He starts off his day like any ordinary student in Taiwan, except that he's not — Chang is a 94-year-old man who suffers from moderate dementia.
The “school” Chang attends is one of 13 senior community daycare centers commissioned by Taipei city government to serve the growing aging population, particularly elderly people suffering from neurodegenerative diseases.
As of December 2010, there were 331,906 people aged over 65 in the capital city, accounting for 12.67 percent of the inhabitants, many of whom work in offices for long hours and have no choice but leave their elderly parents at home alone.
Taking care of the elderly, particularly those with dementia, can take a serious toll on family life and disturb the routine of the entire household, said Tang Li-yu, secretary-general of the Taiwan Alzheimer's Disease Association, who noted that senior centers are a great help to families and to the patients themselves.
“Leaving them at home is not a wise choice. The important thing is that the activities offered at the centers help restore and refresh long-forgotten social and language skills, which have been found effective in delaying the degenerative process of the brain,” she said.
Chang's “school,” for example, features various activity programs that help the elderly regain their confidence and smile. Music therapy, ball games, study groups, handicraft lessons, cooking demonstrations, karaoke teaching, even mahjong. You name it, they have it.
Flag-Raising Ceremony
One of the most popular activities is the flag-raising ceremony, said Huang Shu-hua, vice manager of the Xihu Senior Daycare Center, a newly opened public-funded institution for seniors.
“We wanted to make the elderly feel they are still a part of the community. So, as many of our clients are military veterans and retirees from school and government service, we came up with the idea of holding a flag-raising ceremony,” said Huang.
“Everyone participates in the ceremony, one way or another,” said Huang, explaining that a military retiree rings the bell, a retired principal delivers speeches and a former civil servant leads the group in singing the National Anthem.
“They love it,” she said. After all, not many health care facilities use the national flag as wall decorations and replace clocks with portraits of the founding father of the Republic of China, Sun Yat-sen.
“My father was so excited to go to school for the first few days that he would get dressed as early as 4 a.m., out of concern that he would miss the bus,” said Chang's daughter.
“The service has taken a burden off my mother's shoulders. My father, who used to be short tempered, has learned to care for other's feelings through interacting with his 'classmates,'” she added. “It has brought us closer than before.”
While the centers have obviously benefited some families like the Changs, Tang said, the government's goodwill is not always well accepted.
For example, there are only 27 seniors being cared for at the Xihu center, far less than its full capacity of 60.
Benefits and Costs
“Sending your parents, especially those with minor mental degeneration who do not show physical disabilities, sometimes invites rumors from conservative neighbors who think you are abandoning your parents and shirking filial duty,” Tang said.
Many are also unaware of the benefits of senior day care centers and hold a stereotyped view unless they come and see for themselves, she said.
Of course, there are more who worry about the costs.
The maximum charge for government-run senior centers per person admitted is about NT$16,000 (US$500) per month, covering all costs Monday to Friday from 7 a.m. through 6 p.m., regardless of health condition, said a social welfare department official.
All services, including lunch, are free to low-income families.
“If the family cannot afford the monthly fee, I still suggest sending them in one to two days a week, which costs around NT$600 per day,” Tang said, noting that private day care centers are normally more expensive.
While Taipei City launched a senior-friendly plan to establish at least one public day care center per administrative district years ago and is three short of accomplishing its goal, Tang expressed concern over the availability of such facilities in the country's other municipalities.
“The aging problem will only worsen over the years and the centers should strive to be more reachable,” she said.
Noting that many senior centers are located in the countryside and require a lot of travel time, she applauded the idea of setting up centers in more traffic-convenient locations.
The Xihu senior day care center, situated in a mass rapid train (MRT) station building in Neihu, then, is a role model for other municipalities, and probably other nations as well.
'Incentive'
Families can pick up or drop off their elderly relatives without needing to exit the metro. “The best thing is, they don't have to worry about being caught in rain or traffic,” said Huang, adding that this is an incentive that can attract potential clients.
Even if seniors don't live close to an MRT station and are afraid of getting lost connecting between MRT lines, they can sign up for the “school bus,” a pickup service run by the center.
“Growing old in a community with which you are familiar is important,” said Huang, pointing to the dual advantage of staying with family at night and meeting new friends in the daytime.
Since 1993, Taiwan has been classified as an aging society, based on the United Nations definition, which is when the over-64 population reaches 7 percent of the total.
Demographers predict that the figure will double by 2018, which will put Taiwan in the “aged society” category. Taiwan's over-64 population is growing at the second-fastest rate in the world, slightly behind Japan.
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