Supporting the elderly in a ‘super-aged’ society: Japan Part 3

Japan’s approach to dementia makes the country an exceptional pioneer in the field. It involves effective public education campaigns and training available to all carers – family, friends, volunteers and professionals as well as the fusing of community-based support networks with patient data and advanced technology.

In 2004, the Japanese government launched a nationwide campaign, ‘The 10-Year Plan to Understand Dementia and Build Community Networks’. This inspired wide ranging initiatives most of which are still running including the ‘Dementia Friends’ and ‘Dementia Café’ concepts that have been emulated in several countries including, Canada, India, Indonesia, Ireland, the Netherlands and UK.

A priority in Japan was to remove the heavy social stigma associated with dementia. The term for dementia was officially changed from ‘Chiho’, which carried negative associations, to ‘Ninchi-sho’, meaning ‘cognitive disorder’. A nationwide ‘caravan’ or roadshow was launched to train over one million Ninchi-sho supporters. As of April 2020 an estimated 12 million dementia care helpers have been trained.

According to the Health, Labor and Welfare Ministry, the training is designed to educate Japan’s citizens and empower everybody to support and integrate dementia patients into a more inclusive society.

The purpose is not to make citizens experts in dementia but rather to support those with dementia, as well as their families, and make each town or neighbourhood a place where it’s more comfortable for them to live.

Standard text and video materials are used nationwide for the seminars, with variations according to the attendee groups which include not only adults but also schoolchildren. Among the following content covered are the following:

● recognition of the symptoms of dementia;

● diagnosis and treatment;

● the role of each health care professional;

● prevention;

● attitudes towards people with dementia; and

● understanding of the caregiver experience

Kobe City, the sixth largest city in Japan, is an example of how the community care works on a larger scale. In 2018, Kobe became the first city in Japan to pass a municipal order to establish Dementia-Friendly Community Development. By outlining the vision and the regulations framework, Kobe sent a signal to, and enlisted the support of, key local stakeholders: private businesses, academia, and citizens.

The ordinance also acted as a platform for research institutes, universities, and the Kobe Biomedical Innovation Cluster (KBIC), the city’s world-class hub for regenerative medicine, among other parties, to collaborate on finding ways to improve prevention and early intervention.

To have more people screened, Kobe City made an annual check-up for dementia free of charge. All expenses associated with a second, more detailed examination, which may involve MRI or CT scans, are also refunded. Kobe citizens has shown universal commitment to the dementia friendly community program by agreeing to local taxes being raised to fully fund it.

The government has also turned to a novel high-tech solution to help keep people with dementia safe: QR codes. Local government officials distribute wearable barcode badges to dementia patients and their carers to help locate patients if they wander off or become lost.

The barcodes are square, scannable QR codes, which can be read by anyone with a smartphone. Information like the patient’s identification, his or her local city hall and its telephone number is embedded into the unique code. These adhesive barcodes, worn on clothing or bracelets, make it easier to locate a person if he or she goes missing.

These barcode stickers and decals are a free service provided by the local government as just one high-tech innovation that the Japanese tech sector is pursuing to help alleviate a burgeoning mental healthcare crisis.

Other QR code technology has been introduced in Japan recently. One such invention is a tiny, 1/2-inch waterproof sticker that attaches to a fingernail or toenail. These nail decals work the same way as the clothing badges, but offer an extra level of protection, should a dementia patient wander off without her clothes or shoes. The decals stay on for an average of two weeks.

While the electronically tracking of individuals via barcodes and QR codes has caused some resistance by privacy advocates by and large it is strongly supported in Japan because it has been proven to protect the most vulnerable.