At a clean and sunny community center in Seoul, the South Korean capital, senior citizens make clay models of their own faces in an arts class. Some of the faces are vivid and lifelike. Others are expressionless and indistinct. The project is intended to help the seniors remember what they look like.
This is the Gangseo District Center for Dementia. Since 2006, Seoul has opened a dementia center in each of the city's 25 urban districts.
It's one of the novel approaches that South Korea has developed to cope with an epidemic of dementia. Recent data suggest that South Korea is now the fastest-aging country on Earth.
By some estimates, nearly 40 percent of Koreans will be 65 years old or older by midcentury. In a sense, the country is suffering from its rapid development, which has been accompanied by soaring life expectancy and plummeting birth rates.
The Gangseo center provides sports and music classes, with the aim of giving dementia patients a sense of participation and accomplishment, as well as some physical and cognitive exercise.
The centers also help to ease the burden and isolation of family members like Jeon Om-ryul. Her husband was diagnosed with dementia, and she has been bringing him to the center every week for the past two years.
"This is my biggest worry," she says. "For 12 years, I raised my granddaughter, until my husband got sick. Now I take care of him. I've never had the energy to think of myself. Whenever I think of what will happen to me, all I can do is cry. I wonder who will take care of me. I fear that only the government can."
Treating Dementia As A Disease
In 2011, South Korea passed a dementia management law, establishing the centers and mandating that citizens older than 65 be checked for dementia symptoms.
Social worker Kim Dong-hun says the most fulfilling part of his job at the center is helping the patients to imbue their activities with purpose and meaning. But he says the social stigma associated with dementia makes it hard to reach out to patients.
"We publicize our programs intensively, but one of the biggest challenges we face is that many people still have not changed their attitude toward dementia," Kim says. "Even if you go to their house to find them, they don't want to come out."
Sung Mi-ra, secretary-general of the Seoul Metropolitan Center for Dementia, which coordinates the 25 community-level centers, estimates that South Korea currently has about 530,000 dementia patients, out of a total population of 50 million. This number has risen 27 percent in the past four years. She estimates there will be 1 million patients by 2025.
She says dementia costs South Korea the equivalent of $8 billion a year in hospital fees and lost income, and that figure will double every decade. Sung says South Koreans need to start seeing dementia as a disease.
"In past, whenever someone got dementia, it was treated as a natural occurrence," Sung says. " 'If you get old, you lose your mind,' went a common saying. Nobody treated this condition because people believed that's just the way it is."
Changing Attitudes Toward Elder Care
Compared with other developed countries, very few elderly South Koreans live in nursing homes. Confucian attitudes about filial piety are still prevalent here, and while they are less common now, many families still have three or more generations living in one home.
Sung says South Korea's approach to aging assumes that family members — not the government — will provide most of the care to the elderly.
"Institutionalizing a demented parent is seen as unfilial," she explains. "For this reason, dementia patients should be living at home with their families. So what is important is that the community creates an environment where this is possible. This is why centers like ours are being established around the country."
Another hallmark of South Korea's approach is to train young people to empathize with the elderly, and prepare for their own senescence.
At a gleaming glass and steel community center called the Seongnam Senior Complex in Seoul's southern suburbs, students giggle as their classmate Kim Dong-hyun plays the role of a bedridden senior who is hoisted from his bed into a chair using a winch and sling.
The students are wearing sandbags to weigh down their limbs, back braces that force them to stoop, and glasses that impair their vision. Kim says he's still mulling over the implications of his training.
"I am worried about the aging of our society," he says. "We need to get ready. I'm not sure what I personally can do to get ready. ... Have a lot of children to take care of me in my old age, I guess."
In another class, the students put on 3-D glasses to mimic the effects of dementia. The class instructor says the training inspires some students to reconsider how they treat their elders. Others, though, say it simply makes them dread the thought of growing old.