China has the largest population in the world with now over 1.3 billion people. It also has the largest absolute old population in the world with over 7% of its population now over 65 years of age. They number will increase to over 10% by the year 2010 and give China over 150 million people over the age of 65 years old. That will be half of the population of the whole United States in the year 2010. These figures are staggering.
What is more important is what these figures mean in terms of health care costs to the whole of Chinese society and the burden this large amount of people will have for Chinese society in the coming years and decades.
It is believed that in the age group over 65 years of age 5-10% of the people have a dementia of some type. Thus in the year 2002 that number in China alone is between 5-9 million people and by 2010 that number will grow to between 8-15 million people, that is people with some form of dementia. Why is this important to China? It is important because these people will not be able to work and productively help their families and the larger Chinese society. These people will consume large amounts of resources from society and their families in terms of not only money but also time. Thus there are important questions for all societies with a growing population of people with dementia and especially for China. Some of these questions are the following. What is dementia and how though can these people be helped? How can families with family members with dementia's help their other loved ones? A story can illustrate these points for us.
Wang Shi Tou was 52 years old. His 77-year-old father had been forgetting to come to his house to help he and his wife with their one-year-old grand son. Wang Shi Tou thought be was sick or had other things to do. But after a month or so they wondered what was going on. They called him and all he said was I forgot but will come tomorrow. This again continued for several more weeks and then they became concerned that something might be wrong. They went to his house and the house was more messy and dirty than it usually was. When they asked him why his house was dirty he said he did not know.
Wang Shi Tou's father over the next few months continued to be the same. However, he did not improve. He continued to forget things and his dress, apartment and appearance continued untidy. Finally Wang Shi Tou and his wife decided to take him to the hospital to be evaluated by the doctor. There the doctor listened to Wang Shi Tou's father's history, then he examined him and then he did ordered some blood tests. He then asked if he could do a CAT Scan of his head. This is an expensive but good test on the head to see if there are cancers in the head or other things, which could cause Wang Shi Tou's father to loose his memory. All of the blood tests and all of the x-rays came back normal.
The doctor then talked with Wang Shi Tou and his wife at length about their father's condition. The doctor told them that his father probably had a form of Dementia. Only a biopsy of the brain would prove this conclusively. However, the doctor told him that this was unnecessary. His history and clinical picture all fit with the picture of a dementia.
Wang Shi Tou and his wife did not know much about this. The doctor went onto explain that a dementia is a process in the brain where people slowly loose their ability to make appropriate judgements and think well. He said people loose at least two of the following abilities: language, memory, has personality changes and impaired judgement. In time a person will loose abilities in all of these areas. Certainly at this time Wang Shi Tou's father had memory loss, personality changes and impaired judgement.
What caused this problem they asked? Some are caused by problems like certain Vitamin B12 deficiencies or too low of a thyroid hormone level. However, Wang Shi Tou's father had all normal lab values. The doctor told them that the majority of people had a dementia from a process, which is not fully understood. However, it is related to growing older and at this time the treatment is not that good. There are a few very expensive medicines, which are available, which delay the advance of the dementia from occurring so fast. However, there were no medicines which prevent the dementia fully or which cure it once it has started. What should they do?
The doctor gave them some literature to read and then asked them to return the next week to discuss treatment options they might have for Wang Shi Tou's father. Wang Shi Tou and his wife read the material. However, they were concerned about what they could do and felt increasingly helpless that they could help his father as the doctor said there was not any very good treatment. In the midst of their concern they listened to a radio program which talked of Jesus Christ and how he helped those with needs. The person on the radio said the following, 'Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light (Matthew 11.28-30).'
The person on the radio said that this reading was from the Bible. Wang Shi Tou had heard about the Bible but knew little about it. Also, the person on the radio said that this reading was about a man named Jesus Christ. The person on the radio said that Jesus Christ will give us rest from our burdens of life whether they are physical, emotional or spiritual. This was certainly good news for Wang Shi Tou and his wife as they were physically and emotionally worn out from the stress his father had given them. They wanted to know more about this Jesus Christ.
The next day they listened to the program and it mentioned the following reading also from the Bible, 'While Jesus was having dinner at Matthew's house (Matthew was a local tax collector and most were corrupt and hated by the people), many tax collectors and 'sinners' came and ate with him and his disciples. When the Pharisees saw this, they asked his disciples, 'Why does your teacher eat with tax collectors and 'sinners.' On hearing this Jesus said, It is not the healthy who need a doctor, but the sick. But go and learn what this means: 'I desire mercy, not sacrifice.' For I have not come to call the righteous, but sinners (Matthew 9.10-12).'
The man on the radio program stated that the tax collectors were undesirable people because they stole from the people when they paid their taxes. Also the 'sinners' were people like prostitutes and other undesirable people like this. Jesus was accused for eating with them because they were the undesirable people of society. However, Jesus said 'it is the sick who need a doctor.' And 'I desire mercy and not sacrifice,' and 'I have come to call the sinners to me, not those who think they are good.' The man on the radio said that Jesus really had compassion on people. Wang Shi Tou and his wife really agreed with this. They wanted to know how to have compassion on Wang Shi Tou's father. He was really in need of care. His father needed help but they did not know how to give it and were really concerned and anxious.
The next week they returned to the doctor who began to review some other things about Wang Shi Tou's father. The doctor told them this condition would not go away and would slowly get worse. In fact they told him that most people in his condition will need to be around someone all the time soon and then will need total care after several years. This could be done in their home with help from the outside but some people are put in nursing homes because they require total care to eat, dress, and loose their total memory. He overall would not live much more than 4-6 years from now.
The doctor told them that the most important thing was for him to have a very simple routine of life, which does not change. Going to his son's house on the bus was too complicated. They asked him if they needed to have their father move in with them and the doctor said that had advantages and disadvantages. The advantage is that they would be able to watch him better. The disadvantage is that he might be a large disruption for their family and add a lot of stress to their family life.
The doctor also told them that regular discussions would help him from getting lonely which was a big problem. People with dementias forget what they ate for breakfast that day but remember what they did 30 years ago. Thus regular giving of small amounts of information is important. They must be very patient with Wang Shi Tou's father.
Could they leave him alone? This was hard to tell but possibly. However, if he wandered off he could get lost and forget how to get back home. They told him to make a chain and put it around his neck with his name, address, telephone and Wang Shi Tou's name, address and home phone number. If he wore this and got lost then he at least someone could call them. Also they could put all of his phone numbers he would use next to the phone in large characters so he would not forget them.
Wang Shi Tou and his wife left the hospital and the doctor feeling a little bit better. However, they were still concerned about how to approach all of this. Should they sell their father's home and have him move in with them? Or leave him at home? They would have to think about these things. However both of them recalled the radio programs that Jesus would help those who are weary and that he came to help the sick. How could he help them?
The next day the radio program talked about sin and what it was. They had wondered what it was as they talked about it on the radio program. The man on the radio program stated that sin was where a person goes against what God wants them to do. They wondered what difference this made? Another person read another passage from the Bible, 'the wrath of God is being revealed from heaven against all the godlessness and wickedness of men who suppress the truth by their wickedness, since what may be known about God is plain to them, because God has made it plain to them. For since the creation of the world God's invisible qualities-his eternal power and divine nature- have been clearly seen, being understood from what has been made, so that men are without excuse (Romans 1.18-20).'
The reader on the radio said that this shows all of us have gone against God. His eternal power and divine nature are clear to us but we ignored them and thus are without excuse. That is sin or going against what God wanted for us. They went onto read another part of the Bible which said, 'For all have sinned and fallen short of the glory of God (Romans 3.23). This shows that everyone has gone against God, no one is innocent. Thus we are all separated from God. Wang Shi Tou wondered how this separation could be bridged so he could have the comfort Jesus had promise for the weary?
The radio program went onto read from the Bible the following. 'But showed his love for us in that while we were sinners Christ died for us (Romans 5.8).' This was amazing, the people on the radio said. Even when we were going against God he died for us which showed us God's great love for us. But Wang Shi Tou wondered what difference Jesus Christ's death meant for us? Then they read another passage from the Bible, which answered that question. It said, 'for the wages of sin is death but the gift of God is eternal life through Jesus Christ our Lord (Romans 6.23).' The result of sin was death, but God gives eternal life through Jesus Christ. That life starts when we accept Jesus Christ into our hearts. That life is what give's us rest from our weariness, which is what Wang Shi Tou, wanted. How could he have that life in Jesus Christ he wondered?
The next day the man on the radio told them how to receive eternal life through Jesus Christ. He read again from the Bible, 'If you confess with you mouth that Jesus Christ is Lord and believe in your heart that God raised him from the dead you will be saved (Romans 10.9,10).' They explained that this means you must believe that Jesus died on the Cross for your sins and after his death he was raised to new life and is alive today to show his victory over sin and death. If you believe that you will be saved.
Wang Shi Tou believed this and prayed this prayer, 'Dear Lord Jesus, I know that I have sinned and have done wrong. I know you died on the Cross-for my sins. I believe that after you died on the Cross you rose again to new life. Please come into my life.' Wang Shi Tou and his wife prayed this prayer and found new life in Christ and the rest from their weariness to help his father in the remaining years of his life.