Uji’s Dementia Friendly Community Approach

Noriyo Washizu, Alzheimer’s Association Japan

Background

Japan has the most elderly society in the world. We are approaching an era with approximately 7 million people living with dementia, where with one in five elderly people will have dementia.

The early stages of Japan’s dementia friendly communities approach began at governmental and grass roots level in the early 1990s. Today almost all prefectures have been moving towards a New Dementia Policy established by the government in 2015. However, the stage of development varies from community to community.

There are many progressive dementia friendly communities in Japan and Uji is one of them.

Uji’s history

Uji city in the prefecture of Kyoto was declared a Dementia Friendly City in March 2015. The goal of the Uji declaration is the same as Kyoto Prefecture’s, which was based on around 1350 questionnaire responses from people with dementia, their carers, and professionals.

Uji city’s dementia friendly community (DFC) approach started in 1990 and 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.

Progressive approaches of Uji

Over more than 20 years of work and study, Uji determined that the major obstacle against DFCs was “slow intervention”. Dr Mori and Dr Takechi, both advocates of the DFC approach, analysed many difficult cases and found that the earlier people are included in a care network, the better and longer they live in the community. A timely and appropriate intervention is key to a DFC.

Based on this information, Uji started progressive and unique approaches.

One is the Early Stage Dementia Intensive Support programme started in 2014. The programme follows this key process:

  1. Early detection through a lifestyle questionnaire sent to all citizens over 65 by mail.
  2. Collecting the answer sheets returned by mail and visiting non-responders, achieving a collection ratio of 95%.
  3. Screening the answer sheets and finding people who require intervention.
  4. The first visit is to classify people using Uji’s original check sheet and for a medical and welfare professional team to carry out an assessment.
  5. Early stage intensive support provided when required.
  6. A team monitors the person’s lifestyle and health status for a year.
  7. Completion of cases with good outcomes and reassessing those with greater needs.

Another progressive approach unique to Uji is encouraging people living with dementia to become involved in community activities and the policy making process. About 20 people living with dementia and their family carers formed a group through sports activity 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 DFC, as well as to advocating for those who cannot express their opinion.

Uji keeps moving forward

The following are Uji’s upcoming projects:

1) Dementia action alliance:

Uji will start the dementia action alliance named Lemonade in March 2016, which embraces the entire community. It will introduce more citizens into the dementia network and will make a linkage with employment or volunteer work for people living with dementia.

 2) Publication of Words of People living with Dementia

Dr Mori will publish the booklet of Words of People living with Dementia, which will be a guide for Uji’s DFC approach.

Four powerful engines

Uji is successfully proceeding with a DFC because there are four powerful engines which enables it to continue: first, there is a medical and welfare team led by dedicated specialists; secondly, there is a public welfare corporation that provides comprehensive and quality care; thirdly, the municipal government prioritises dementia; and finally, people living with dementia and their carers formed the most powerful one - Lemon Company. These four excellent engines and their perfect combination will reach a real Dementia Friendly Community.