Friday June 23, 2017

Restaurant of Order Mistakes & other ideas with dementia in mind

Today is my dad’s 85th birthday. Of course, he wishes his golf game were better, and we wish he would wear his hearing aids more regularly, but all in all, life is good for this kid from the Bronx, and we will celebrate with extended family in Italy this summer. But aging is not for the feint of heart, and one of the threats on all our minds is the risk of developing Alzheimer’s disease, the most common form of dementia. Worldwide around 47 million people have dementia, and there are 9.9 million new cases every year, a number that is expected to triple by 2050.

Without a cure for dementia in sight, we need to engage in a radical rethink.  How do we thoughtfully and productively make space in our communities and daily lives for individuals with dementia? Leave it to Japan to come up with what some might consider a crazy idea: the Restaurant of Order Mistakes.  Staffed by individuals with dementia, chances are you won’t get what you order, but that is part of its unique appeal. This successful Tokyo pop-up cafe raises awareness, reduces stigma, and creates jobs for individuals living with dementia.

waiters-dementia-restaurant-of-order-mistakes-tokyo-12
Of course we want a cure, but in the meantime, here are some outside the box ideas from around the world on how to increase social inclusion and quality of life for people living with dementia today.

1.

Hegeway Village, Netherlands. Just outside of Amsterdam is a small village called Hogewey where individuals with severe dementia live a seemingly normal village life. You may not be aware that caretakers staff the restaurant, grocery store, hair salon and theater – and maybe that’s best. Living in a functioning community, even if it’s small-scale, can provide a sense of purpose, a key factor that research from Chicago’s Rush University Medical has shown to be associated with less cognitive decline with the same amount of actual brain damage from Alzheimer’s disease. The state healthcare funded village of Hogewey may not be realistic and scalable to meet the needs of the growing Dementia-affected population around the world, but it’s an inspiring model where it can be implemented.

2.

Singing for the Brain, UK. There are now 200 Singing for the Brain groups across England, Wales, and Northern Ireland, where older individuals with dementia participate in choirs and sing song after song, music they know by heart. This is great brain exercise that helps keep the brain active, and perhaps helps to maintain neural connections and better cognition.

3.

London, the world’s first Dementia-friendly city? The Pan-London Dementia Action Alliance aims to make London a city where the 70,000 people living with dementia are able to participate in society with a high quality of life. The provisions range from increasing diagnosis and awareness to training citizens as “Dementia Friends” who might help someone find the right bus or spread the word about dementia on social media. The Dementia Action Alliance will need to gather a lot of political will to make their expansive vision a reality, but they’re working towards it.

4.

Sharing Dance, Canada. Canada’s Center for Aging Policy is partnering with Canada’s National Ballet School to study the effectiveness of a new “Sharing Dance for Active Seniors” program. Dance has been shown to help improve the aerobic power, muscle strength, balance and mental health of older adults and can reduce social isolation as well as the risk for falls in those with dementia. This is one of the first federally funded national public health intervention strategies focused on the arts, and the Public Health Agency of Canada aims to expand the program to more than 120 communities in the next five years.

5.

Home Care in India. The existing health services in India cannot meet the needs of the estimated 3.7 million people living with dementia, and families have very little access to information and support. So the Home Care trial was created to test an innovative solution in Goa, India. Lay workers regularly visit families and homes of people with dementia. Caregivers receive health education and guidance by a professional counselor and psychiatrist. The program has resulted in significant improvements in general health and reductions in distress, and the hope is that such programs could be implemented more widely in low and middle-income countries.

While these programs won’t cure dementia, they can make a world of difference for people living with dementia today. At CUMC, we have a team of scientists working to understand the neuroscience of the brain, learning and memory, including Nobel Prize Laureate Eric Kandel MD and Christine Denney PhD. And Dr. Harold Pincus and I direct the Health and Aging Policy Fellowship Program that connects individuals from a wide variety of professions to policymaking. From basic science to policymaking and programs, we have a lot of work to do to ensure that living longer is truly a good thing.

Oh, and before I forget, happy birthday Dad!

Kathleen M. Pike, PhD - Is Professor of Psychology & Director of the Mental Health Program at CUMC kmp2@cumc.columbia.edu