His father with dementia vanished near home. How can Singapore keep these seniors safe?
As the numbers of dementia cases rise in Singapore, more families will face the challenge of keeping loved ones safe without restricting their lives. Talking Point looks at Japan’s approach and how responsibility of care can be shared.
Ian Chan looking at a family photo, a poignant reminder of his father, who was diagnosed with dementia in 2023.
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SINGAPORE and KOBE, Japan: When Ian Chan learnt that his father, 74, had gone missing last December, hours had passed already.
His mother had woken up at about 3am and realised his father was not in their Bukit Panjang flat. The 31-year-old, who was staying at his mother-in-law’s home that weekend, was told the news in the afternoon.
It was the third time his father, who had dementia, had wandered off. On the previous occasions, passers-by found the elderly man nearby after he had fallen, and they called an ambulance. But no call came this time.
Chan searched the neighbourhood and his father’s usual haunts, but to no avail. At the end of the second day, he returned home late and broke down, fearing that his father “might not be alive already”.
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His father had only S$20 in his wallet. He could “communicate clearly” but would sometimes appear to speak to someone who was not there, Chan said.
The search eventually ended in heartbreak. On Dec 23, the police found the man’s body in a corner of a park about 300m from the family’s home.
Chan had searched nearby but did not think to look in the bushes. To this day, he does not know how his father died.
His experience highlights a risk more families may face as Singapore’s population ages. About 100,000 people here are living with dementia, a number the Ministry of Health expects will grow to 152,000 by 2030.
Dementia Singapore estimates that an average of two people with the condition go missing each month. Most of them are found within a day, but some can be difficult to locate even when they do not travel far.
In a two-part special, Talking Point finds out how someone with dementia can go missing for long stretches in a safe, connected city and whether such disappearances can be prevented.
The programme also travels to Japan, which has the world’s second-oldest population after Monaco, to learn how some of its cities rally families, businesses and residents to help keep people with dementia safe.
WHY THEY WANDER
Dementia, a brain condition that may progressively impair memory, thinking and language functions, among other things, can leave a person disorientated or lost even in a familiar place.
People with dementia may set out for the market, then forget why they left home, how to go back or how long they have been outside, cited Jinesh Mukesh Shah, a consultant in the National Neuroscience Institute’s neurology department.
WATCH: My mum went missing — Why people with dementia wander (22:32)
Some forms of dementia such as Lewy body dementia can also affect the way people interpret what they see, making an ordinary environment appear confusing or threatening.
“The presence of certain visual hallucinations may cause them to leave their original site — for example their home — in search of safety,” Shah said.
According to Ng Teng Fong General Hospital, more than half of people with dementia wander at some point. The number could be even higher; the Alzheimer’s Association in the United States puts it at 60 per cent.
The same applies to the number who go missing. “We may not be hearing about people who wandered off and then were … quickly found,” said Shah.
To put herself in their shoes, Talking Point host Munah Bagharib tried the Experience Dementia in Singapore, a virtual reality simulation developed by Dementia Singapore, in which a 79-year-old with dementia, Auntie Lucy, wanted to go to the market.
As Lucy searched for her purse and keys, her daughter shouted instructions from another room, adding to the noise and bright light she already found overwhelming.
When she wanted to enter the kitchen, a mat appeared to turn into a hole. Black spots also emerged everywhere, like “insects on her skin”. “That was trippy,” concluded Munah, who called the experience “overstimulating”.
For the 37-year-old, it offered a glimpse into what her 69-year-old mother, Azeezah Aidid, whom she calls Mamreh, might be seeing.
Mamreh, who has frontotemporal dementia, sometimes hesitates before stepping onto a different surface, possibly because “she sees it as something dangerous”, Munah reflected.
In 2017, the same year she was diagnosed, she got lost on a familiar route to a relative’s home. While on the phone with Munah, she kept repeating: “One, three, nine.”
She was referring to the number of lots indicated as available in an open-air car park. Munah eventually realised this and found her after about an hour.
Nowadays, even everyday activities such as grocery shopping are no longer straightforward. Munah must manage the trolley and shopping while ensuring her mum does not fall or walk away.
“I felt like I was just a hawk,” Munah said after shopping at a supermarket. “Caregivers can do everything right. But one missed moment is all it takes for someone with dementia to vanish.”
“POINTLESS TO LOCK HIM UP”
To find out what can be done to help carers, Munah visited Kobe, the capital of Hyogo, a Japanese prefecture whose population is more than 5.3 million, not markedly dissimilar to Singapore’s population of 6.1 million.
Hyogo recorded 1,454 cases of missing persons with dementia or suspected dementia in 2024. Across Japan, the number who were reported missing averaged one every 30 minutes last year, with one to two deaths a day.
With the urgency of the situation, Kobe introduced several support measures last year. Residents aged 65 and over are offered free dementia screening. Those with diagnosed dementia can apply for a subsidised GPS tracker, accurate to within 50 metres outdoors.
They also receive 20 “safety stickers” with a QR code. Families can register those at risk of going missing, and members of the public who spot someone wandering alone can scan the code.
When a report is made, it allows the city to issue an alert to a network of volunteers, the police and businesses. A dedicated call centre can assist families who still cannot locate their loved one.
Kobe’s mayor, Kizo Hisamoto, who helped push for the measures, said the aim was to “create a society where everyone can be found”.
The technology has its limitations, however. Using the GPS tracker to find her producer in a crowded shopping district, Munah found that the location was not updated in real time.
The tracker’s app interface did not offer directions either and sometimes showed places her producer had not visited.
“If this was me trying to locate where my mom has gone, … I’d be crying, crashing out on the street,” said Munah. She took about 30 minutes to find her producer.
The issue of missing persons with dementia was pushed into the spotlight in Japan as far back as 2007, when Ryuichi Takai’s 91-year-old father wandered onto a railway line and was fatally injured in a train accident.
Takai was working in Tokyo, a four-and-a-half-hour drive away. Back home, his mother was napping and his wife had stepped out to dispose of cardboard boxes. In that short interval, his father disappeared.
The family had tried locking a chest-high gate, but Takai’s father would attempt to climb over it. “I learnt that it was pointless to lock him up (at home),” the 75-year-old recounted.
After the accident, the railway company sought damages of 7.2 million yen, about US$68,000 then, arguing that the family should have stopped him from leaving home. Japan’s Supreme Court eventually dismissed the claim.
WATCH: “Pointless to lock him up” — How Japan keeps seniors with dementia safe (23:11)
Looking back, Takai regretted becoming frustrated when he had to repeat himself to his father. “I really should’ve learnt more about dementia,” he said, “so I could’ve been kinder to him.”
HOW JAPAN GETS THE COMMUNITY INVOLVED
Takai’s case raised a broader question: If families cannot watch over someone with dementia round the clock, who else can help? In Kobe, that responsibility extends to people whose jobs often bring them into contact with older residents.
For example, there are more than 31,000 women in Japan who deliver Yakult to customers, many of whom live alone. In Kobe, these workers undergo 90 minutes’ dementia training and wear an orange band identifying them as dementia supporters.
On their weekly visits, they look for signs of dementia such as repeated speech during conversation and difficulty with tasks like shopping and cleaning.
“If we notice even the slightest concern, we can contact the local community support centre for help,” said Yakult lady Mariko Kitora.
When a customer once failed to return home after his usual walk, his family alerted Yakult. Kitora shared details of his appearance in a staff group chat so her colleagues could help search for him.
Hyogo Yakult is now taking its role one step further. In the city of Kakogawa and nearby areas, Yakult ladies will use a “Mimamori” (meaning “watching over”) app on their rounds.
If they pass by someone wearing a monitoring tag, the app will send the location to the person’s family, widening the detection area and helping to spot potential emergencies earlier.
Yakult is part of a network of more than 600 dementia-friendly businesses across Hyogo.
They include a supermarket where every employee is trained to recognise signs of dementia. The store is also linked to Kobe’s rapid-alert network, which notifies businesses, volunteers and neighbourhood groups when a registered person is reported missing.
Co-op Kobe Supermarket store manager Kazufumi Yamada said his role was to ensure that older customers and those with dementia “can use the store safely and with peace of mind”.
Two hours away in Aichi prefecture, Obu city begins dementia education early. Every first-year junior high student — as well as city officials — must attend a dementia supporter course.
City official Yuki Fukaya said teaching children of school age helps to spread understanding across a wider population. About 27,000 of Obu’s 93,000 residents — almost three in 10 people — are now trained supporters.
The city also issues an orange tag that people with dementia can wear to signal they may need assistance.
Obu is looking at prevention too. At the National Centre for Geriatrics and Gerontology, Munah tried the CogniBike, pedalling while solving puzzles in an exercise designed for people with mild cognitive impairment, often considered the stage before dementia develops.
While dementia has no cure, gerontologist Hiroyuki Shimada said exercise can help reduce behavioural and psychological symptoms, including wandering. But no single machine is effective without sustaining a balanced diet, cognitive activity and social interaction.
In Singapore, there are 16 dementia-friendly communities, and they use large housing block numbers, colours and motifs, for example, as wayfinders. There are also more than 800 dementia go-to points (GTPs) with trained staff who can assist someone who appears lost.
Munah questioned how useful the navigational features would be, however, for someone with dementia at a moderate stage, like her mother. She also found the GTP posters easy to miss.
Some premises have limited space for larger decals, noted Charlotte Wong, deputy director of caregiving and community mental health at the Agency for Integrated Care. But overall, the initiatives have raised awareness, she said.
She recommended that Singaporeans download Dementia Singapore’s Cara app, which carers can use to alert users when a loved one with dementia goes missing.
And just as Wong saw Japan’s proactive approach as something Singapore “can work on”, Munah also gained a new understanding from her visit.
“What I want now is not just to stop my mum from getting lost. I want her to still be seen, be included and live with dignity,” she said.
“Maybe that’s what Singapore needs — to stop treating dementia only as a crisis to manage and to start understanding and preparing for it much earlier.”
Watch this Talking Point special here: Part 1 and Part 2. The programme airs on Channel 5 on Thursdays at 9.30pm.
Source: CNA/dp
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