Alzheimer’s in Our Communities: A Journey of Care, Connection, and Courage

In many corners of the world, families face a challenge that doesn't get enough attention—Alzheimer's disease. It sneaks in quietly, starting with small moments. Maybe your loved one forgets where they put the keys or struggles to recall the name of someone they've known for years. At first, it feels like normal aging, but soon you realize it’s something deeper, more profound. Alzheimer’s is here, and with it comes a journey of loss, love, and resilience.

Alzheimer’s: What It Is and How It Touches Us All

Alzheimer’s is more than just forgetting things; it’s a disease that gradually takes away the ability to think, remember, and carry out the simplest of tasks. It’s a long, winding road, and those living in developing nations, with fewer medical resources and less community awareness, often find themselves navigating it with limited support.

Imagine watching a person you love—the mother who raised you, the friend who’s always had your back—slowly become someone who no longer recognizes your face. They may get lost in the very streets they’ve walked all their lives, or struggle to make sense of everyday objects. Alzheimer's is relentless, but the journey is not without moments of connection and understanding, if we know where to look.

The Weight on Families and Carers

In places where formal healthcare can be hard to access, family members step into roles they may not feel ready for: carers, therapists, and advocates, often without the support they need. It’s a heavy burden, and the emotional weight can be crushing.

You’re dealing with a loved one who, at times, may be confused or scared, and at other times angry or withdrawn. They may forget who you are, but the care they need remains constant. Whether it’s helping them eat, bathe, or simply making sure they don’t wander away and get lost, you’re in it 24/7.

For many, there’s no break. There’s no respite care center just down the road, no team of specialists to take over when you need rest. It’s you, your family, and the weight of responsibility. This is where communities can step in, and where we need to rethink how we support those walking this difficult path.

Community-Based Solutions: What We Can Do Now

In places where high-tech hospitals and dementia care facilities may be out of reach, we have to be creative. We look to what we do have—our communities, our shared knowledge, and the power of human connection. Here are a few things we can do, right now, to make a difference:

- Training local carers and community health workers: Knowledge is the most powerful tool. With the right training, community members can become an extended care network, helping families recognize Alzheimer’s early and learn practical ways to support those affected. Workshops can teach basic care techniques, safety tips, and how to communicate with a loved one whose mind is slowly slipping away.

- Creating safe spaces at home: A house that’s familiar can quickly become dangerous for someone with Alzheimer’s. Simple things—like removing sharp objects, adding locks to doors to prevent wandering, or marking important areas—can prevent accidents. Keeping the environment calm, organized, and predictable can reduce anxiety and confusion for both the person with Alzheimer’s and their carer.

- Building peer support networks: Sometimes, the best medicine is a listening ear. Families caring for loved ones with Alzheimer’s can benefit immensely from talking to others in the same situation. Sharing stories, challenges, and small victories creates a sense of solidarity that reminds us we’re not alone.

- Encouraging routine and engagement: Routine is like a lifeline for people with Alzheimer’s. Even small activities, like helping with meals, listening to music, or simply sitting together, can make a difference. These moments of engagement help maintain a sense of purpose and connection, which benefits both the carer and the individual.

Finding strength even is the difficulty

This disease is tough, no question. It challenges us in ways we never imagined, but in the midst of the struggle, there’s a strength that emerges. It’s in the quiet moments when a carer holds the hand of someone who can no longer speak their name, or in the resilience of families who wake up every day and say, “We’ll keep going.”

In developing nations, where resources may be scarce, we rely on the oldest, most reliable tool we have: each other. Neighbors become caregivers, and communities become support networks. What we lack in formal systems, we make up for with human connection, creativity, and heart.

Hope for the Future

Around the world, researchers are working tirelessly to find treatments that could slow down Alzheimer’s, or maybe one day, stop it altogether. But until then, we have to rely on what we know works: community support, education, and adapting our environments to make life easier for those living with the disease.

It’s easy to feel overwhelmed, but remember, you are not alone in this. There’s a community around you that can help, and every small step—from creating a safer home to joining a peer group—makes a world of difference.

The road ahead is long, but together, we can walk it with dignity and courage, hand in hand. Alzheimer’s may change the way we live, but it doesn’t have to take away the humanity and love we share.

Carey Cheung

Occupational Therapist

Global Community Disability Consultant

The Art of Environmental Modifications for Amputees in Low-Resource Settings

There’s a certain kind of challenge in how people adapt to life after losing a limb, especially in parts of the world where resources are as scarce as clean water. It’s not just about surviving; it’s about making the most out of what you have, transforming spaces with simple, creative solutions that can make all the difference.

In the developing world, where high-tech prosthetics and fancy gadgets are rare luxuries, it’s the environment itself that must adapt. It’s here that resilience and ingenuity shine brightest. Let’s explore how, with just a few basic tools and some thoughtful planning, we can help amputees reclaim their independence.

1. Tailoring the Workspace: Crafting Independence

Imagine a person with a left-sided amputation at the mid-humerus waking up every day to a kitchen that feels like it’s working against them. The simplest tasks—preparing breakfast, making tea—become monumental challenges. But there are small changes that can transform this space from an obstacle course into a place of empowerment.

- Non-slip mats: Placing a non-slip mat on the countertop can prevent dishes, pots, and utensils from sliding around, making them easier to handle with one hand.

- Adaptive cutting boards: A cutting board with spikes to hold vegetables steady, or one with a raised corner, can make chopping and slicing much more manageable.

- Utensils with built-up handles: Simple modifications like foam tubing or store-bought adaptive utensils with thicker handles can make gripping easier for those with limited hand function.

- Lowered shelves or adjustable racks: Bringing everyday items within easy reach by lowering shelves or using adjustable racks can make a world of difference in maintaining independence in the kitchen.

2. Furniture Placement: Clearing a Path

For those who have lost their legs to diabetes or other causes, their once-familiar home can become a maze of obstacles. Narrow doorways, misplaced furniture, and uneven surfaces can all impede movement, particularly for someone using a wheelchair.

- Widening doorways: Slightly more complex. But a simple solution to common wheelchair width issues is a project using local materials like wood or metal to widen doorways to accommodate wheelchairs, providing easier access throughout the home.

- Removing thresholds: Thresholds can be hazardous for wheelchair users; removing or reducing them can help create a smooth transition between rooms.

- Decluttering and strategic furniture placement: Ensuring that pathways are clear of clutter and placing furniture against the walls can open up space for easy navigation.

- Ramp construction: Using materials like plywood or concrete, communities can build low-cost ramps to ensure that entryways are accessible.

3. Harnessing Community Strength

In many developing areas, it’s not just the individual who adapts—it’s the entire community. When someone loses a limb, it’s often the village that steps up, pooling their collective skills to make life easier.

- Community-built handrails: Installing handrails along pathways or in homes using local materials can provide much-needed support and stability for those who are regaining their mobility.

- Shared mobility aids: In some areas, communities create “mobility banks” where donated or shared wheelchairs, crutches, and prosthetics are made available to those in need.

- Local workshops: Organizing community workshops to build or modify adaptive tools, like customized crutch tips using recycled materials, can empower residents to take control of their environment.

4. Repurposing Local Materials: Innovation at Its Best

When resources are scarce, creativity is the best tool in your kit. It’s about seeing potential in what’s around you—reimagining ordinary objects as solutions to extraordinary challenges.

- DIY prosthetic limbs: In some communities, resourceful individuals craft prosthetics using materials like bamboo, wood, and metal. These might not be as sophisticated as their Western counterparts, but they restore mobility and dignity.

- Adaptive grips from recycled materials: A piece of rubber or cloth from an old tire can be fashioned into a grip to make it easier for someone to open doors, hold utensils, or use tools.

- Tire ramps: Old tires can be cut, stacked, and secured to create durable, slip-resistant ramps, helping wheelchair users navigate different elevations.

5. Education and Empowerment: Changing the Mindset

The most significant changes aren’t just in the physical environment—they’re in the mindset of the community. Empowering local health workers, therapists, and carers with knowledge about simple environmental modifications can lead to widespread improvements in quality of life.

- Training sessions: Regular, practical workshops can teach community members how to create adaptive tools or modify homes using readily available materials.

- Resource-sharing networks: Establishing networks for sharing knowledge and resources—like how to use a non-slip mat effectively or where to source affordable adaptive equipment can amplify the impact of environmental modifications.

- Support groups: Creating peer support groups for those with amputations can foster a sense of community, allowing individuals to share tips, modifications, and encouragement.

A Call to Action: Simple Steps, Profound Impact

The journey after an amputation is a long one, but with the right environmental modifications, it’s possible to transform this journey from a struggle into a path of empowerment. In places where the smallest changes make the biggest difference, where a non-slip mat or a makeshift ramp can redefine what’s possible, we find the true essence of care.

Together, let’s continue to care for the person, create with innovation and precision, and collaborate with everyone involved. Because in the end, it’s not just about survival—it’s about living with dignity and grace.

Care. Create. Collaborate.

Carey Cheung

Occupational Therapist

Global Health and Community Disability Advisor

Navigating the Well-being Divide: A Therapist's Journey into the Heart of Early Childhood Development

If there’s one thing I’ve learned from years of wandering the world’s more neglected corners, it’s this: the fate of humanity rests not in boardrooms or parliaments but in the hands of those who shape the smallest, most vulnerable members of our species—children. And if you’re reading this, chances are you’re one of the brave souls working in the trenches, trying to make a difference in the chaotic, messy, and often unforgiving world of early childhood development (ECD). Especially if you’re navigating the maze of global health, disability, and inclusion.

But let's not sugarcoat things. The global landscape of ECD is a paradox—a tapestry woven with threads of hope and despair, opportunity and inequity. You’ve seen it. The well-being divide is glaring. In one village, a child’s future is forged in the fires of poverty, malnutrition, and neglect, while in another, just a few miles down the road, a different child is given every opportunity to thrive. This isn’t just a geographical issue; it’s a moral one.

As therapists, educators, and advocates, you know the science. You understand that the first few years of life are everything. Brain growth, critical windows of development, all that stuff they drill into you in university. But what do you do when the odds are stacked so heavily against you that no amount of training can prepare you for the reality on the ground? When you’re faced with a child who’s not just dealing with developmental delays but is also fighting against a system that’s rigged against them because of their disability, their ethnicity, or simply because of where they were born?

Kofi Marfo, a retired professor with over four decades of experience in ECD, knows the score. His message? We need to stop thinking small. Yes, it’s important to help individual children. It’s essential to provide them with the tools they need to grow, to learn, to become productive members of society. But if we’re going to make a real, lasting impact, we need to think bigger.

It’s not enough to just teach a child to walk if they’re going to spend their life walking into walls built by systemic inequities. We need to tear down those walls.

For those of you working with children with disabilities, the challenge is even greater. Far too often, these children fall through the cracks. The focus on economic productivity, especially in low and middle-income countries, has often sidelined their needs. It’s a harsh truth, but one that must be confronted head-on. We can’t afford to let these children be forgotten. They are not an afterthought. They are the reason we do what we do.

### So, what’s the play here? How do we, as therapists, advocates, and educators, turn the tide? Here are some practical steps:

1. **Start with the Individual**: Each child is unique, with their own story, their own challenges, and their own potential. Take the time to understand their world—what they need, what they fear, what they dream of. Tailor your interventions to the child in front of you, not just the textbook case.

2. **Engage with Families**: Families are the cornerstone of a child’s development. Engage them as partners in the process. Educate them, involve them, and empower them to be advocates for their child’s needs. Sometimes, just showing them what’s possible can be the spark that ignites lasting change.

3. **Collaborate with the Community**: You can’t do this alone. Work with local leaders, educators, and health workers to create a support network around the children you serve. Communities are powerful when they come together with a shared purpose. Tap into that power.

4. **Promote Inclusive Practices**: Wherever you are—be it a clinic, a school, or a community center—advocate for inclusive practices. Push for environments where children with disabilities are not just accommodated but are actively included. Challenge norms that marginalize or segregate. Inclusion isn’t just about access; it’s about belonging.

5. **Mentor and Train Others**: Share what you know. Mentor new therapists, train local caregivers, and build the capacity of those around you. The more people equipped to handle the complexities of ECD, the broader the impact. This ripple effect can lead to sustained change in your community and beyond.

6. **Measure and Reflect**: Track the progress of the children you work with. Reflect on what’s working and what’s not. Use this data to refine your approach and to advocate for better practices. It’s through this ongoing process of learning and adapting that real change happens.

7. **Stay Connected**: Engage with networks of like-minded professionals. Share insights, challenges, and successes. Global health is a vast field, and staying connected can provide the support and resources needed to keep pushing forward.

### The Ripple Effect of Lasting Change

Change happens at every level, and it starts with each of us doing our part. Whether you’re working one-on-one with a child, training a new generation of therapists, or collaborating with community leaders, every action you take contributes to a ripple effect that can transform lives. The work we do is about more than just today—it’s about building a foundation for a better tomorrow.

And let’s not forget the voices that matter most—the children, the families, the communities. Their stories, their struggles, and their triumphs should guide our every move. We’re not here to impose solutions; we’re here to listen, learn, and act in ways that are meaningful and impactful for those we serve.

In the end, the vision isn’t just a lofty ideal—it’s a roadmap for a better world. A world where the work you do doesn’t just change individual lives but reshapes entire societies. A world where children, no matter where they’re born or what challenges they face, are given the tools, the support, and the opportunities they need to thrive.

So, keep fighting the good fight. Keep pushing for that change from top to bottom. Because the work you do today is the foundation for the world we’ll all inhabit tomorrow. And that’s something worth fighting for.

Carey Cheung

Occupational Therapist

Global Health and Community Disability Advisor