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Rising dementia rates among Asian Canadians call for culturally safe services: Report

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Brenda Wong remembers her mother mixing up towels to clean the floor with those for scrubbing dishes. More confusing behaviour followed when a relative mentioned the family matriarch had called seven times within five minutes, each time seemingly unaware they’d already spoken.

Wong and her two sisters had no idea what was going on before taking Chui Foon Chou to her doctor.

When a neurologist diagnosed Chou with dementia in 2006, her daughters feared she’d soon lose her memory, even of them.

“We didn’t have much knowledge about the disease,” Wong said of her 86-year-old mother, who is now completely dependent on her “team” of daughters and home support workers who speak Cantonese.

 

The family has learned that dementia progresses gradually and its symptoms go beyond forgetfulness, fuelling frustration and requiring a large dose of patience from those who have it and their loved ones as their caregiver roles expand.

Some Asians keep dementia a secret to protect the family from embarrassment, said Wong, who believes more education is allowing people to seek help and speak openly about a condition that affects every community.

By 2050, almost one out of every four people who develop dementia in Canada will be of Asian origin, a 785 per cent increase from 2020, says a report released this week by the Alzheimer Society of Canada.

The report, based on modelling by the Canadian Centre for Economic Analysis, says the overall number of people living with dementia is projected to rise to one million by 2030, nearly triple the current amount. It focuses on the diversity of people who will be developing dementia as the population ages, and the need for services to be tailored for various racialized groups.

Lead author Joshua Armstrong, a research scientist with the Alzheimer Society, said a large segment of Asiansin Canada from countries including China, India, Japan and Korea have language barriers, making assessment of dementia more challenging.

Many of them moved to Canada in the 1970s and their dementia is being driven by their age, not a higher risk as a group, he said, though some people have a greater risk based on genetics. High blood pressure, physical inactivity, poor diet and diabetes are among the modifiable risk factors.

“There’s stigma associated with dementia, so that is definitely one thing that we are trying to tackle,” he said of the need for culturally safe services.

Dementia refers to a set of symptoms caused by disorders affecting the brain. Alzheimer’s and vascular disease, for example, contribute to dementia, which causes thinking and memory to worsen over time and affects mood as well as awareness of people, places and time.

It’s too soon to know how COVID-19 will affect the number of dementia cases in the future because the study is based partly on the 2016 census and limited academic literature.

“Any sort of negative impact on the brain is typically associated with increased dementia risks. We know that the virus does have an impact on the nervous system so we are definitely concerned that this might have an impact on dementia rates,” Armstrong said.

Sharon Tong, who works for the Alzheimer Society of B.C. to support services provided to the Chinese community, said some older people in particular fear asking for help because they believe dementia is a mental illness.

A helpline is available for callers to anonymously ask questions in Cantonese and Mandarin, said Tong, adding most inquiries revolve around memory loss and whether that is solely related to aging. The line also offers support in Punjabi, Hindi, Urdu and English.

“They are aware that dementia is not curable and they will quickly jump to end-of-life (issues). And they really worry a lot about long-term care and that they may not have the ethnic food in a facility, and the language barrier, that they may not be able to communicate effectively,” she said.

While an aging spouse and adult children caregivers are often struggling to cope, stigma prevents them from accessing services such as home support and even going to a doctor until the later stages of the disease, Tong said.

A successful one-year pilot project called Coffee and Chat has recently become a regular weekly gathering for 15 people living with dementia and is offered by the society at a community centre in Richmond, B.C., home to a large Chinese population.

“They feel free to talk about what they want to talk about. If, in the middle of the conversation they lose track, others don’t mind.”

Tong said people play card games, do puzzles and chat in the group, but it has a wait list. Another group, for those with early-stage dementia, includes family members.

The Alzheimer Society of B.C. will be hosting its first forum on dementia next month in Surrey for the South Asian community.The report says that some families have noted a lack of South Asian representation in educational materials and videos about dementia.

The Alzheimer Society’s report also notes that an increasing number of Indigenous people are developing dementia and that their risk is high due to social disadvantages that affect factors including diet and adherence to medication.

Rebecca Labilloisof the Ugpi’Ganjig First Nation in New Brunswick said she and her siblings looked after their mother with “no support” from a local health centre before her death in 2013.

Her parents were both veterans so her mother was eligible for some services, but few culturally appropriate supports are available in the community even now, Labillois said from Eel River Bar, N.B.

She called for more training and hiring of Indigenous health-care and support staff who have an understanding of traditions including smudging.

“For people who don’t have these services, I feel for them.”

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

 

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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