10 minutes to understand dementia? Surely we can do better

 As Malaysia's population ages, dementia care deserves far greater attention, training and understanding.

From Dr Cecilia Chan

Recently, I attended a geriatric conference in Kuala Lumpur. During a conversation with a respected and compassionate geriatrician, she shared something that has stayed with me.

Her hospital’s chief executive had instructed her to spend no more than 10 minutes with each patient because, in today’s healthcare system, time is money.

Ten minutes.

How can anyone properly assess an older person in 10 minutes, let alone someone who may be living with dementia?

Dementia assessment is not a checklist. It requires listening, observing, understanding a person’s history and often speaking with family members. It cannot be rushed.

That conversation left me wondering whether we, as a society, are truly prepared for what lies ahead.

Malaysia’s population is ageing and dementia cases are rising. Yet our healthcare system continues to respond as though dementia is someone else’s problem.

Working closely with communities has given me the privilege of witnessing the daily realities of people living with dementia and the family members who care for them. Their struggles are often invisible, but they are very real.

Here’s another uncomfortable truth: many healthcare professionals who look after people with dementia have little to no formal education or training in dementia care.

During one workshop, I was shocked to hear nurses express the belief that people with dementia no longer have feelings; that because they wouldn’t remember what happens, restraint or rough treatment would not matter.

Nothing could be further from the truth. A person living with dementia may forget an event, but they rarely forget how that event made them feel. Fear, humiliation, loneliness and pain can remain long after the memory itself has faded.

I have also watched physiotherapists struggle because conventional rehabilitation approaches often fail in dementia care. Patients with dementia are frequently labelled “uncooperative” when, in reality, the therapy has not been adapted to the way he or she understands the world.

As a result, many lose the opportunity for meaningful rehabilitation – not because they cannot improve, but because we have not learnt how to help them.

Homecare providers, nurses, doctors and therapists generally want to do their very best. But good intentions alone are not enough if we fail to equip them with the knowledge and skills they need.

Amazingly, a barista may spend months learning how to prepare the perfect cappuccino, yet professionals entrusted with caring for some of the most vulnerable members of society often receive little specialised training to provide one of the most complex forms of care imaginable.

Recently, I met representatives from several academic institutions to discuss developing a formal dementia-care programme to help bridge this enormous gap.

Their response was understandable but discouraging. There was little demand, they said. It was not marketable. It was unlikely to be profitable.

I understand that universities must meet enrolment targets and financial realities. But if we only teach what is profitable today, who will prepare our workforce for the realities of tomorrow?

The challenge extends beyond healthcare and education. Stigma still prevents many families from seeking help, while fear of the word “dementia” continues to silence conversations in our communities.

Perhaps that is our greatest obstacle. We are not afraid of dementia itself: we are afraid of talking about it.

Alas, we cannot build a dementia-inclusive society if we are unwilling even to talk about dementia.

Malaysia is ageing. Dementia is not a future problem, it is already our present reality.

The real question is no longer whether dementia matters – it’s whether the people living with dementia matter enough for us to act. - FMT

Dr Cecilia Tan is a gerontologist and dementia advocate.

The views expressed are those of the writer and do not necessarily reflect those of MMKtT.