#South korea Training Children as Dementia Supporters in One of the Worlds Fastest Aging Countries High school students in Seoul, South korea assist a woman with dementia at a nursing home. They were stooped, hobbled, disoriented, fumbling around the house. They got confused in the bathtub and struggled up stairs that seemed to swim before them. oeoh, it hurts, said Noh Hyun-ho, sinking to the ground. oei thought I was going to die, said Yook Seo-hyun. There was surprisingly little giggling, considering that Hyun-ho, Seo-hyun and the others were actually perfectly healthy 11-to 13-year-old children. But they had strapped on splints weighted harnesses and fogged-up glasses, and were given tasks like oedoorknob Experience and oebathroom Experience, all to help them feel what it was like to be old, frail or demented. oeeven though they are smiling for us, every day, 24 hours, is difficult for them, Jeong Jae-hee, 12, said she learned. oethey lose their memory and go back to childhood. It is part of a remarkable South korean campaign to cope with an exploding problem: Alzheimers disease and other dementias. As one of the worlds fastest-aging countries, with nearly 9 percent of its population over 65 already afflicted, South korea has opened a oewar on Dementia, spending money and shining floodlights on a disease that is, here as in many places, riddled with shame and fear. South korea is training thousands of people, including children, as oedementia supporters, to recognize symptoms and care for patients. The 11-to 13-year-olds, for instance, were in the governments oeaging-Friendly Comprehensive Experience Hall outside Seoul. Besides the aging simulation exercise, they viewed a Powerpoint presentation defining dementia and were trained, in the halls Dementia Experience Center, to perform hand massage in nursing homes. oe What did I do with my phone? Its in the refrigerator, said one instructor, explaining memory loss. oehave you seen someone like that? They may go missing and die on the street. In another striking move, South korea is also pushing to make diagnoses early, despite there being scant treatment. oethis used to be hidden and oethere is still stigma and bias, said Kim Hye-jin, director of senior policy for the Health and Welfare Ministry. But oewe want to get them out of their shells, out of their homes and diagnosed to help families adjust and give patients oea higher chance of being taken care of at home. Hundreds of neighborhood dementia diagnostic centers have been created. Nursing homes have tripled nearly since 2008. Other dementia programs providing day care and home care, have increased fivefold since 2008, to nearly 20,000. Care is subsidized heavily. And a government dementia database allows families to register relatives and receive iron-on identification numbers. Citizens encountering wanderers with dementia report their numbers to officials, who contact families. To finance this, South korea created a long-term-care insurance system, paid for with 6. 6 percent increases in peoples national health insurance premiums. In 2009, about $1 billion of government and public insurance money was spent on dementia patients. Still, with the over-65 population jumping from 7 percent in 2000 to 14 percent in 2018 to 20 percent in 2026 dementia is straining the country, socially and economically. oeat least one family member has to give up work to provide caregiving, said Kwak Young-soon, social welfare director for Mapo District, one of Seouls 25 geographic districts. Because South korea encourages people to work well past retirement age, families may also lose dementia sufferers incomes. Most families no longer have generations living together to help with caregiving, and some facilities have long waiting lists, but oewe cant keep building nursing homes, Mr. Kwak said. oewe call it a ghost. Its basically eating up the whole house. Dementia Epidemic South korea is at the forefront of a worldwide eruption of dementia from about 30 million estimated cases now to an estimated 100 million in 2050. And while South koreas approach is unusually extensive, even in the United states, the National Alzheimers Project Act was introduced this year to establish a separate Alzheimers office to create oean integrated national plan to overcome Alzheimers. Supporters of the bill, currently in committee, include Sandra Day OCONNOR, whose late husband had Alzheimers. South korea also worries that dementia, previously stigmatized as oeghost-seeing or oeones second childhood could oedilute respect for elders, Mr. Kwak said. oetheres a saying that even the most filial son or daughter will not be filial if they look after a parent for more than three years. So the authorities promote the notion that filial piety implies doing everything possible for elders with dementia, a condition now called chimae (pronounced chee-may): disease of knowledge and the brain which makes adults become babies. But South koreas low birth rate will make family caregiving tougher. oei feel as if a tsunamis coming, said Lee Sung-hee, the South korean Alzheimers Association president, who trains nursing home staff members, but also thousands who regularly interact with the elderly: bus drivers, tellers, hairstylists, postal workers. oesometimes I think I want to run away, she said. oebut even the highest mountain, just worrying does not move anything, but if you choose one area and move stone by stone, you pave a way to move the whole mountain. South korea is even trying to turn a crisis into a business opportunity. The Aging-Friendly hall, financed by the Ministry of Knowledge Economy, encourages businesses to enter oesilver industries, producing items for feeble elderly people, from chopsticks that are easier to pick up to automated harnesses that hoist people from bed, sliding along a ceiling track, and deposit them onto toilets or living room couches. College students visit the hall and don blue 3-D glasses for oedementia Experience video journeys following people disoriented on streets or seeking bathrooms. Throughout South korea, Mrs. Lee leads oedementia supporter training, arguing against longtime practices of chastising or neglecting patients, and advocating for preserving their skills and self-esteem. One tip: give demented relatives oea washing pan and washboard and say, oe The washing machines terrible we need your help washing clothes, she told 200 senior citizens interested in nursing home jobs or family caregiving advice. If patients say, oe Im good at making soy soup, but forget ingredients, guide them step by step, she advised. Otherwise, oethey may make it into salt soup, and everyone will say, Oh, this is terrible, you stop doing it. Even the youngest are enlisted. Mr. Kwak, the local government official, arranges for nursery school classes to play games with nursing home patients saying that it destigmatizes dementia and that patients who oeregress to earlier days may oefind it easier to relate to young children. And Dr. Yang Dong-won, who directs one of many government-run diagnostic centers in Seoul, has visited kindergartens, bringing tofu. oethis is very soft, like the brain, he said, letting it crash down. Now, oethe brain is destroyed. oedementia is very bad for you, so protect your brain, he said, with exercise, oenot drinking too much sugar, and saying, oe Daddy, dont drink so much because its not good for dementia. At a Dementia March outside the World cup Soccer Stadium children carried signs promoting Dr. Yangs Mapo district center: oemake the Brain Smile! and oehow is Your Memory? Free diagnosis center in Mapo. The Mapo Center for Dementia perches at a busy crossroads of old and new, near a university and a shop selling naturopathic goat extracts. It has exercise machines out front and a van with pictures of smiling elderly people. Even people without symptoms come, Dr. Yang said. They are oeeased by hearing, You do not have dementia and can visit two years later. Cha Kyong-hos family was wary of getting him tested. oedementia was a subject to hide, said his daughter, Cha Jeong-eun. oei worried his pride would be hurt going through this kindergarten experience. But when oemy mother asked him to get ingredients for curry rice he came back with mayonnaise, she said. And one day, Mr. Cha, 74, a retired subway official, could not find his way home. oei was like, Where the hell am I? he said. Ultimately, he visited Mapos center, finding the testing challenging. oesometimes I dont remember what I read, or I can see it with my eyes and my brain is processing it, but I cannot say it out loud, he said about the questions. oehow can my brilliant brain remember everything? Jeez, its so headachy. Checking his ability to categorize items, Dr. Yang asked, oewhat do you call dog and tiger? oei call them dog and tiger. oepencil and brush? oeoh, theres a word for that. oeairplane and train? oei feel embarrassed I dont know. oeyou have a lot of loss of memory, Dr. Yang said. oethis is the very beginning stages of Alzheimers disease. He suggested that Mr. Cha get a government-subsidized brain M. R i. to confirm the diagnosis, and said drugs might delay symptoms slightly. He recommended Mapos free programs oeto stimulate what brain cells he has. These include rooftop garden oefloral therapy, art classes making realistic representations of everyday objects, music therapy with bongos sounding oelike a heartbeat. Mr. Cha sighed. oei think, he said, gesturing toward his brain, oethat somethings wrong with this, just a little bit. Students as Helpers Schools offer community service credit, encouraging work with dementia patients, whom students call grandmas and grandpas. Teenage girls do foot massage at the Cheongam nursing home, which is run by Mrs. Lee, the Alzheimers Association president, for women without sons to care for them. In South korea, sons families traditionally shoulder caregiving responsibilities. During one massage session, 16-year-old Oh Yu-mi rubbed a patients toes, saying: oeim doing the heart. The heel is the reproductive system. It will help them excrete better. Another girl doing foot massage, Park Min-jung, 17, was shaken to realize that dementia could explain why her grandfather recently grabbed a taxi and circled his old neighborhood seeking his no longer-existent house. oehe used to be very scary to me, she said, but training made her feel that oei can do things for him. A patient wept as the girls left, upsetting 16-year-old Kim Min-joon, the massage groups leader. She said social workers suggested being less effusive to patients so the girls leaving would be less traumatic: oeif there is love or affection of 100 grams, cut it up into 1 gram each and distribute it over oe100 visits, not all at once. But oeim not good at controlling that, Min-joon said. Even at school, oethe feeling of their touch remains with me. A boys high school selects top students to help at Seobu Nursing Center, doing art therapy and attempting physical therapy with dances and oeballoon badminton (the racket is stretched pantyhose on a frame). The boys write observations to help Seobu adjust programs. At school, they wrote questions on the blackboard: oeproblems and solutions of communicating with the elderly. Ways to improve and execute exercise routine. How to make sure were all on time. oethey dont comprehend my words, said Kim Su-hwan, 16. oemaybe we should get closer to their ears, suggested Kim Jae-kyeum. Maybe oesome of us could massage them, said Su-hwan. oeyou do that, Su-hwan, snickered Jae-kyeum. oesmile at them more, another student said. oesome of us look like we dont want to do this. For Kim Han-bit, 16, the program is intensely personal. Han-bit was 13 when his grandmother who practically raised him, got Alzheimers, and oei would just feel it was annoying and walk out of the room, he said. oeshe would ask to do an activity, and I would say, What business do you have doing that? It was my responsibility to feed her, give her drinks, wash her face. But I even resisted and fought back, he said. When she died, he added, oei couldnt let out tears. The dementia caregiving program had made him oewonder why I wasnt able to do that with my own grandma, and I think I should do better in the future to compensate for all my wrongdoing, he said. oei could have taken care of my grandmother with a grateful feeling. If only I could have. Recently, he worked to engage Lee Jeong-hee, a patient half his height with missing teeth who laughed, but spoke incoherently. oewhen I come next time, he said tenderly, oeplease remember me. Via New york times Share Thissubscribedel. icio. usfacebookredditstumbleupontechnorati

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