Japan - Dementia Friendly Communities

Bridging Communities; Sharing Our Memories
Dementia Friendly Japan Initiative (DFJI)
Dementia Friendly Sanada, Ueda City
Eisai Human Health Care
Heart Ring Movement
Honeywell Ibasho House
Nationwide Caravan to train Ninchisho Supporters
Orange Door
Uji City's dementia friendly community

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Picture: Dementia Friendly Japan Initiative (DFJI)

Bridging Communities; Sharing Our Memories

The Fujinomiya project, Bridging Communities; Sharing Our Memories, run by high school students, supports intergenerational interaction based on the history of the local area using photographs. Students are also involved in internships in which they record photographs and memories of a person with dementia by speaking to them and compiling a life history of the person.

Dementia Friendly Japan Initiative (DFJI)

In 2011, the Center for Global Communications at the International University of Japan, Fujitsu Laboratories Ltd. and Dementia Friendship Club began formal discussion on ways to increase awareness of dementia and improve the lives of people living with dementia. As a result of their findings, in 2013, the Dementia Friendly Japan Initiative (DFJI) was launched. DFJI is led by people with dementia and carers in partnership with local government, private enterprises, academia and non-profit organisations. A national event took place in 2014, bringing together 200 people from various sectors to establish the nine key areas of activity required for furthering the campaign. To date, more than ten projects are in progress including Run Tomo, which has seen people with dementia and their families, as well as young and elderly people, each running or walking a short distance with a total distance of 2,500km and passing on a sash. Other projects include fashion and healing days specifically aimed at women with dementia, steps towards dementia friendly public transport and fragrance workshops in which emotions and memories can be recalled through sense of smell.

Dementia friendly Sanada, Ueda City

In the former town of Sanada in Ueda City in central Japan, a multi-stage approach to creating inclusive communities led by people with dementia began in 1993. The project working group – comprised of local service providers, community groups, people with dementia and their families – developed a four-phase strategy: 1) to enhance dementia care within institutions, from total care for all to group living specifically for people with dementia; 2) to transfer dementia care into the community, from a day centre to a group home in the community; 3) to transfer further to the community, from the group home to a multi-functional care centre; and 4) Local resident participation with community building, centred on the group home and multi-functional care centre. The idea was to build upon the strengths of people with dementia and provide opportunities for them to fulfil their potential. Since 2006, a number of group homes were making it possible for people with dementia to carry out activities of everyday life, and multi­functional care centres had been formed which provided day care and a short stay facility as well as home visits. A local base had also been established where people with dementia host activities such as lunch clubs and dinner parties, inviting local friends and residents to attend. An awareness-raising programme for the community is provided in the form of seminars and training in how to communicate effectively with people with dementia.

Eisai Human Health Care

Japanese pharmaceutical company Eisai is one example of an organisation that is supporting awareness of dementia and the inclusion of people living with dementia through a company­wide initiative. Eisai’s Human Health Care (HHC) scheme is an innovative approach to ensuring their staff are more understanding to those who require medical treatment. As part of their corporate responsibility, all staff in offices across the world are required to spend 1% of their working hours with people with dementia and their families in order to discover the reality, thoughts and concerns of those who benefit from their treatments and other available services. Eisai has also been providing dementia training for pharmacies in Japan since 2011 and recommend that all insurance-based pharmacies and distributors of their medications become Ninchisho Supporters in the national programme. In 2014, they began collaborating with other companies to develop a dementia friendly community in Toyama City.

Heart Ring Movement

The Heart Ring Movement in Tokyo aims to raise awareness, encourage compassion, thoughtfulness, kindness and cooperation between individuals, organisations, and the community, and to change the negative image of dementia to a positive one. The campaign is spearheaded by three directors of medical organisations in Japan. The movement is focused on telling society the “positive truth that people with dementia can spend satisfying days”.

Honeywell Ibasho House

Ibasho, a charitable organisation that aims to create socially integrated communities that value its elder residents, set up the Honeywell Ibasho House in Ofunato in 2013. The project was inspired by the spirit of intergenerational help and support witnessed during and after the devastation of the 2011 earthquake and tsunami. Ibasho House, which was designed and built with input from elder local people, is a place where the community gathers and embraces the wisdom and abilities of older people. People with dementia are also encouraged to participate in the activities to their full ability.

Nationwide Caravan to train Ninchisho Supporters

Japan’s approach to creating dementia friendly communities has provided inspiration worldwide for its innovation, involvement of people with dementia in decision-making and person-centred approach. In 2004, Japan’s government announced the change of the word for ‘dementia’ from ‘Chiho’ which carried negative connotations to ‘Ninchi-sho’, meaning cognitive disorder. With this change, the country’s government launched a nationwide campaign, 10-Year Plan to Understand Dementia and Build Community Networks.

Among the projects inspired by this change was the Nationwide Caravan to train Ninchisho Supporters programme, which was launched in 2005. It took an ambitious approach to raise awareness of dementia and train various groups and individuals, in their personal or professional capacities, to best support people with dementia and carers to live well in their community. The Ninchisho Supporters training is a specialised 90-minute seminar for the public held at schools and offices and for community groups across the country. During the seminar, attendees learn about the disease itself, how it affects the lives of those living with dementia and what they should know in order to effectively support people with dementia. Standard text and video materials are used nationwide for the seminars, with variations according to the attendee groups. By the end of the programme, attendees are expected to have a good understanding of dementia, freeing themselves from any prejudice they may have, and to become supporters and advocates for those living with dementia in their everyday lives. Those who attend the seminars become Ninchisho Supporters and receive an Orange Ring bracelet.

Almost 5.5 million people in Japan had attended the seminar as of September 2014 and, by 2015, almost all local governments in Japan were running a dementia friendly community programme. The Ninchisho Supporters programme had resulted in more initiatives, such as the Buddy Bank befriending network scheme and SOS Wanderers Network, where Ninchisho Supporters help in the search for people with dementia who go missing. By 2014, 60% of the country was covered by the network. The Ninchisho Supporter concept was a key focus of research for Alzheimer’s Society (England, Wales and Northern Ireland) during the development of their Dementia Friends programme. The Japan and England initiatives have since been replicated in a number of countries, including Australia, Canada, India, Indonesia, Ireland, the Netherlands, Scotland and Sri Lanka.

Orange Door

Only in recent years have people with dementia in Japan felt able to speak out about their experiences in public and the creation of the Japan Dementia Working Group marked a real change in culture. Tomofumi Tanno, who is 41 and a member of the Working Group, has set about making his community in Sendai more dementia friendly. As well as creating help cards to explain to members of the community that he may need their help, he also founded Orange Door as a meeting place for people with dementia. The aim of Orange Door is to provide ‘a listening ear, information and guidance – and above all, a sense of hope’.

Uji City's dementia friendly community

The early stages of Japan’s dementia friendly communities approach began at governmental and grass roots level in the early 1990s. However, the stage of development varies from one community to another. There are many progressive dementia friendly communities in Japan and Uji is one of them. Uji City’s dementia friendly community approach started in 1990 and over more than 20 years of work and study, Uji determined that the major obstacle against dementia friendly communities was “slow intervention”. Dr Mori and Dr Takechi, both advocates of the dementia friendly community approach, analysed many difficult cases and found that the earlier people were included in a care network, the better and longer they lived in the community. Based on these findings, Uji has developed projects to raise awareness, provide support and training programmes for carers and professionals, and implemented the Long Term Care Insurance and the National Dementia Supporter Campaign. Their Early Stage Dementia Intensive Support programme was launched in 2014 to detect local residents who may have dementia and provide them with support in the community. Uji residents living with dementia are also encouraged to become involved in community activities and the policy making process. Around 20 people living with dementia and their family carers formed a group through sports activities and memory cafes. The group, named Lemon Company, is playing an important role in raising awareness, speaking out at the municipality council meeting to build a dementia friendly community, as well as advocating for those who cannot express their opinion. Future plans for Uji include the formation of a Dementia Action Alliance named LemonAid, which embraces the entire community. It will introduce more citizens into the dementia network and will make links with employment or volunteer work for people living with dementia. A book, Words of People Living with Dementia, will be published and will guide dementia friendly efforts.