從名人辭世談失智預防、抑鬱防範、輕生干預、臥床老人照護與人生深層思考 (Discussing Dementia Prevention, Depression Control, Suicide Intervention, Elderly Bedridden Care)

我坐在電腦桌前，翻閱著零碎的報導與訊息，一則則新聞推送進入眼中：2024年12月2日，資深音樂人劉家昌癌逝（享年83歲）；2024年12月4日，知名作家瓊瑤因抑鬱與生命痛楚輕生身亡（享年86歲）；2024年12月6日，飾演《情書》的日本女星中山美穗（享年54歲）被發現陳屍家中，雖然後續釐清是意外而非輕生，但仍讓人震撼不已。即便我對瓊瑤的作品不熟、對中山美穗的影視作品涉略不深，卻曾聆聽過許多劉家昌與瓊瑤作品相關的主題曲與插曲，那些旋律曾引領我感受愛情的甜美與苦澀。如今，這些名人相繼離世的消息猶如暮鼓晨鐘，提醒我審視人生中的脆弱面向：失智、抑鬱、輕生、臥床老人，以及死亡本身。

雖然議題繁多又複雜，但我想透過更詳實的探討與舉例，嘗試為大家提供一條思索之路：如何預防失智、如何面對抑鬱與輕生、如何照顧臥床長者，以及如何在無常的人生中尋找意義。讓我們更深入、更冗長地談論，讓此篇電子報成為一個思想的容器，盛載對生命課題的多層次省思。

一、老化社會的挑戰：失智症預防與早期行動

隨著平均壽命不斷延長，失智症已成為全球關注的公共衛生議題。失智症不僅影響個體的記憶、認知與判斷力，更會波及家人照護者，造成身心壓力。

故事舉例假說： 小明的父親在78歲時開始出現記憶混亂，從忘記每天的新聞內容，到不知道自己的房間在哪。小明最初抱持僥倖心理，覺得父親只是「老了，難免健忘」。然而一年後，父親出門買菜卻找不到回家的路，被鄰居送回時，神情茫然。醫師診斷為早期失智，建議小明與父親調整生活方式。若在父親還相對健康時就開始安排固定運動、腦力遊戲（如拼圖、益智問答）、參與讀書會、社區舞蹈課程，或許能延緩病程。

實務建議：

1. 中年預防：中年即保持運動習慣，戒除過量飲酒、控制血壓血糖。
2. 腦力刺激：養成閱讀習慣、學習新語言或樂器，接觸藝術展覽、音樂會。
3. 社會參與：加入志工組織、社區活動或旅遊團體，豐富人際互動。社交活動可增強腦部神經連結。

二、心理黑洞：抑鬱症的防範與療癒

瓊瑤的輕生突顯抑鬱症的隱蔽性。抑鬱並非簡單的情緒低落，它可能長期扭曲一個人的思考，使人感到世界失去色彩、生命失去意義。

故事舉例假說： 小美是一位在人際關係中表現圓融的女子，她在職場經常笑容滿面，解決問題游刃有餘。然後，下班後的小美卻陷入深深孤寂，難以入眠、對食物毫無興趣，總是覺得「我活著到底有什麼用？」一日，她鼓起勇氣求助心理師，在諮商過程中，她發現自己在童年時期曾遭遇家庭矛盾的傷痛未癒，職場壓力與自我要求過高加劇了抑鬱。透過諮商與藥物調整，以及參加團體療程，小美學會更溫柔地看待自己，適度放下完美主義，慢慢走出抑鬱陰影。

實務建議：

1. 早期辨識症狀：若長期無故悲傷、失眠、易怒或對活動失去樂趣，就該提高警覺。
2. 專業協助：心理諮商、精神科治療、適度藥物使用都是正確且應當嘗試的途徑。
3. 環境支持：家人、朋友、同事的理解很關鍵。簡單問候「你還好嗎？需要聊聊嗎？」能帶來極大安慰。

三、輕生干預：在深淵旁伸出援手

輕生並非懦弱，而是長期苦痛無處宣洩的結局。瓊瑤的選擇使我們看到，即使才華洋溢、人生看似豐富的人，也可能被心理痛苦擊倒。

故事舉例假說： 小強發現室友小安近來表現異常，常在深夜低泣並自言自語「或許離開才是解脫」。小強沒有視而不見。他先耐心傾聽小安傾訴，再查詢輕生防治資訊，協助小安聯絡24小時心理求助專線與心理諮詢中心。透過專業人士的介入，小安暫緩了輕生衝動，並開始長期心理治療。事後，小安感謝小強：「幸好你沒有忽視我的狀況。」

實務建議：

1. 觀察徵兆：若有人提及死亡、分送重要物品、行為反常，應提高警覺。
2. 及時介入：傾聽、安慰、協助尋求專業支援，如心理師、醫生或輔導團體。
3. 社會資源：媒體、學校、職場應廣泛宣導輕生防治資源，如24小時求助熱線、網路心理諮詢平台。

四、臥床老人：晚年生命不應只是「等待結束」

長壽並非保證優質晚年生活，臥床老人面臨行動不便、失能、慢性病痛，生活品質大打折扣。有些甚至被困在家中，缺乏社交、文化刺激，陷入深深的寂寞。

故事舉例假說： 小林的祖母因中風長期臥床，一開始家人只顧物理照護：餵食、清潔、翻身，但祖母神情死寂。小林後來想到祖母年輕時愛聽瓊瑤電影主題曲，便天天放老歌給祖母聽，並邀請社區志工來訪，分享昔日故事。慢慢地，祖母用微笑、眼神與微弱的手勢回應，似乎重新感受到被愛與重視。

實務建議：

1. 完善長照：政府推動長期照顧2.0或類似計畫，提供居家服務、日間照顧、安寧照護，有助分擔家庭負擔。
2. 社區參與：志工探訪、藝術治療、音樂、閱讀、簡單手工，都能豐富臥床長者的內心世界。
3. 家庭支持：教導家屬情感陪伴技巧、壓力紓解方法，並設有陪伴者支持團體。

五、意外死亡與無常：中山美穗案例的啟發

中山美穗之死被證實是一場意外事件，而非輕生。這提醒我們，死亡的來臨不一定有預兆，生命中充滿了難以掌控的偶然。面對意外，我們能做的便是提升生活的安全意識、做好風險管理，同時珍惜平凡日常。

實務建議：

1. 居家安全：做好居家防跌措施、安裝緊急呼叫系統、居家照明適度。
2. 常備應急計畫：告知家人緊急聯絡人、保持手機暢通、隨身攜帶重要聯絡資訊卡片。
3. 心理預備：面對意外風險，接受人生無法全部掌控的事實，越是明白無常，就越能珍惜當下。

六、從死亡思考人生：愛與行動的取向

這些名人離世的訊息讓我深思：當死亡無法避開，我們還能為生命做什麼？我意識到，生命的價值不在於長短，而在深度與廣度。我們能否透過愛、關懷、教育與政策改革，建構一個更有韌性的社會網絡，讓失智患者不被遺忘、抑鬱者能獲得幫助、輕生者有機會回頭、臥床長者不因失能而被世界隔絕？

故事舉例假說： 小安是一名普通的上班族，聽聞瓊瑤輕生、中山美穗意外猝逝後，她決心將「關懷」落實在日常。她每週去參加社區讀書會，分享一些正向心理學的書籍；假日時擔任老人院志工，播放音樂給長者聽；在公司裡，她主動關心那位常常獨自吃午餐的同事，問問對方最近心情如何。小安說：「我或許無法改變整個世界，但至少能改變我周遭的世界。」

七、社會與政策面：多元支持的建構

個人努力固然重要，但若沒有社會系統的支持，成效有限。我們需要政府、NGO、醫療體系、社區組織共同努力。

實務建議：

1. 長照與心理衛生政策：加強長期照顧服務、提高心理諮商可及性、設立輕生防治中心。
2. 媒體與教育：媒體應謹慎報導輕生事件，避免細節化與浪漫化；學校應將心理健康教育納入課程，培養學生自我覺察與助人技能。
3. 產業與職場友善：雇主可提供員工心理諮詢資源、彈性工時、壓力管理講座，使職場成為心理健康的防護牆。

八、文化層面的啟發：透過藝術、音樂與故事來理解生命

我曾多次聆聽劉家昌與瓊瑤作品相關的歌曲，那些旋律抒發出愛情的起伏與人生的酸甜苦辣。藝術、音樂與文學並非只是娛樂，更是理解生命複雜性的窗口。當我們欣賞一首歌、一部電影、一篇小說，我們往往能在別人的故事中找到自己的影子，從他人經驗中汲取勇氣。

實務建議：

1. 透過藝術治療舒壓：音樂療法、美術創作、戲劇表演可幫助紓緩心理壓力。
2. 公共藝術與展演：社區辦展、街頭音樂會、書店講座，創造人際交流平臺，減輕孤立感。
3. 跨文化學習：觀賞外國電影、閱讀國際文學，汲取不同文化面對生死的智慧。

九、落實到我自己的人生：從思考到行動

我不只是旁觀者，在目睹這些新聞後，我也審視自身生活。是否平時忽略了自己的壓力信號？有沒有對家中長者的照顧不足？在面對身邊朋友情緒低潮時，我是否迅速逃避，而非耐心傾聽？

我決定採取一些實際行動。例如，在每日行程中安排半小時靜心冥想，檢視自己的情緒狀態；每個月抽出一天拜訪家中的長者親友，陪他們聊天、聽他們述說過往。

十、將經驗化為行動藍圖

人生在無常、老化、疾病、心理壓力、意外與死亡交錯下仍可發光，我們只需給自己與他人更多機會。

綜合行動藍圖：

1. 個人層面：維持身心健康（運動、飲食、睡眠），學習壓力管理技巧，勇於求助心理專業。
2. 家庭互助：定期家族聚餐、電話問候長輩，鼓勵家成員彼此談論情緒與擔憂，不讓問題悶在心中。
3. 社區參與：加入志工組織、參加藝術工作坊、推廣輕生防治資源，成為社區的溫暖一環。
4. 政策倡議：透過民意代表、社會運動、倡議團體，呼籲政府補強長照系統、推廣心理諮詢、設立失智防治中心。
5. 媒體正面影響：鼓勵媒體責任報導，不渲染輕生細節，不詆毀心理疾病患者，以尊重與事實為導向。

結語：接受無常，創造溫暖，活出深度

不論是劉家昌的癌逝、瓊瑤的輕生、中山美穗的意外身亡，都在提醒著我們：無常是人生的底色。我們無法逆轉時間、攔阻死亡，但能選擇如何面對、如何行動。

在面對失智、抑鬱、輕生、臥床老人挑戰時，我們能否將這些事件視為學習契機？讓我們從沉痛中看見需求，從震驚中激發行動。人生或許充滿難題，但我們可以透過彼此扶持、政策改革、教育推廣和藝術啟發，使這條路多些光亮和溫暖。

讓我們在這個瞬息萬變的世界中，更珍惜身邊的人、更留意自身的健康、更勇敢地面對每個轉折。如此，我們便能在面對生死大哉問時，不致手足無措，而能懷抱一份經深思後的沉穩與勇氣。

-李士展 (Shi-Zhan Li)

英文版(English version)

I sit at my computer desk, browsing through fragmented reports and messages. One piece of news after another appears before my eyes: On December 2, 2024, renowned musician Liu Jiachang passed away from cancer at the age of 83; on December 4, 2024, the well-known writer Qiong Yao died by suicide due to depression and the pain of life, aged 86; on December 6, 2024, the Japanese actress Miho Nakayama (aged 54), famous for her role in "Love Letter," was found dead at home—later clarified as an accident rather than suicide, yet still profoundly shocking. Even though I am not very familiar with Qiong Yao's works, nor have I delved deeply into Miho Nakayama's filmography, I have listened to many theme songs and soundtracks related to Liu Jiachang and Qiong Yao’s creations. Those melodies once guided me to feel the sweetness and bitterness of love. Now, the consecutive passing of these celebrities strikes like a bell in the twilight, reminding me to examine the vulnerable aspects of life: dementia, depression, suicide, bedridden seniors, and death itself.

Though these issues are numerous and complex, I hope that through more detailed exploration and examples, I can offer a path for thought: how to prevent dementia, how to face depression and suicidal tendencies, how to care for bedridden seniors, and how to find meaning in a life full of uncertainty. Let’s discuss more deeply and lengthily, letting this newsletter become a vessel of thought—holding multi-layered reflections on life’s challenges.

1. The Challenge of an Aging Society: Dementia Prevention and Early Action

As average lifespans continuously lengthen, dementia has become a global public health concern. Dementia affects not only an individual's memory, cognition, and judgment but also burdens family caregivers, causing both physical and mental stress.

Hypothetical Example: Xiaoming’s father, at 78, began showing memory confusion—from forgetting daily news to not knowing which room he was in. Initially, Xiaoming hoped it was just normal aging forgetfulness. However, a year later, his father left home to buy groceries and couldn’t find his way back. Brought home by a neighbor, he looked utterly lost. The doctor diagnosed early dementia and advised Xiaoming to adjust his father’s lifestyle. Had they started earlier—scheduling regular exercise, mental games (like puzzles, trivia), joining reading clubs, or community dance classes—perhaps the disease’s progression could have been slowed.

Practical Suggestions:

• Middle-Age Prevention: Begin in midlife. Maintain exercise habits, limit excessive alcohol, control blood pressure and blood sugar.
• Mental Stimulation: Foster a reading habit, learn a new language or instrument, visit art exhibitions, attend concerts.
• Social Participation: Join volunteer organizations, community activities, or travel groups. Social events can enrich interpersonal interactions, strengthening brain neuronal connections.

2. Into the Psychological Abyss: Preventing and Healing Depression

Qiong Yao’s suicide highlights the hidden nature of depression. Depression is not simply feeling blue; it can distort a person’s thinking over the long term, making the world lose its color and life lose its meaning.

Hypothetical Example: Xiaomei excels in interpersonal relations at work, always smiling and solving problems with ease. After work, however, she falls into deep solitude, struggling with insomnia and no appetite, repeatedly asking herself, “What’s the purpose of living?” One day, mustering courage, she sought help from a therapist. During counseling, she realized unresolved childhood family conflicts and high self-expectations at work had intensified her depression. Through therapy, medication adjustments, and group sessions, Xiaomei learned to treat herself more gently, to ease her perfectionism, and gradually emerged from the shadow of depression.

Practical Suggestions:

• Early Recognition of Symptoms: Prolonged sadness, insomnia, irritability, or losing interest in activities should raise alarms.
• Professional Help: Psychological counseling, psychiatric treatment, and appropriate medication are correct and advisable measures.
• Environmental Support: Understanding from family, friends, and colleagues is crucial. A simple “Are you okay? Want to talk?” can bring immense comfort.

3. Suicide Intervention: Reaching Out at the Edge of the Abyss

Suicide is not weakness but the end result of long-term, unaddressed suffering. Qiong Yao’s choice shows us that even those seemingly rich in talent and experiences can be defeated by psychological pain.

Hypothetical Example: Xiaoqiang notices his roommate Xia’an acting strangely lately, often weeping at midnight and murmuring, “Maybe leaving is the only release.” Xiaoqiang does not turn a blind eye. He patiently listens to Xia’an’s distress, then searches for suicide prevention information, helping Xia’an contact a 24-hour mental health hotline and counseling center. With professional intervention, Xia’an’s suicidal urges eased, and he began long-term psychological therapy. Afterwards, Xia’an thanked Xiaoqiang: “I’m so glad you didn’t ignore my situation.”

Practical Suggestions:

• Observing Warning Signs: Talk of death, giving away valuables, unusual behavior requires vigilance.
• Timely Intervention: Listen, comfort, help seek professional support, such as a therapist or doctor.
• Social Resources: The media, schools, and workplaces should broadly publicize suicide prevention resources like 24-hour help lines and online counseling platforms.

4. Bedridden Seniors: Late Life Need Not Be Merely “Waiting for the End”

Longevity does not guarantee a high-quality late life. Bedridden seniors face immobility, disability, chronic pain, and possibly long-term loneliness due to lack of social or cultural stimulation.

Hypothetical Example: Xiaolin’s grandmother became bedridden after a stroke. Initially, the family only provided basic care: feeding, cleaning, turning her over. The grandmother’s expression remained vacant. Later, Xiaolin remembered that his grandmother once loved listening to theme songs from Qiong Yao’s movies, so he played old songs daily and invited community volunteers to visit and share stories from the past. Gradually, his grandmother responded with smiles, eye contact, and subtle gestures, showing that she still felt love and value.

Practical Suggestions:

• Improved Long-Term Care: Government-promoted long-term care policies or similar programs to provide home services, day care, and hospice care can ease family burdens.
• Community Participation: Volunteer visits, art therapy, music, reading, and simple crafts enrich the inner world of bedridden seniors.
• Family Support: Teach family how to offer emotional companionship, stress relief methods, and provide support groups for caregivers.

5. Unexpected Death and Impermanence: Lessons from Miho Nakayama’s Case

Miho Nakayama’s death was an accident, not suicide, reminding us that the arrival of death is not always predictable. Life brims with uncontrollable occurrences. Facing accidents, we can improve safety awareness, manage risks, and cherish ordinary daily life.

Practical Suggestions:

• Home Safety: Improve home lighting, install handrails, use anti-slip mats to reduce accidents.
• Emergency Preparedness: Share emergency contact info with family, keep phones accessible, carry a card with essential contacts.
• Mental Preparation: Accepting that life cannot be fully controlled helps us treasure the present moment more.

6. Reflecting on Life through Death: A Direction of Love and Action

These celebrity deaths make me ponder: since death is inevitable, what can we do for life? I realize life’s value isn’t in its length but in its depth and breadth. Can we, through love, care, education, and policy reforms, build a more resilient social network, ensuring dementia patients aren’t forgotten, depressed individuals receive help, those on the brink of suicide find a way back, and bedridden seniors aren’t isolated?

Hypothetical Example: Xiao’an is an ordinary office worker who, after hearing about Qiong Yao’s suicide and Miho Nakayama’s accidental death, decides to incorporate “care” into her daily life. She attends community reading clubs sharing positive psychology books; on holidays, she volunteers at nursing homes, playing music for elders. Xiao’an says, “I may not change the entire world, but I can at least change the world around me.”

7. Social and Policy Levels: Building Multi-Faceted Support

Individual effort matters, but without systemic support, effectiveness is limited. We need combined efforts from the government, NGOs, healthcare systems, and community organizations.

Practical Suggestions:

• Long-Term Care and Mental Health Policy: Strengthen long-term care services, improve the accessibility of counseling, and set up suicide prevention centers.
• Media and Education: Media should be cautious reporting suicides, avoiding detailed and romanticized portrayals; schools should include mental health education to nurture self-awareness and helping skills.
• Business and Workplace Friendliness: Employers can provide mental health counseling resources, flexible work hours, and stress management workshops, making the workplace a safeguard for mental well-being.

8. Cultural Dimensions: Understanding Life through Art, Music, and Stories

I have listened to many songs related to Liu Jiachang and Qiong Yao’s works—those tunes express the ups and downs of love and the bittersweet of life. Art, music, and literature are not merely entertainment; they are windows to understand life’s complexity. When we enjoy a song, a film, or a novel, we often find our own reflection in others’ stories, drawing courage from their experiences.

Practical Suggestions:

• Art Therapy to Relieve Stress: Music therapy, visual arts, and drama can help alleviate psychological pressure.
• Public Art and Performances: Community exhibitions, street concerts, and bookstore talks create platforms for interpersonal interaction, reducing isolation.
• Cross-Cultural Learning: Watching foreign films, reading international literature—gaining wisdom from how different cultures face aging, disease, and death.

9. Implementing into My Own Life: From Thought to Action

I’m not just a bystander. After witnessing these news stories, I also examine my own life. Have I ignored my stress signals? Have I done enough for the seniors in my family? When faced with friends in emotional decline, do I escape or patiently listen?

I decide to take concrete actions. For example, schedule half an hour of meditation daily to check my emotional state; every month, set aside a day to visit elderly relatives, chatting and listening to their stories.

10. Turning Experience into an Action Blueprint

Life shines even amidst impermanence, aging, disease, psychological stress, accidents, and death—if we give ourselves and others more chances.

Comprehensive Action Blueprint:

• Individual Level: Maintain physical and mental health (exercise, diet, sleep), learn stress management, and seek professional help when needed.
• Family Mutual Support: Encourage emotional communication among family members, share caregiving responsibilities, prevent problems from festering in silence.
• Community Participation: Join volunteer groups, attend art workshops, promote suicide prevention resources, and bring warmth to the community.
• Policy Advocacy: Through representatives, social movements, and advocacy groups, urge the government to reinforce long-term care systems, promote psychological counseling, and establish dementia prevention centers.
• Media’s Positive Influence: Encourage media to report responsibly, avoid sensationalizing suicide details, and not stigmatize people with mental illnesses—respect and facts should guide their narrative.

Conclusion: Accepting Impermanence, Creating Warmth, Living with Depth

Whether it’s Liu Jiachang’s death from cancer, Qiong Yao’s suicide, or Miho Nakayama’s accidental passing, all remind us that impermanence is the backdrop of life. We cannot reverse time or halt death, but we can choose how to face it and how to act.

Confronting the challenges of dementia, depression, suicide, and bedridden seniors, can we view these events as learning opportunities? Let’s find needs within sorrow and inspire action amid shock. Though life is full of difficulties, through mutual support, policy reform, educational outreach, and artistic inspiration, we can make this journey more luminous and warm.

In this rapidly changing world, let’s cherish those around us, attend to our own health, and bravely meet every twist and turn. Then, when confronted with the grand question of life and death, we will not be at a loss, but instead hold a calmness and courage born from thoughtful reflection.

-Shi Zhan Li (李士展)

這些都是我上了很多課程才學會的東西！

These are things I learned from taking many courses!

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