia

CARA is currently tied up with MSO’s OneService app to help persons with dementia who are lost to reunite with their families much quicker and more effectively, widening the search process.

6. Hyperlocal Dementia Search Networks

Another initiative by the Community Outreach Team (CREST) team at AWWA is the Woodlands-Sembawang Dementia Search Activation Network (DSAN) that helps to facilitate searches for lost seniors in the neighbourhood via Telegram chat.

Caregivers living within the Woodlands-Sembawang vicinity may register to join this chat channel and broadcast to the group if their loved ones go missing. The group will be notified to actively support.

Read more about DSAN:

Building a Telegram Community to Find Lost Seniors with Dementia
Register to join the Telegram Chat channel here

7. Tracking Public Transport History

For persons living with dementia who prefer to move around on their own via public transport, caregivers may consider a combination of technologies to support their loved ones’ while monitoring their transit movements.

The EZ-Link has developed the Family Account feature on the EZ-Link app where caregivers are able to add their loved one’s SimplyGo EZ-Link card details to their Family Account. Through the Family Account, caregivers can monitor their loved ones’ detailed transit history, including the latest bus stop and MRT station they were at with their EZ-Link cards. This may be helpful for caregivers to narrow down their location based on last known MRT station or bus stop.

Caregivers will have to upgrade their loved ones’ EZ-Link cards to SimplyGo EZ-Link in order for it to be added to the Family Account.

All concessionary privileges will remain, and caregivers will also be able to top up their loved ones’ SimplyGo EZ-Link cards through the app without using the physical card.

For more information:

Visit ezlink.com.sg
The Straits Times: New ez-link family account feature lets users link 7 cards to 1 account and top them up remotely

8. Google Maps and Timeline

For persons living with dementia who are still carrying their mobile phones, another helpful solution is the use of the Timeline feature in Google Maps. Google Maps is free for use and a good wayfinding solution. To use the Timeline feature, you will need to enable “Location Sharing” on Google Maps on your loved ones’ smartphone. This can then be shared with trusted caregivers and family members.

Google Timeline tracks places visited by your loved ones and creates a day-by-day historical record of your loved one’s movements, providing caregivers with insights into their loved ones frequently visited locations and daily routine.

In cases your loved ones go missing, a guided search feature can help guide caregivers to their loved ones last known location.

9. Location Sharing Through Chat Apps

For persons living with dementia who are still fairly proficient with chat apps, these chat apps come with additional features which allow persons living with dementia to share their locations with their caregivers. Chat apps such as WhatsApp, Telegram, and WeChat have this feature. Caregivers can discuss this function with their loved ones.

An alternative to this is to request for your loved ones to take photos of prominent landmarks and their surroundings (when feeling disoriented) to help caregivers locate their precise location.

10. Activating Family & Friends

Life360 is a family safety mobile application that helps families track movements of members within a private family circle. Caregivers will be able to view the location history of their loved ones living with dementia and place an SOS message to the family circle should the need arises.

One-tap direction is also a helpful feature to guide caregivers to their loved ones when needed.

This app is currently free for use, but it comes with a monthly subscription for additional safety features.

For more information: Visit life360.com

Every person living with dementia is unique. They have different needs and preferences. Caregivers may consider using a combination of different technological solutions to ensure the safety of their loved ones.

We encourage caregivers to view technology as a compensatory option to continue supporting your loved ones with dementia to remain active. The usage of these tools can be modified over time as your loved ones’ ability change over time.

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The Power of Self-advocates in Dementia

Peter Cher — Tue, 22 Aug 2023 01:17:19 +0000

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As a person living with dementia or a care partner of one, feelings of frustration are not uncommon, especially when navigating spaces and systems that are not designed to meet your needs. In times like this, have you ever felt like something has to be said and done so that you, and others like you in the community, do not have to feel this way again? Have you ever wanted to take the lead in making these changes? If you have, you may want to consider becoming a dementia self-advocate.

Self-advocates have been essential in bringing about positive change, especially in the disability movement¹. In fact, policies, research studies and various other dementia-related initiatives have benefitted from the involvement of persons living with dementia and their care partners in the development phase. ²

Read on to find out what advocacy is, why it is important, and how you can become one.

What Does Advocacy Mean?

Advocacy is about having a voice. It is about speaking up on what you believe in to achieve personal and collective change. Unsurprisingly, advocacy and empowerment go hand in hand, in that advocates are empowered to influence matters that affect them and take charge of their lives.

In the context of dementia, advocacy can involve the sharing of stories, raising awareness about the issues faced as a person living with dementia or a care partner, and creating a positive change for the dementia community on a larger scale. Persons living with dementia and care partners involved in such advocacy efforts are often referred to as self-advocates.

Being a dementia self-advocate is no easy feat. It takes a lot of courage and strength to speak up for yourself especially as a person living with dementia, where the common misconception is that persons living with the condition may not be able to think or decide for themselves. However, with the support of an already existing network of advocates and programmes aimed at empowering persons living with dementia to lead purposeful lives, anyone can become a self-advocate. The work put into becoming one will also be worthwhile as you will be better equipped to represent your community, as well as enable and empower others around you to build a dementia-inclusive society.

Why Should Persons Living with Dementia and Their Caregivers be Involved in Self-advocacy Efforts?

Research has shown that dementia advocacy offers potential improvements in well-being for those involved, through the activity itself and via extension of the advocate’s social networks.³ While these benefits are notable, it is also important to recognise that:

Persons living with dementia and their caregivers have a right to be involved in decisions that impact their lives.
Persons living with dementia bring with them lived experiences, knowledge and skills that may not be obtainable from organisational stakeholders. Furthermore, dementia manifests itself differently in every person living with dementia. This means that more voices are needed to ensure diverse and accurate representation of dementia in the community.

What Does Advocacy Look Like in Singapore?

As Singapore works towards the goal of dementia-inclusivity, significant effort has been put into raising public awareness about dementia and making the necessary amendments to services, policies and physical spaces to better meet the needs of persons living with dementia and their care partners. This opens up more space for dementia advocacy, which allows advocates to act as story tellers, co-facilitators, co-creators and active contributors to the conversation surrounding dementia.

Advocacy efforts come in all shapes and sizes. Self-advocates can be involved in as much or as little as they would like in a wide range of activities, including:

Research opportunities

Involvement in research may include providing advice on research priorities and methodologies, speaking with various stakeholders, being a research participant or working as a research partner on the project.

Participating as a representative on advisory boards or committees

Advocates can choose to do this on a local and/or global scale.

Providing input and having a say on issues related to the dementia cause

Emily Ong is a member on the Alzheimer’s Disease International (A.D.I.) Board of Directors for the position of person with dementia. She also serves in the Global Review Panel of the A.D.I. Accreditation Team and is a focus group member of the WHO Global Dementia Observatory Knowledge Exchange.

In this blogpost, she shares her journey as a dementia advocate, and how she has stepped up her advocacy efforts at the regional and global levels.

Read on to find out more.

Sharing their stories on various platforms

Storytelling is a powerful way to connect with and inspire one another, which explains why it is an effective tool in advocacy. Advocates may choose to share their stories in various ways such as on their personal social media platforms and in media interviews.

Sharing personal experiences and inspiring others on various platforms

As the primary caregiver to Rodney, her husband living with dementia, Jacinta’s caregiving journey has been filled with ups and downs. But through it all, she continues to do her best to support him in all that he does and empowers him to live his life meaningfully. Theirs is a story of love, courage, and perseverance.

In this blogpost, Jacinta sheds light on Rodney’s diagnosis, their shared challenges, and the steps they take together to overcome them.

Read on to find out more.

Providing feedback on various initiatives, policies and dementia care innovations

The involvement of advocates, especially from the planning stage, is effective in identifying service gaps as well as examining existing policies, services and solutions to ensure that they are meeting the basic and evolving needs of the dementia community.

SBS Transit & “Find Your Way” Initiative

A collaborative effort between SBS Transit and Dementia Singapore, “Find Your Way” aims to help persons with dementia navigate bus interchanges and MRT stations with ease. This wayfinding initiative was inspired by past research studies, which have found reminiscence to be effective in stimulating parts of the brain that deal with long-term memory and cognition.

Dementia self-advocates Anjang Rosli and Emily Ong served as advisors to this initiative.

Read on to find out more.

Public education

As more focus has been placed on increasing public knowledge and awareness about dementia, many learning institutions and workplaces have actively sought out experts in the field of dementia to educate students and staff on the topic. Coupled with facts and information, advocates also share their lived experiences and call-to-action with those present.

The Many Voices of Dementia
Source: Alzheimer’s Society

The Many of Voices of Dementia Advocacy is a short film with seven people living with dementia in different countries, talking about their experiences of self-advocating, their motivation, and top tips. It was produced by Alzheimer’s Society, 3 Nations Dementia Working Group (3NDWG) and Dementia Alliance International (D.A.I.) as part of a project exploring dementia self-advocacy and inclusion.

Want to Become a Dementia Self-advocate?

Voices for Hope

Voices for Hope is an empowerment programme aimed at empowering persons living with dementia and their care partners to embark on their self-advocacy journey. Piloted in 2019, it is a 10-week programme that equips participants with relevant skills and fosters confidence in them to actively share their stories, their needs and views publicly. The goal of Voices for Hope is to change societal attitudes, reduce the stigma of dementia and improve the landscape of how persons living with dementia are perceived and supported.

Who should join

Voices for Hope is best suited for persons who are diagnosed with mild-stage dementia, fairly proficient in communication and articulation, and with stable care arrangements.

How to join

For more information on how to sign up for the programme, click here.

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Service Provider	In Partnership With
Allkin Singapore Ltd	Sengkang General Hospital
Allkin Singapore Ltd	Ang Mo Kio Polyclinic Punggol Polyclinic
Dementia Singapore Ltd	Khoo Teck Puat Hospital National Neuroscience Institute Tan Tock Seng Hospital
Fei Yue Community Services	Ng Teng Fong General Hospital
Fei Yue Community Services	Bukit Batok Polyclinic Bukit Panjang Polyclinic Choa Chu Kang Polyclinic
Filos Community Services Ltd	Institute of Mental Health Woodlands Health
Filos Community Services Ltd	Geylang Polyclinic Tampines Polyclinic
Montfort Care	Changi General Hospital
Montfort Care	Eunos Polyclinic
NTUC Health Co-operative Ltd	Alexandra Hospital National University Hospital
NTUC Health Co-operative Ltd	Clementi Polyclinic Jurong Polyclinic Pioneer Polyclinic Queenstown Polyclinic
Thye Hua Kwan Moral Charities Limited	Singapore General Hospital
Thye Hua Kwan Moral Charities Limited	Outram Polyclinic

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1. Tracker with SOS and Geofencing Capabilities

2. Tracker with Call-and-Fall Detection Capabilities

3. Adapting Bluetooth Trackers

4. Adapting Tracking Through “Find My Device” Apps

5. CARA – Engaging the Community

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9. Location Sharing Through Chat Apps

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