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.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
