Tuesday’s Supreme Court ruling siding with a family over a rail operator in a case where a dementia suffer was struck and killed by a train highlights the burdens faced by family caregivers and the need for society to offer them assistance, an expert on the mental illness has said.
The high court ruled that the family was not obligated to compensate a railway operator for damages sustained after the man wandered onto the tracks and was killed.
The case marks the first time the top court has ruled on a family’s responsibility in supervising dementia patients.
“The ruling should be an opportunity to change people’s mindset that the wandering of dementia patients is a negative thing,” said Mariko Hattori, an executive at Japan Society of Care Management. “The family, the local society and companies should cooperate with each other to watch over the patient and create an environment where patients can live in peace.”
To address the issue, municipalities are joining together with local cooperatives, gas station operators and taxi companies to watch out for dementia patients who have wandered off and gone missing.
According to the Japanese Consumers’ Co-operative Union (JCCU), roughly 800 out of 1,741 municipalities have signed agreements as of December with some 90 co-ops across the country to keep an eye on people with dementia and respond in times of emergency.
Under the agreement, co-op delivery personnel will check for signs something is wrong, such as unopened mailboxes when they visit the homes of those with dementia, and report any irregularities to authorities.
The initiative began in 2007 and quickly spread across the country, leading to many situations where delivery personnel have stepped in to offer assistance, the organization said.
“When I called in at the door because there was no response, I heard a voice calling for help. I then called the police and paramedics,” said a delivery person who works at a co-op located in the city of Saitama but which also operates in Tokyo and Chiba.
“I once noticed food products I delivered the day before still on the doorsteps,” said another worker at the same co-op. “When I called the family and went inside with them, the elderly resident had collapsed due to a stroke.”
In other cases, delivery workers found elderly people who were lost and escorted them to nearby day centers, or called for ambulances after they were found collapsed on the side of the road.
The Health, Labor and Welfare Ministry estimated there were some 4.62 million people in the country, aged 65 and over, with dementia as of 2012.
In a separate 2013 survey by the ministry, it was found that 51.2 percent of households with a family member aged 65 or older needing nursing care was taken care of by another family member around the same age or older.
“We want to sign contracts with more municipalities and contribute to creating communities in which people feel safe,” said Atsushi Yamagiwa, who leads the effort at the JCCU.
Delivery staff at the JCCU have also taken special government-sponsored courses on how to deal with dementia sufferers and respond to their needs.
The organization said it now has over 25,000 workers who have been certified, comprising about a quarter of the total number of co-op workers nationwide.
To alleviate the burden on families taking care of dementia patients, the city of Kushiro in Hokkaido has set up a system with police, taxi companies and other outlets to look for dementia patients who go missing. The scheme has helped locate an estimated 30 to 50 sufferers who have wandered off every year since it was implemented.
In Takasaki, Gunma Prefecture, the city offers a global positioning system service for free which allows police to track down dementia patients if their families report them missing.
In December, police found a man in his 80s about 10 kilometers away from his home in the neighboring city 45 minutes after family members reported him missing.