Edition Quarter June

GROEEBT'SING AZ ACTIVITES INFORAMZ ATION

Over the past few months, we have held several activities and I want to say a million thanks for the support of all members. It is with great pleasure that we present our quarterJune newsletter. I don’t like to think about myself getting dementia, but personally, if I were one of the lucky people living with dementia who is happy, I would want to live. But if I became greatly distressed I would like to know I’d had the option of assisted dying in my advanced care plan, for both the sake of myself and for the people who love me. ~ Dr.Kate Dr Gregorevic , Geriatrician hospital in Melbourne ~

AZ Activities KOTA KINABALU 23 MEI - Rotary club has invited Sabah Alzheimer's Disease Support Association to deliver a presentation during their event.

https://www.aplaceformom.com/caregiver-resources/articles/best-foods-for-dementia-patients-to-eat

By Dr Chris Chong President of Sabah Alzheimer’s Disease Support Association A) BILLS, BANKING AND INVESTMENT Having difficulties paying bills is often one of the first signs of memory loss. Some patients will forget to pay their bills, leading to loss of important services such as heat, electricity, and telephone. Other patients will pay bills twice. Some patients will Sometimes, the need for help with bills and have both problems. In dementia cognitive problems banking can arise suddenly, such as when a can impact the skills required to pay bills, manage person with dementia faces the death of a banking, and prepare annual tax returns. spouse who was previously responsible for the bills. For nearly all people with dementia, someone will eventually need to take over responsibility for bills and SUGGESTION : financial organisation. Anticipating needs as far in advance as possible is important to avoid problems 1. If a patient with mild cognitive impairment or faced when bills are not paid. Specific financial needs very mild Alzheimer’s disease dementia is in dementia include the following: continuing to pay the household bills and do other banking duties, we recommend that their Scheduling payment of bills work be reviewed with a family member at least Establishing shared access to online banking monthly to assure that no problems are information with a responsible individual developing. Taking steps to avoid being taken advantage of by scam phone calls seeking financial information 2. Several options exist for co-management of a Safeguarding essential documents and wallet banking and bills, including establishing a co- contents (e.g driver’s license and credit cards) signer or having a joint account. Creating either shared access or responsibility for accounts. The need for assistance with managing financial affairs often gradually becomes apparent over time and coincides with gradual cognitive decline.

Creating either shared access or responsibility for People can also be provided with a pre-filled accounts allows for observation to ensure timely debit card with an amount acceptable for loss if payment of bills while affirming a person’s sense of the card is misplaced. These strategies allow independence. patients to feel that they are still capable of making banking decisions and purchases. Fraud notification programs often provide a cap for charges and send a message to an account holder 4. Investment : Even the most healthy and when a charge exceeds the amount or for other intelligent individual will sometimes make bad suspicious activity. investments leading to significant financial losses. Investing is a complicated art, and 3. In our society it is easy to have rapid access to depends upon being aware of the latest large amounts of money or purchasing power using information along with good judgment and automatic teller machines (ATMs) and credit cards. reasoning abilities (and of course a bit of luck). By the time the patient is in the mild stage of Given the complexity of investing, it is not Alzheimer’s disease dementia it is usually prudent to surprising that many patients who eventually remove access to these cards. Patients with ready develop Alzheimer’s disease or another dementia access to cash can be easily exploited. Solicitations will have made poor investments in the years from unscrupulous individuals frequently appear in before their diagnosis. The tragedy is that the mail and by the phone. sometimes lifelong savings or retirement funds are lost within a short period of time. We recommend that a patient diagnosed with mild cognitive impairment or any type of dementia immediately relinquish any form of investing. B) WORKING/ EMPLOYMENT Should a patient with mild cognitive impairment work? As more adults work into their 70s and 80s, there are more individuals who are working at the time of their diagnosis of mild cognitive impairment (and, more occasionally, very mild Alzheimer’s disease or other dementia). Whether individuals with mild cognitive impairment and very mild Alzheimer’s disease dementia should continue working depends upon the individual, their job, and how long they have been doing the work.

If the individual has been doing the job for many years, it is likely that many of the manual and cognitive skills have already been consolidated in memory, and can therefore be maintained for a period of time. From the patient’s perspective, working is almost always good: working typically provides a healthy routine, intellectual stimulation, socialization, and other helpful qualities such as maintaining feelings of self-worth and avoiding depression. From the employer’s and society’s perspective, it depends upon whether the patient’s cognitive impairment disrupts the performance of the job and whether there are risks or dangers involved. For example, an individual with mild cognitive impairment could continue to work on an assembly line in which their task is procedural in nature (not requiring memory, judgment, or reasoning), is relatively circumscribed, and the person at the next stage of the assembly line will be aware of any errors made. Another example of an appropriate job to continue includes making handmade crafts such as pottery or articles of clothing; again the work depends largely on procedural memory (not affected by mild Alzheimer’s disease dementia), and the quality of the work will generally be readily apparent. Inappropriate jobs to continue include those that involve supervision at almost any level, from watching children at a daycare center to managing a business. Other inappropriate jobs to continue include those that involve memory, judgment, and reasoning that affect people’s lives at any level, such as a clinical or legal professional. Sales jobs may be appropriate if the work is circumscribed, the patient is already quite experienced, and the supervision of the patient is appropriate. For example, one of our patients was able to continue her job and be productive as a florist well into the mild stage of Alzheimer’s disease dementia. SUGGESTION : When to stop working can be a challenging decision for many reasons, ranging from financial implications to social opportunities and friendship. Stopping working is often a clear indicator that real cognitive changes have started. The decision to stop working can be very stressful and poses a risk for an episode of depression in people aware of their ongoing cognitive changes. Decision to continue or end employment must be made on a case-by-case basis, with involvement of those affected by the decision whenever possible. Reference: Navigating Life with dementia : James M Noble, American Academy of Neurology 2022 Six Steps to Manage Alzheimer’s Disease and Dementia: Andrew Budson, Oxford University Press 2022

Upcoming Events (LOCAL) Sabah Az Outreach Awarness Program in Ranau. Datuk Hjh. Zahra Ismail, Vice President Sabah Az with YB Datuk Hjh Amisah Yassin who is based in Ranau had successful discussion on the awareness program that we are proposing in Ranau for 2023. All the time we've had a program in Kota Kinabalu. We are now going to reach out to other districts. That why its called out reached programe. Sabah Az will be collobarating with a NGO in Ranau Forum - 'Pengenalan Kepada Demensia' in October 2023. PUBLIC RELATION & PUBLICITY SABAH Az

Upcoming Events (INTERNATIONAL) Alzheimer’s Association International Confrence 33rd Alzheimer Europe Conference 2023 (AAIC) on the 16th July 2023 PUBLIC RELATION & PUBLICITY SABAH Az

WEBSITE Alzheimer’s Disease International Alzheimer’s Europe Alzheimer’s UK Dementia Australia Dementias Alliance International (for people with dementia) Alzheimer’s Disease Foundation Malaysia (ADFM) BPSD - app for clinicians to understand and manage behavioural and psychological symptoms of dementia Care4Dementia - app for carers to understand and manage behavioural and psychological symptoms of dementia PUBLIC RELATION & PUBLICITY SABAH Az