post by Lok Kan
In pace of the rapid growth of ageing population, the number of dementia sufferer increases steadily at the same time. It was reported that more than 425,000 Australians are affected by dementia, which becomes the second-ranked cause of death overall (Macpherson, 2018). Old age, certainly, is the main risk factor of dementia. About one-third of people aged over 85 live with dementia. The treatments for the dementia sufferer are increasingly concerned as the pharmacological approach had been found minimally effective according to many findings.
Those high risk of behavioral symptoms, like falls, delirium and stroke, are failed to manage by any drugs and that’s why non-pharmacological approaches are being discussed increasingly to handle the problems (Galik, 2016). A few years before, the Hong Kong Alzheimer’s Disease Association (2018) advocated to take reference from the traditional Chinese wisdom, Confucianism, to design an intervention model for deteriorating the impairment of dementia sufferers. What are the implications to social work intervention from this strategy?
In my opinion, the implications that brought by the Confucianism intervention approach are similar to the ideas suggested from the article, which is a multimodal and an individualized strategy. On top of that, however, I would like to highlight the importance of cultural-based factor.
An individualized intervention method is encouraged under the concept of ageing-in-place. In fact, group work approach and mass programmes are preferred under the principle of the effective use of resources. But is it effective to put some of them into a group and deliver the same level of intervention? I don’t really think so simply because every dementia sufferer has different level of impairment in different functions. So, I would suggest making a specific exercise plan for each patient according to their individual needs, and then the clients can work it out by themselves anywhere they like.
Moreover, a multimodal training for dementia sufferers means the intervention is including different exercises for one’s physical, mental and social abilities to slow down the deterioration of such functions. Comparing with other therapies, such as reminisce therapy and art therapy, most of them focus on training one or two abilities of the sufferer and neglect the importance of others. So, a multimodal strategy is essential to cover all the capacities of the sufferer.
Finally, the cultural factors become one of the important elements in the intervention of dementia sufferers. This was shown in the findings that some social workers in Israel found the existing problem of consistency and contradiction between the local culture and the Western intervention strategies they learnt (Zoabi & Savaya, 2012). Thus, cultural factors are believed to be an important element in the social work interventions. According to the experience of the Confucianism intervention approach in Hong Kong (Wong et al., 2015), one of the critical points was the cultural-based instruments used in the designed activities, for example, Chinese opera for music programme, Chinese chess for interpersonal skills training…etc. In fact, all of them added values to the intervention and so, basically, I agree the suggestions from the article, but I would like to remind the importance of cultural elements in those exercises. For example, while people in Hong Kong like to play MahJong to stimulate one’s mental ability, it doesn’t popular to Western people. So, it is important to design and select the effective activities to the sufferers. On one hand, I personally think cultural knowledge is a very good source to design the intervention for the clients, on the other hand, it becomes a challenge for social workers to pick up such knowledge.
Galik, E. (2016). Treatment of dementia: Non-pharmacologic approaches. In M. Boltz & J.E. Galvin (Eds.), Dementia care: An Evidence-based Approach (pp. 97-112). Switzerland: Springer.
Hong Kong Alzheimer’s Association (2018). About Six Arts. Retrieved from http://www.hkada.org.hk/en/?page_id=1834
Macpherson, H. (2018, April 9). Six things you can do to reduce your risk of dementia. New Zealand Herald. Retrieved from https://www.nzherald.co.nz/lifestyle/news/article.cfm?c_id=6&objectid=12028619
Wong, Gloria H.Y., Ng, Carmen K.M., Lai, Claudia K.Y., Lee, Maggie N.Y., Lum, Terry Y.S., Jiang, Nan., … Dai, David L.K. (2015). Development of Six Arts, a Culturally Appropriate Multimodal Nonpharmacological Intervention in Dementia. The Gerontologist, 55(5), 865-874