Introduction

Dementia is a progressive and irreversible cognitive decline that affects one’s memory,
thinking, behaviour and the ability to perform everyday activities (WHO, 2017). Elderly is the
main risk group for dementia. Therefore, prevention of dementia is important to elderly. In order
to increase the knowledge among elderly to prevent dementia, a primary health care activity,
health talk with interactive activities, was held on 2nd of November, 2017 from 2:00 p.m. to 3:30
p.m. in Evergreen Nursing Home with 29 participants in total. The event was divided into four
parts included stretching exercise, health talk, origami activity and song listening.

Summary of the Primary Health Care Work

Health talk with interactive activities was used as a tool for health education. Dementia
education programme helps non-professionals to develop a better understanding of dementia
and remove the stigma attached to it (Weidinger, 2016). Through the education, information is
received and integrated by participants, which can bring about attitudinal or behavioral changes
to prevent disease (Rankin & Stallings, 2005). The impacts of dementia was explained in the
talk and therefore, participants could know more about the importance of preventing dementia,
which could enhance the willing of participants to get into preventive measures.
Stretching exercise helps in preventing dementia with age advancement (Paillard, 2015).
According to Leisure and Cultural Services Department (2014), stretching exercise increases
the expansion of brain capacity and let the brain stay active.
Through the demonstration and return-demonstration, participants could understand the
manipulation of stretching exercise, which could be used as a preventive care to lower the risk
of dementia.
Origami can train hand-eye coordination and enhance the coordinations between
different areas of cerebrum of participants (Lee, et. al., 2011). All participants were taught to
fold a heart in this session. As a result, the risk of dementia in elderly could be reduced through
origami activity.
According to a study, music listening helps improve mood, orientation, memory and
general cognition (Särkämö et al., 2014). Therefore, song listening was used as a preventive
method that could help in preventing dementia in elderly participants.

Literature review on PHC concepts & the integration in the community project
Primary Health Care is a health care policy to the public that generated and adopted by
WHO since 1978 in Declaration of Alma-Ata (WHO, 2017). There are several important
elements in PHC.
First, PHC reflects and grows from the socio-economic conditions, political
characteristics and communities (International Conference on Primary Health Care & UNICEF,
1978). Second, PHC addresses the main health problems in the community, which provides
promotive, preventive, curative and rehabilitative services accordingly (International Conference
on PHC & UNICEF, 1978). Third, PHC includes at least the education concerning prevailing
health problems and the methods of preventing and controlling them (International Conference
on PHC & UNICEF, 1978). Forth, PHC involves all related sectors and aspects of national and
community development (International Conference on PHC & UNICEF, 1978). Fifth, PHC
requires and promotes maximum community and individual self-reliance and participation in the
planning, organization, operation and control of PHC (International Conference on PHC &
UNICEF, 1978).
PHC concepts were applied from planning to implementation of this community project.
According to Hong Kong Alzheimer's Disease Association (2017), the prevalence rate of
dementia in Hong Kong is one tenth at 70 and above and one third at 85 and over and
therefore, it is a main health problem in the community among elderly. The aim of health talk is
increasing the knowledge of dementia among elderly in order to provide promotion in preventive
methods of dementia to elderly. Target population in this activity is the elderly who does not
suffer from dementia. Therefore, health talk can increase the awareness of elderly participants
and empower elderly the skills for preventive methods of dementia. Therefore, the risk of getting
dementia reduced among the elderly participants.

Reflection on the activity

The activities were held quite successful in general but there were still some limitations
and challenges during the activities.

Limitations and Challenges

Communication was the main problem during the activities. Since some elderly
participants were language barrier, having hearing problems, low education level, they might not
understand the contents in health talk. Besides, limited mobility of the elderly affected the ability
to perform stretching exercise in some elderly participants. Since some elderly had health
conditions ,such as, past history of stroke and became difficult to follow stretching exercise.

Solutions
It is suggested that more photos and fewer words can be used in the health talk
PowerPoint slides and therefore, the participants is easier to understand the content of the talk.
Besides, it is important for the elderly with hearing problems to wear their own special assist,
such as, hearing aids before attending to the activities, which can reduce the communication
problems among the elderly. Comfortable environment with adequate lighting and free from
distraction, such as, background noise is important for concentration of elderly to the talk.

Self-Reflection
Through this community project, I could understand more about how to organise an
activity for primary health care in Hong Kong. I did not realized that we needed to devote so
much in organising a PHC activity before this community project but I still enjoyed to hold an
activity that could help in preventing dementia among elderly.

Work accomplishment could be gained in this community project. I could construct an

activity from planning to implementation and evaluation. Compared to the clinical placement in
medical or surgical ward, I think that community nurse is more suitable for me since I hope that I
can gain work accomplishment in my further work rather than follow the prescriptions of doctors.
This community project inspires me the hope to become a community nurse in further.
 Holding health talk with interactive activities lets me learn more about how to construct
an activity for the public. I hope that I will participate more PHC activity in the further.

Reference
Department of Health of Hong Kong. (2012). Primary Care And You - Concept of Primary Care
and Family Doctor. Retrieved from http://www.pco.gov.hk/english/careyou/concept.html

International Conference on Primary Health Care, & UNICEF. (1978). Primary health care :
Report of the International Conference on Primary Health Care, Alma-Alta, USSR, 6-12
September 1978 ("Health for all" series ; no. 1). Geneva: World Health Organization.

Leisure and Cultural Services Department. (2014). Fitness programmes for the elderly.
Retrieved from http://www.lcsd.gov.hk/en/healthy/fitness/elderly.html#1

Lee, J. S., Noh, K. O., Kim, B. K., Choi, W. S., Lee, S. M., Moon, O. K., Park, J. H. & Kim, S. W.
(2011). The Effects of Handicraft Activities on Hand Promptness and Grasp in the Elderly.
Journal of International Academy of Physical Therapy Research, 2(2), 308-317.

Paillard, T. (2015). Preventive effects of regular physical exercise against cognitive decline and
the risk of dementia with age advancement. Sports medicine-open, 1(1), 20.

Rankin, S.H., & Stallings, K.D. (2005). Patient education. (5thed.). Philadelphia:
Lippincott.

Särkämö, T., Tervaniemi, M., Laitinen, S., Numminen, A., Kurki, M., Johnson, J. K., &
Rantanen, P. (2014). Cognitive, emotional, and social benefits of regular musical activities in
early dementia: randomized controlled study. The Gerontologist, 54(4), 634-650.

Weidinger, L. (n.d.). Dementia education programme for non-professionals: An evaluation of its

effectiveness. European Journal of Public Health, 26(Suppl_1), European Journal of Public
Health, 11/2016, 11/01/2016, Vol.26(suppl_1).

World Health Organization. (2017). Dementia. Retrieved from

http://www.who.int/mediacentre/factsheets/fs362/en/

World Health Organization. (2017). The world health report- Chapter 7: Health Systems:
principled integrated care. Retrieved from http://www.who.int/whr/2003/chapter7/en/index1.html