Like young children, elderly people with dementia are prone to wandering off and getting lost. Few nations know this like Japan, where last year more than 10,700 people with dementia were reported missing—up by about 460 from the previous year, according to the national police agency.
That number is only likely to keep climbing. Japan now has more than 10 million people over the age of 80, and enough women over 100 to fill New York’s Yankee Stadium. One quarter of the country’s residents are already above 65, the working-age population is rapidly shrinking, and the nation’s birth rate fell to a record low last year—as it did in the previous three years.
And its life expectancy, meanwhile, remains unusually high.
There are already 5.2 million Japanese over 65 with dementia. That will rise to up to 7.3 million in 2025—roughly one in five of Japan’s elderly people, and one in 17 of its total population. As well as wandering about aimlessly, dementia sufferers have a tendency to become confused by changes in their environment, and lash out verbally.
In May, Japan’s health ministry estimated that the cost of providing health and social care for the nation’s millions of dementia sufferers totaled ¥14.5 trillion ($118 billion) last year. Nearly half the cost was borne by families. Meanwhile about 440,000 people in Japan left their jobs between 2007 and 2012 to care for their ill or incapacitated parents and other relatives—the last thing a nation worried about worker shortages needs.
But this isn’t only Japan’s problem. In South Korea, Greece, Italy, Portugal, and Spain, more than 40% of the population will likely be over 60 years old in 2050. So how Japan copes with dementia may provide some much-needed lessons for the rest of the world. Here are some of the things it is trying.
Long-term care insurance. Under this mandatory system, rolled out in 2000, at age 40 every Japanese resident pays a monthly insurance premium. They become eligible for a range of services—including daycare centers and meal delivery—when they turn 65, or get sick with an aging-related disease. The idea is to help seniors live more independently, reduce the burden on family caregivers, and create a market of companies competing to provide the eligible services.
Flexible working schedules. While some companies in Japan create workplace policies hostile to employees who must take time off to care for elders, others do the opposite. Under the law, a worker can take up to 93 days off to care for a relative who becomes ill or injured, with employment insurance covering 40% of their salaries. Takeda Pharmaceutical goes well beyond that, offering employees up to a year of nursing leave. The clothes retailer Uniqlo offers a workweek of four 10-hour days, designed for workers to spend time on child-rearing and nursing care.
Dementia-care training. Hospitals are finding it a challenge to deal with the increasing number of dementia sufferers, who might wander about, remove their tubes or needles, or cause trouble with other patients. “The nurses tend to be exhausted as they struggle to keep up with them,” a nurse at Nagoya’s Kamiiida Daiichi General Hospital told the Yomiuri Shimbun. The government initiated dementia training programs for physicians and nurses, and hopes to have 87,000 people participating in them by the end of 2017.
Driver-screening program. Of the approximately 470 fatal accidents caused by drivers aged 75 and over last year, 38% involved a driver with some form of cognitive impairment. Under a revised law, people suspected of having dementia will need to provide a medical certificate that they are capable of driving.
Daycare centers. About 7% of the nation’s over-65 population uses daycare centers, which focus on keeping visitors active both physically and mentally through activities such as cooking or day trips. Some serve as daycare centers for kids, too, mixing the young and old. Others incorporate art therapy.
Short-term-stay offerings. Family caregivers who want to keep their relatives at home can use this option for the occasional break, bringing in relatives for stays of up to 30 nights.
Search-and-rescue programs. Being tested in about 40 cities, these efforts involve teams of social workers and medical professionals looking for people who have dementia but have not yet been diagnosed with it. The teams attempt to sign people up for services offered under the long-term care insurance program. Japan hopes to have teams in every city in a few years.
Cooperation with stores. In the Osaka prefecture, which leads the nation in reported cases of dementia sufferers gone missing, four major convenience store chains agreed to function as “dementia supporters” to assist seniors who appear disoriented. The chains, which between them have about 3,500 stores in the prefecture, send store managers to training sessions on how to identify and assist dementia sufferers. They will also cooperate with a quasi-governmental patrol-and-watch network that shares data on missing elderly via emails and faxes.
