SINGAPORE: After a long day at work, all Lucy Chan wants to do is to put her feet up when she gets home.
But those moments of peace are often interrupted by her mother, Khoo Chwee Lye, whose mind might see-saw between happiness and anger within minutes. That unpredictability has been unnerving.
“When we have a busy day in the office, and you come home, and all you want to do is to just rest … she starts complaining about past events,” said Chan.
“It’s not recent, nothing (has) happened, but it’s just that she suddenly recollects not-so-nice memories, and then she’d start talking and crying. I think those days are very frustrating.”
Chan has to diffuse tensions at home almost weekly now because of her 76-year-old mother’s mood swings, six years after the latter was diagnosed with dementia.
Once independent and capable of having an active lifestyle, Khoo can no longer live alone — her daughter, son-in-law, four grandsons and a helper take turns to care for her.
In Singapore, dementia affects one in 10 people aged 60 years and above. This amounts to an estimated 82,000 people, a number set to rise beyond 100,000 by 2030.
READ: Nearly 3 in 4 persons with dementia in Singapore feel ashamed, rejected: Study
While most types of dementia cannot be cured, some of the symptoms can be managed. And through technology, caring for dementia patients can be made a little easier. The series Gadg(AID) looks at six ways of doing so. (Watch this episode here.)
1. USING VIRTUAL REALITY TO UNDERSTAND DEMENTIA
Many carers, even the professionals, tell Alzheimer’s Disease Association (ADA) senior programme coordinator Joanne Loy: “I don’t know what the dementia (sufferer) is thinking about (or) looking at.”
She has spent five years trying to bridge this gap. And it was only last year that the ADA introduced a virtual reality (VR) experience so carers could see the world through the eyes of a person living with dementia.
Participants put on a pair of VR goggles and take on the perspective of Edie, a person with dementia. The goal is to make one’s way through the house to the bathroom.
Chan even heard a hissing sound around her while using this tool. “It’s actually (their) delusions,” explained Loy. “They’re most of the time very sensitive to noise. Certain volumes are normal to us, but to them are considered as high-pitched.”
Also, the patterns on the VR wallpaper looked as if they were pulsating.
The ADA’s VR perspective.
Regarding this, Loy said some dementia patients may have suffered damage to the occipital lobes, which process and interpret everything one sees. “As a result, they might feel very groggy,” she added.
The experience offered Chan what she thought was a “good” perspective to the world of dementia patients like her mother.
2. A WALKING STICK GETS SMART
Mood swings aside, Khoo also struggles with mobility issues. “She likes to go downstairs … and she doesn’t want to carry a stick. She doesn’t want people to know she needs that,” said her daughter.
Falling is not uncommon among dementia sufferers, many of whom report bouts of dizziness.
But seniors like her often see the walking stick as a symbol of shame. It is no surprise to Tan Lee Tuan, the founder of start-up Bekind Solutions, that some of them choose to wander around without one.
So he turned the walking stick into an accessory with a number of functions, including as a torch, an umbrella and an alarm that is activated if the user falls.
“(The) umbrella is a very natural way to camouflage a walking stick. Because in Singapore, it rains all the time, and it’s quite normal to carry an umbrella,” he said.
Tan Lee Tuan showing his walking stick to Khoo Chwee Lye, her grandson Daniel Law (left, seated) and Gadg(Aid) host Preston Lim.
His invention, which took three years to develop, also has an in-built radio and MP3 functions. “There’s a lot of research about how music therapy can help to slow down the rate of dementia,” he cited.
When he first brought his smart cane to Khoo, she was not sold on the idea. “If I use this downstairs, everyone would stare at me. It’s not raining — why carry an umbrella?” she questioned.
A week later, however, she seemed happy with her new accessory and even used it when she went to church.
“Nice to use! If not … (would) I still go and walk every day?” she said. “My legs are weak, so I need this. If not, I can’t walk much.”
3. ANOTHER DEVICE TO DETECT FALLS MAY BE NEXT
At home, a webcam monitor’s Khoo’s movements. But it offers a restricted view and cannot be installed where privacy is needed. So it does not allay Chan’s fear of her mother falling and getting hurt.
A solution here may be found in SoundEye, which uses artificial intelligence to isolate and analyse the sounds a person would make in an emergency.
With its deep-learning sound recognition technology, the device can recognise abnormal sounds like screams, coughs and groans, said inventor Tan Yeow Kee. When those sounds are picked up, a sensor triggers an alert to the carer.
The device also has a motion sensor to detect whether a person is moving. “If you place this inside the washroom, for example, if the person … isn’t moving inside the washroom, we can detect that,” said Tan.
This device would be helpful to someone like Khoo and her family. But for now, it remains a work in progress.
4. STIMULATING THE BRAIN WITH PICTURES AND SOUND
The frustration of forgetting, coupled with audio and visual distortions, can cause stress and anxiety for dementia sufferers like Khoo.
Her grandson Samuel Law, who recently graduated with a diploma in psychological studies, was inspired to do a project about reminiscence therapy because of what his grandmother was going through.
Reminiscence therapy works by reviving long-lost memories for those with dementia, and the science behind it is essentially about stimulating parts of the brain that handle long-term memory.
Law pointed out that caregivers of dementia patients can show them pictures and items from their past, including clothes they used to wear, to help them remember things from the past and to boost their memory.
Not only can this help them feel some joy revisiting happy memories, it can also help reduce their stress, agitation and frustration.
Law’s tool-kit requires another person to interact with Khoo, but that is not always practical given that for most of the week, family members are either out at work or in school.
As a solution, programme host Preston Lim showed the family a reminiscence therapy book, which Khoo’s family could insert photographs into and even use to record audio messages for her.
Said Lim: “When your mum … hears the message that someone has recorded for her and (is) associated with this specific memory, hopefully this would be useful to help her remember things from the past.”
Chan felt that the book would be helpful, as her mother likes to flip through photo albums at home. “Sometimes she does look at the photos. Maybe she’s thinking of the past,” she added.
5. USING VIRTUAL REALITY TO TRIGGER MEMORIES
So far, reminiscence therapy has brightened the mood in Khoo’s household and staved off some of her mood swings.
To take it a step further, Gadg(AID) asked Eugene Soh, the founder of Dude Studios, to “transport” Khoo to the one place she loves, Chinatown.
Soh runs a social enterprise making VR recreations of places that the disabled or infirmed wish they could see, but can never reach.
“We make VR scapes for people with dementia. This is the first time we shot one specifically for her (Khoo), but this same scene can be used for anyone else who has been to that same place,” said Soh.
When he used VR to let Khoo experience walking along the streets of Chinatown, she could describe the various buildings there. “When we use reminiscence therapy for VR, it is immersing them in that space,” added Soh.
“The effect would be times 10, because it’s immersed. It’s all around them instead of (them) looking at a picture, a video or looking at nostalgic objects that from the past.”
Khoo even recalled having raw fish porridge there and shopping with her friends in Chinatown.
Chan thought this therapy was helpful as it triggered some memories of her mother that she had not shared with them before.
6. SETTING THE MOOD WITH MUSIC
Research has shown that in dementia patients, the parts of the brain that stay intact are associated with music.
Michelle Lee is the founder of I’m Soul Inc, a social enterprise that uses technology to enable people to make music for the benefit of their mind, body and soul.
One of the devices she uses is Soundbeam, which uses ultrasonic sensors to translate body movement into music. For people with dementia, even if they forget many things, “the last thing that they forget is music”, she said.
“It’s in your primal brain, so you remember songs from long, long ago,” she said. “To be able to get back that lucidity, you find songs that resonate with them and then bring back that memory.”
At first, Khoo look unengaged and sceptical when she saw the device. But once she heard her favourite song “Ye Lai Xiang”, she started to warm up to it, singing and humming happily.
Law thinks this type of music therapy can bring communities and families together, especially with the elderly and those with special needs.
“This week has been a downer for her. And she’s complaining about quite a few things … but today (it’s the) opposite. She’s so happy,” he said.
Added Lee: “Once you have the social engagement, those things about loneliness, isolation, depression kind of go away … So there’s hope.”
Watch this episode of Gadg(AID) here.
