Wednesday, September 21, 2022

Hey, Hey, It's World Car -Free Day - 22nd September, 2022

This is a Car-Free Day in Toronto from a couple of years ago since the day fell on a Saturday. Unfortunately it falls on a Thursday this year, but you'll get an idea of the kind of fun you could have on a Car -Free Day.
 

 Dear Friends, I can see you aren’t as excited about the topic of Ageing so I’m giving you a break today and promise to finish up on this topic really soon.

It just happens to be World Car -Free Day tomorrow, so I thought we should take a few minutes to think about that. The aim is to showcase more sustainable  forms of transport – walking, cycling and public transport, all of which reduce air pollution and CO2 emissions from the use of fossil fuels. The latter have unfortunately been rising. Obviously organisers hope that the joy of not using one’s car will go beyond that one day and that people will have so much fun that they will want to keep doing it. Usually it involves street closures and street parties, games and perhaps foot or cycle races as well. Read more here about the health costs of pollution from cars.




With transport being the EU's second highest polluting sector, 56 countries are also celebrating European Mobility Week which has been running from September 16 to culminate in Car -Free Day.  This year 2,845 towns and cities are hosting  events.  Not all of them are based in Europe. They come from as far afield as Uzbekistan,  Japan, South Korea, Ecuador, Botswana, Iceland, Brazil and Argentina, so there is no reason why your town or country couldn't take part as well. I know it's a bit late for this year, but now would be the time to register and plan for next year's. You can see some typical activities here. You'll not that many of the actions such as Turkey's activities for the visually impaired involving nature walks and tandem bike rides or Estonia's mobility map for people with disabilities, are still about inclusiveness and accessibility, so we aren't entirely off - topic.

Following the success of its previous Cycle Festival, Nepal is hosting a second one this year. I hope they have sag wagons!

 

As with World Car -Free Day, there is a more serious side to this as well. It involves city authorities making permanent changes such as adding more bike lanes or improving public transport to make cities, safer, healthier and greener for all. You can see some of their activities here. This year’s theme is “Better Connections” and you can read all about that here.


 

 

 

 

 

 



Saturday, September 17, 2022

Putting Age Friendly Principles into Practice - 5b Including People with Dementia

 

Image Nick Youngson CC BY-SA 3.0 Alpha Stock Images















As it happens, September is Dementia Awareness Month in Australia and World Alzheimer’s Month in other parts of the World. There is also a special World Alzheimer’s Day on September 21.st  Dementia is the blanket term for several forms of progressive cognitive decline, but Alzheimer’s Disease, itself representing at least three different conditions, accounts for about 60 – 80% of cases, so the two terms are often used interchangeably. However, neither is an inevitable consequence of ageing.

In either case, Dementia is a growing problem around the world and is already the world’s 7th leading cause of death. According to  Alzheimer’s International approximately 55 million people suffer from Dementia today with that number expected to rise to around 139 million by 2050. Apart from Climate Change, this is likely to become one of the biggest challenges societies will face in future. 

The aim of such commemorative events is to raise awareness about these conditions, to recognise the symptoms in order to obtain an early diagnosis because in the early stages, progression can be slowed if not halted, and to call for greater understanding for those affected. It’s not just about being kind. It is a human right that all people, regardless of age, disability or cognitive ability, be treated equally. For those who are diagnosed with such conditions, there is a great deal of help and support -almost every country has some type of organisation which will help. You can see a list at the end of this post. However, there are also other movements under way such as Dementia Friends and Dementia Cities, so I will talk about some of those here. Scotland even has a Dementia -friendly National Park.

Recognising the Early Signs

 


Note: Just because you have once again forgotten where you put your glasses or car keys doesn’t necessarily mean that you are on the road to irreversible decline. As you can see from the  above video there are also other diseases which need to be eliminated before a definite diagnosis can be made and Hey, even if that does happen, it doesn’t mean that you can’t live a good life, especially with a little help from others. In the early stages, progress can be slowed with medication and symptoms can certainly be alleviated. Click here for more about recognising early symptoms

Here's a little clip about why we shouldn’t discriminate against people with Dementia

 

 

Dementia Friends

Japan already had 4.6 million people with dementia  in 2013. It responded by starting its Dementia Friends program in 2004 with a nationwide caravan to train volunteers, raise awareness and support people with dementia living in the community by teaching people in schools in schools, offices and other community settings to recognise the symptoms, about diagnosis and treatment and how to effectively help people. Today there are Dementia Friends in 67 cities including two in the USA  and there are 19 million friends around the world, 11 million of them in Japan.

Dementia – friendly cities

The city of  Bruges in Belgium was one of Europe’s world’s first dementia -friendly cities, producing information booklets, recruiting 90 businesses and conducting staff training sessions for them. They have a sign of red knotted handkerchief in the window to indicate that they will be patient, compassionate and willing to help, and an army of volunteers to help keep tabs on visitors. It’s about keeping people safe, being inclusive and reducing the stigma about this condition.

Dementia -friendly cities now exist in over 40 countries and also include cafes, malls and co -operative businesses. The UK also has several and the city of York even has a dementia – friendly station. Bus drivers in Northumbria are trained to recognise people with dementia and how to respond to them and we’ve already talked about the British Transport Police under mobility.

Below is a short video by a member of Victoria Police force with first -hand experience of having a family member with dementia, talking about the way to approach someone living with dementia. There's also a longer one here.



Speaking with my local police, they say having a tracking device is the easiest and quickest way to locate someone who gets lostst. I haven’t found much on this topic other than Project Lifesaver which uses satellite technology and has trained volunteers in place to bring wanderers home – and they aren’t just seniors. Unfortunately, while they seem to be very big in the USA, they seem to be few and far between elsewhere. It would be best to speak to your local Dementia support group - see the International listings at the end of the post, as they are sure to be able to give you the best advice for your area.

Dementia Cafes

Dementia cafés like the one in Melville (earlier post) were started by a Dutch psychologist in 1997and were found to have a positive effect because they enable dementia sufferers and their carers to socialise. This is because isolation tends to hasten decline. Dementia cafés have since taken off around the world too.

More Help for Carers

Looking after carers is very important. Looking after others is not only very demanding but often leads to carers being unable to look after their own needs which in turn leads to stress, social isolation and burnout.

 Many places have Day Care and longer Respite Care – ask your nearest help centre (below) and other activities to provide some relief for carers. China, which has 11 million dementia sufferers, most of whom are cared for at home, is working hard to establish community care centres, both to relieve the burden on hospitals and to make them more accessible to people with dementia. The Chinese government is also collaborating with an Australian university to improve help for carers at home and to make to make self -help support available to the many people of Chinese origin now living in Australia.

There is also a huge range of resources online to help those caring for people with dementia at home, many of them in other languages. In this context I want to mention the excellent series of  free CareBlazer videos by Geropsychologist, Natalie Edmonds PsD ABPP. Each one is very short but deals with specific problems and behaviours which might be encountered. Most of the places listed at the end of the post will also be able to help. Alzheimer's org UK  for example has  excellent ideas for activities which can easily be done at home.

NB: Alzheimer's UK warn against buying expensive commercial products which claim to halt or reverse dementia. Yes, they say, brain training is generally a good thing – think Sudoku, Crosswords, puzzles etc. and by all means do them for enjoyment -but the data is not yet in as far as claims for many expensive offerings go.

Organisations which can help

INTERNATIONAL: Alzheimer’s International

Umbrella organisation for around 120 different countries, in many languages too

AUSTRALIA:    Dementia Australia                                        1800 100 500

                            Helpline, free info kit, Email support    

EU Countries :  Alzheimer's Europe                

UK:                   Alzheimer's UK                                     

SCOTLAND:  Alzheimer's Scotland                     

                        24-hour helpline,  and 22 resource centres

 CANADA:    Alzheimer’s Society  

                       Also has information in Hindi, Mandarin and Cantonese

USA:            Alzheimer’s Association  

                                                                   

NEXT: Overcoming Ageism  and Discrimination against Older People

 

Monday, September 12, 2022

A Brief Look at Suicide Prevention around the World

World Suicide Prevention Day – Sat 10th September


 

Globally suicide remains a leading cause of death – ahead of  deaths from malaria, road accidents, homicide, malnutrition, natural disasters and even war, yet few countries have been able to reduce their suicide rates. In all countries the suicide rate for men is twice as high than for women and in some countries it is even higher.

I’m not going to write a great deal about this today. A great deal has already been written. See for example the very detailed suicide prevention strategies which have already been published as part of the World Health Organisation’s LIVE LIFE Campaign, aspects of which have been successfully implemented in a number of countries. The suicide rate does vary greatly however both within and between countries - by culture, by religion, income levels and gender, so what works in one region may not work in another, but what seems to be lacking is not so much the how, or even resources, but the failure to make suicide prevention a priority and to have a coordinated approach.

 

Developing National Prevention Strategies

 The first part of the WHO program  - the LIVE aspect, is a ten -point toolkit to help countries to establish and implement their own national plan starting with how to analyse the problem and bring all stakeholders together, right through to monitoring, evaluating and reporting on what worked.

 

 

 



Specific Ways to Reduce Suicide Rates

Part II of the WHO’s program -The LIFE section is about ways in which to reduce the incidence of suicide in general. Just as detective stories rely on key points such as MEANS, MOTIVE and OPPORTUNITY, it has four key features. We’ll look at each of these in turn.

 

1.     Limit access to means

2.     Interact with media to create awareness but ensure responsible reporting

3.     Foster Socio -emotional skills in schools

4.     Early Identification, assessment and follow -up of anyone affected by suicide.

 

1.       LIMITING MEANS

Suicide is often a snap decision in the light of some negative experience. Many people who attempt suicide but survive, report that if they’d only had a moment to reflect on what they were doing, rather than reacting in the heat of the moment, then they would never have tried to take their own life. This highlights the need to remove readily accessible means. A few examples follow. The WHO pages have many more.

 

-          Restricting firearms has been effective in a number of countries including Australia, the UK,  Israel and Switzerland. A recent Danish study confirmed that restricted access led not only to lower suicide rates from that cause, but in most cases to lower rates overall. Denmark has had a declining suicide rate for the last two decades. In the USA whose suicide rate is particularly high, firearms account for 60% of the deaths, or more than 24,000 people, twice the homicide rate, 10 times the European average and 30 times higher than the UK.

 

-          In low to middle income countries, availability of pesticides has been linked to high suicide rates, so restricting access to them has been effective in a number of Asian countries including Fiji, Malaysia, Sri Lanka and the Republic of Korea. South Korea’s ban on paraquat not only contributed to a halving of suicides, but has not resulted in any reduction in crop yields, thanks to a program which encourages the use of less toxic alternatives and the promotion of organic farming.

 

-          South Korea has long had closed safety glass doors in its subway stations – particularly near universities and schools. These doors align precisely with the carriage doors and only open when the train comes to halt so that no one can fall or jump onto the tracks. It is now erecting barriers on its railway bridges. In Australia, Brisbane’s Gateway Bridge has one and in Hobart, the Tasman Bridge not only has barriers, but surveillance cameras and emergency telephones.

 

-          Other measures  include restricting supplies of pharmaceutical drugs to small quantities and making packaging more difficult to open. In institutional settings removal of ligature points has been helpful as has the substitution of natural gas in households in the UK.

-         If someone you know is in deep distress, it may be helpful to ask their family remove any items which could be used in the event of a suicide attempt. See more about getting help at the end of this post.

2.       INTERACTING WITH THE MEDIA


The media can help to create awareness about suicide but done incorrectly it can sometimes lead to copycat behaviour. For this reason guidelines have been established about how to report on it responsibly e.g. by not sensationalising suicides, especially celebrity suicides and to focus on those who have successfully overcome such feelings or who display help -seeking behaviour. The UK’s Samaritans Support Service has developed very detailed tips on to how to present such material in print, on television, in film, drama and literature. Lithuania monitors its media closely and asks for amendment if the guidelines have not been followed. Austria awards an annual prize for good reporting on suicide. 


3.       FOSTERING SOCIO -EMOTIONAL LIFE SKILLS FOR ADOLESCENTS

 

Because suicide is the fourth leading cause of death among young people,* the WHO has developed a comprehensive program for 10 – 19 -year -olds, Its “Helping Adolescents Thrive (HAT)”program teaches young people how to problem solve and manage stress. It trains educators and others involved with young people in say, youth centres or detention centres for displaced young people, how to recognise risk factors and warning signs, about creating a safe school environment – free of bullying and discrimination, how to foster positive social connections, healthy use of social media and so on, and forges links with support services and the wider community. As well as increasing awareness of signs of distress in oneself and others, it conveys information about what support is available. It also reduces the stigma associated with mental health and needing help. Read the full text here.

 

In 2009, the European Union funded a two – year research program “Saving and Empowering Young Lives in Europe (SELYE)" to determine which school intervention programs were most effective. This involved at 168 schools across 10 countries and 11,110 students. The “Youth Aware of Mental Health (YAM)” program was found to be a clear winner.

Young people who participated showed a 50% lower rate of suicidal behaviour and new cases of moderate to severe depression were also reduced by 50%. It emphasises peer support, empathy towards others and how to go about seeking help. It also helps to change students’ perceptions about mental health and makes them more resilient in the face of adverse life events. The program has since been commercialised in collaboration with Sweden’s Karolinska Institute as Mental Health International and has been taken up or trialled in many countries throughout the world including Australia, India, the USA and Europe with some 100,000 students having taken part. Read more here.

 

4.       EARLY IDENTIFICATION, ASSESSMENT, MANAGEMENT AND FOLLOW -UP


Among the benefits of large projects such as SELYE, is that researchers learned a great deal about youth behaviour and how to identify individuals and groups who may be more at risk than others. There are other forms of early recognition too. Japan for instance, immediately refers people to the Health Sector if they visit the Social Welfare Department with financial difficulties for example. People experiencing physical or mental health conditions are also at greater risk and should be identified by their health professionals for special attention.

The Islamic Republic of Iran has developed a smooth pathway via local GPs for early treatment for those experiencing depression.

Assessment and Management is more for professionals in the field. The Republic of Korea has expanded its emergency department from 25 locations in 2013 to 85 locations in 2020 as part of its revised National Suicide Plan.

Providing multidisciplinary reviews after a suicide led to a reduction in suicide in clinical populations in  England and Wales.

Follow -up is important both for those who have attempted suicide and anyone affected by it, including those helping others through a crisis. Besides formal follow – up by Health Departments and the like there is an increasing role for the meaningful participation by such "survivors' in community support either as volunteers in crisis centres, in self – help groups and in providing input into programs and policies involving those at risk of suicide. See for example “Roses in the Ocean” an Australian organisation or Scotland’s Lived Experience Panel. 

Canada has recently instituted a program whereby those who counsel others also have a chance to discuss their experience with other facilitators for mutual support, to share successes and failures and to promote best practices in prevention. This has proven especially beneficial for those working in isolation.

 

Decriminalising and Destigmatising Suicide

          

Not specifically mentioned in the WHO literature, but mentioned by the Guardian, is the fact that suicide remains illegal in some 20 countries and a further 20 countries ban it on religious grounds. This makes it very difficult to assess the extent of the problem and also makes it very difficult for those affected to seek help.

 

* Sadly, the suicide rates for older people are even higher at 24.5% for those over 70 and 14.25 % for people between 50 and 69, but they hardly rate a mention because they are overshadowed by deaths from other causes such as cardio - vascular disease and cancer in higher age groups.

 

WHERE TO GO FOR HELP AND SUPPORT 

 If you or anyone you know is experiencing distress call your local helpline. Some are listed below. Find out what yours is and put it in your phone or on your fridge. You may never need it, but someone else might. In extreme cases, just call your local emergency number or go to your nearest hospital.

 

AUSTRALIA:      Lifeline                                       13 11 14

                            
USA:                                                                          1-800-SUICIDE

National Suicide Prevention Hotline                      1 -800 -275 -8255

CANADA:               

Canada Suicide Prevention Service                        1-833-456-4566

Connex Ontario                                                        1-866-531-2600.

UK:  The Samaritans                                               116 123  

INDIA:                                                                       99220-01122/99220-04305             
 

A LIST OF INTERNATIONAL HELPLINES CAN BE FOUND HERE

There are also specific ones for specific groups or issues. For example the USA has one for the LGBTQIA community and you can text many of them too. See more about using Hotlines here.                      

 

Next time we'll be returning  to our discussion about Age - friendly cities.