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Getting past the stigma of dementia

by Philip Brasor

Special To The Japan Times

Last April, the Nagoya High Court ordered a 91-year-old woman in Obu, Aichi Prefecture, to pay ¥3 million in compensation to JR Tokai for disruption of service after her husband was struck and killed by one of the company’s trains. The man, who was 85 at the time of the accident in December 1997, suffered from dementia and had somehow ended up on the tracks. The court said the woman should have been watching him more attentively and was thus responsible for JR Tokai losing money as a result of the accident.

The ruling brought fresh media attention to the issue of dementia and the corollary problem of haikai (wandering by seniors). In a similar incident last October, an elderly man fell on the tracks of the JR Yokohama Line as a train approached. He was saved by a 40-year-old woman who was killed in the act. JR East did not sue the man or his family, perhaps because the media hailed the dead woman as a hero. However, in February a woman in her 70s was killed while trying to push her bicycle across tracks operated by Tobu Railways in Tokyo’s Adachi Ward. Service was disrupted for two hours, and no one has reported Tobu suing anyone.

In these latter two cases the media did not say whether or not the elderly persons involved suffered from dementia. The health ministry says that more than 4.5 million Japanese were diagnosed with the condition in 2012, and that another estimated 4 million had what is called “mild cognitive impairment,” which means they are sometimes disoriented but generally can take care of themselves. Since dementia in any degree can be a source of shame for families of people who shows signs of it, the authorities and the media are careful with the term, and this reluctance to indicate the obvious has exacerbated the problem.

Earlier this month, NHK aired a one-hour special about wandering seniors. The program said that in 2012, 9,607 “persons with dementia” throughout Japan were reported missing by family members, and 9,478 missing persons with dementia were “found” in the same year, though some had been reported missing in previous years. Of these, 5,524 were found by police and 3,230 returned home on their own or were confirmed found by family members. In 359 cases, the missing person was found dead. Significantly, 6,263 persons were found within 24 hours of being reported missing, and 2,979 within a week.

The scale isn’t huge, but 180 seniors reported missing remained so at the end of 2013, and though 59 percent of recovered missing seniors are found within a kilometer of their homes, there have been situations where these seniors were in plain sight of the public but not reported for days or even weeks. In one case, an 87-year-old woman was found dead in a narrow space between buildings across the street from her home more than a week after she disappeared.

NHK’s aim was to look at methods being used to address the problem, and focused on one woman suffering from Alzheimers who had been in a facility in Tatebayashi, Gunma Prefecture, since 2007, when police found her wandering around a railway station. When asked her name, she said it was Kumiko. The surname Yanagida was printed on her socks, but on her underwear was the given name Mieko. Police posted information on a nationwide database, and the woman was moved to a public nursing home. She didn’t give police much to work with about her past, but was relatively lucid in the beginning. However, three years ago her condition deteriorated and she is now bedridden and unresponsive.

Then, on May 12, the day after the special aired, the woman’s 68-year-old husband, Shigeo Yanagida, came to Tatebayashi and saw her for the first time in almost seven years. A relative had seen the program and told him. His wife’s name is Mieko, and it so happened that May 12 was their 41st wedding anniversary. She was wearing a wedding band inscribed with the date May 12, and NHK had shown it.

It wasn’t the first time NHK had had such success. On one of its nightly news bulletins in April it ran a story about an elderly man who had been in a nursing facility in Osaka for two years after being picked up while walking along the street. The next day his family came to claim him. As NHK pointed out in the special, systems for dealing with wandering seniors are inconsistent, and something as simple as broadcasting an image of a person who had been found on the streets could be very effective.

However, many people are reluctant to provide photos of their loved ones because they don’t want to advertise the fact that a member of their family is senile and, perhaps more importantly, that they were not able to prevent that person from wandering away. But the police can only do so much with the limited information they have, and they don’t necessarily handle that information well. In the case of Mieko Yanagida, the police miswrote the name they found on her underwear and distributed it on the database as “Emiko.” However, the name Yanagida is not common, and since Mieko lived in Asakusa and her husband had reported her disappearance to the authorities, the local police should have not only picked up on her surname in the database, but also the fact that though Tatebayashi is 60 km from Asakusa there is a direct train line connecting the two stations.

According to Asahi Shimbun, more and more local governments are trying to persuade families with missing seniors to allow them to distribute photos and more detailed information. Kushiro, in Hokkaido, has taken a proactive approach by announcing missing seniors on a local FM station as soon as a report is made and insists on using full names. They’ve had a better success rate than the national average. As it stands, most local governments just do the bare minimum.

The special showed how easy it is to identify and find missing seniors using the resources of mass media. NHK could easily provide such information on a regular basis, and not just once in a while. Isn’t that what “public” broadcasting is all about?