With a million people living with dementia, how long will we have to fear it?
Selected by senior life experts
A Guide to Dementia for a Dignified Aging

★ Recommended by Won Hye-young, co-representative of the Well-Dying Culture Movement, and former president of the Korean Geriatrics Society, Yoon Jong-ryul!

By 2025, Korea will have entered a super-aged society, and it is said that one in ten people over the age of 65 suffer from dementia.
With the rapid increase in the elderly population, the number of people with dementia is also expected to increase.
Yet, our current thinking about dementia can be summarized in one word: 'If you get dementia, your life is over.'
This is because there is a strong perception that it is a disease that makes it impossible to live the way you want by losing yourself, and that it is a disease that only becomes a burden to your family.

The author of Person-Centered Care, known as the most ethical dementia care method in the world, who is leading this movement in Korea, says, "Dementia may not be curable, but people with dementia can maintain their daily lives."
Having observed many dementia patients in the field for a long time, the author has witnessed cases where dementia progresses quickly to severe symptoms even in the early stages, and cases where people live relatively normal lives for a long time, to the point where one wonders, "Are they really dementia patients?"
This depends on whether the symptoms or feelings of the person with dementia are the focus.
This means that by alleviating negative emotions such as loneliness, it is possible to maintain the early stage of dementia, when symptoms are not so severe, for as long as possible and live according to one's own will.
The author emphasizes that for this to happen, it is necessary to treat the person involved with love, either by oneself or by those around oneself.


Of course, it is best not to get dementia.
However, dementia, a byproduct of aging, can strike anyone and at any time.
The author says that dementia is no longer something to be feared, as there are ways to slow its progression even if it does occur.
To achieve this, we must first understand what dementia is, correct our prejudices about dementia, and provide a new perspective on dementia.

According to a domestic dementia awareness survey conducted by the Central Dementia Center, the disease that the elderly in Korea fear most is dementia (43 percent).
Children fear that their parents will develop dementia, and parents with dementia fall into despair, saying, “My life is over.”
These days, as the number of patients with early-onset dementia before the age of 65 increases, dementia is becoming a fearful disease for middle-aged and older people, even those in their 30s.
Some people wish for euthanasia due to extreme fear and denial about dementia.
Dementia is sending our entire society into a panic.

--- p.49 From “We Who Hate Our Future”

Dementia is the disease with the longest survival period.
For example, if you are diagnosed with Alzheimer's disease in your early 60s, you may live for more than 20 years.
Of course, the problem with dementia is that the symptoms gradually worsen after the onset.
However, while some people can maintain their daily lives for a long time even after being diagnosed with dementia, there are also cases where people are diagnosed with mild dementia and their memory is almost lost within a few months, and the condition deteriorates rapidly to the point where it becomes impossible to live alone.
Even if you are diagnosed with dementia, if you manage it well in the early stages, it is possible to enjoy your daily life.
However, in many cases, the moment they are diagnosed with dementia, they despair and give up on all their efforts.
If you give up, dementia will worsen rapidly.
--- p.65 From “Those who are not afraid have the power to overcome dementia”

Emotions are deeply involved in our thoughts, judgments, and decisions.
It makes us more likely to remember happy or extremely sad events, and when making important decisions, we base our judgments on memory data selected by our emotions.
It also has a major impact on health and dementia.
Positive thoughts and feelings release dopamine, which reduces pain in our bodies.
Conversely, anger and negative thoughts are detrimental to your health.
It is well known that loneliness has a negative impact on health, comparable to smoking 15 cigarettes.
Feelings of loneliness can cause cardiovascular problems and harm your health in every way you can think of: personality disorders, mental illness, cognitive decline, diabetes, arthritis, and more.
--- pp.103~104 From “Dementia Comes Through Bad Emotions”

What is the self you want to retain until the end? According to Carl Rogers' person-centered theory, which emphasizes humanistic psychological counseling, the "authentic self" is comprised of one's values, beliefs, and experiences.
Living true to yourself means living according to your own standards and desires, not those of others.
American social psychologists Christopher Sabat and Harriet Foster presented an interview with a dementia patient who had been a lawyer in his youth.
When asked, “Were you a lawyer?” he is said to have replied, “I am a lawyer.”
Being diagnosed with dementia doesn't mean he's lost his identity as a lawyer.
Because he majored in law, spent his entire life advocating for the law and using his legal knowledge to help others in their difficulties, his identity will always be that of a 'lawyer.'
--- p.130 From “I Will Remember What I Like”

How many close friends are needed to feel safe? Several studies examining relationships suggest that three to five close friends is the optimal number.
But even that number cannot be considered safe in old age when relationships are reduced.
The number of friends is like a candy jar.
The amount I can handle is the most appropriate.
People who have a broad perspective on the world are said to meet and associate with a wide variety of people.
You can make friends with people of different educational levels, backgrounds, political views, and religions.
The same goes for age.
We need old friends to help us grow old and new friends to help us stay young.
--- p.145 From “The more friends you have and the more often you meet, the better”

According to British social policy scholar Mary Daly, care is 'the work of looking after someone who cannot take care of themselves.'
Care must meet three essential needs: first, to provide assistance in daily life, and second, to provide assistance in crisis situations.
Lastly, the most important thing is companionship.
The key is intimacy, being ‘by your side.’
It is about both the caregiver and the care recipient existing alongside each other as their complete selves.
Caring is the desire for the other person to be happy.
It is a mutual giving and receiving, contributing to the satisfaction of the other person's needs.
--- pp.191~192 From “Care that makes everyone feel comfortable while caring for each other”

Laughter changes our brains, and laughing together is more effective than laughing alone.
In one study, participants watched a comedy film alone or with a close friend, and then their brains were scanned using positron emission tomography (PET).
In the brain after laughing, we were able to confirm that the production of opioids, which are stress relievers, increased.
A key finding was that the laughter effect was greater for those who watched the comedy with a friend than for those who watched it alone.
The effects of laughter and joy are not limited to healthy people.
Even in dementia patients, laughter can activate brain cells and increase the number of wrinkles in the brain.
In dementia care, it is important to understand and care for the anxiety or nervousness felt by the patient to maintain a good mood, which is important in preventing the progression of the disease.
--- p.212 From “The Misconception That Dementia Eliminates Emotions”

Sometimes, people lie as a temporary measure to calm the anxiety of dementia patients.
When a grandmother with dementia visits her deceased spouse, she says, “Grandpa is out right now.
“Just wait a little bit and he’ll be back,” he said, trying to appease her.
Even with good intentions, lying can actually destroy trust with the other person, which can have negative consequences for future care.
People with dementia do not show symptoms of dementia 24 hours a day.
Even if you are delusional, the next moment you recognize reality.
When I find out that the other person has been lying to me, I no longer trust that person.
To form an attachment, you need to 'accept the person as they are', 'treat them sincerely', and 'have an attitude that acknowledges the person's world'.
--- p.223 From “Principle 2 of Emotional Care: Build a Mature Relationship”

In person-centered care, we prioritize joint decision-making in care and treatment.
To understand and practice the desire for inclusion, we must first remove the barriers within our own hearts.
The first mental barrier to dementia is the idea that 'there is cognitive decline, so I have to do it for them.'
The idea that it is dangerous to leave a person with dementia alone and that everything must be done for them leads to oppressive caregiving.
Such care ignores the person's potential and takes away things he or she can do for himself or herself, ultimately leaving the person worse off than he or she is now.
--- p.243 From “Principle 5 of Emotional Care: Being Together”

Efforts to create dementia-friendly environments aren't just for people with dementia.
I may also worry about caring for my parents, or my spouse or sibling may be diagnosed with dementia.
I might start losing my memory first.
At that time, you will face firsthand how much of a burden it is on you and your family due to difficulties in preparing meals, doing housework, using public transportation, and pursuing hobbies that cannot be resolved with hospital treatment alone.
Changing negative thoughts about dementia and showing interest in the elderly people with dementia around you.
This is no different from helping others and protecting my future life and the lives of my family.

--- p.299 From “Understanding the Role of Love in Supporting Oneness”