Caring for dementia sufferers

About 4.62 million people aged 65 or older in Japan are estimated to suffer from dementia, and roughly 10,000 such people are reported missing each year. Although thousands of them are reunited with their family as they either return home on their own or are rescued after wandering about for days, weeks or months, hundreds of them are found dead, including some who are killed in accidents.

This serious issue needs greater public attention especially as the aging of the Japanese population continues to accelerate. Family members alone cannot be held responsible for protecting the elderly from these hazards. Community-based support mechanism involving public services, businesses and local residents will be needed.

One of the symptoms of dementia is orientation disturbance, in which people’s sense of their identify, time or where they are becomes impaired. This can lead people to wander about aimlessly without knowing where they are headed. Last week, a 67-year-old woman who disappeared from her home in Tokyo in 2007 was reunited with her family at a care facility in Tatebayashi, Gunma Prefecture. The woman, who has dementia and was unable to tell the police her name when she was taken into protective custody in the city seven years ago, was misidentified, which prevented a match in missing persons reports. Her recent appearance on an NHK TV program featuring the problem of senile dementia prompted her relatives to contact the broadcaster and locate her.

There are others who meet more unfortunate fates. In 2007, a 91-year-old man was hit and killed by an incoming train at a station in Obu, Aichi Prefecture, after leaving home unnoticed by his wife and wandering onto the train tracks. In April, the Nagoya High Court ordered the widow, now 91, to pay ¥3.59 million in damages to Central Japan Railway Co. to cover the losses that the accident caused to the firm’s train operations.

The court determined that the wife had failed in her duty to keep watch over her husband, who was suffering from dementia and had a habit of wandering away from home. She had lived alone in the house with him, while they were economically supported by their son who lived nearby. The man reportedly walked away from home when the wife, who was also ailing and in need of nursing care herself, had dozed off.

The court came under criticism that its decision ignores the harsh realities surrounding many elderly people with dementia and their families. Roughly 520,000 people are on waiting lists nationwide to enter nursing homes that provide intensive care for the elderly with severe physical conditions or dementia. With the availability of such facilities limited, many of these people are being cared for by their families, and in growing numbers — as in the Obu case — by their elderly spouses.

It would be impossible for family members to keep round-the-clock watch over relatives with dementia. Some people in similar situations say that if all the responsibilities are placed on family members, they may have no choice but to confine the dementia sufferers inside the house or even keep them physically restrained.

In 2013, 10,300 elderly people with dementia were reported missing by their families, up from 9,607 in the previous year. In 2012, the whereabouts of 9,478 such people, including those who had disappeared in 2011 or earlier, was confirmed. Most of them were found alive but 359 were discovered to have died.

Efforts are needed by the central and local governments, as well as at the community level, to ease the burden on families and ensure the safety of elderly people with dementia.

Omuta, Fukuoka Prefecture, is one of the municipalities that have launched community-based efforts. Formerly a thriving coal mining base, Omuta has witnessed the rapid aging of its population — with 32 percent of its 120,000 population 65 years or older, compared with the national average of 25.1 percent. The city has worked with local residents and nursing care business operators to take measures to help the elderly with dementia to live safely, including training of care experts as well as enlightenment programs to give residents accurate knowledge of dementia symptoms.

It has set up a local network of communication in which the police, when they get search requests from families of elderly people, relay information about the persons’ clothing and physical features to fire departments, post offices and taxi companies. This information is also transmitted via email to about 4,000 residents on the city’s mailing list. In 2012, tips from local residents and businesses enabled the police to locate about 160 missing elderly people.

The health and welfare ministry in 2005 launched a program to disseminate knowledge on communication with dementia sufferers. Companies from various sectors including supermarket chains, banks and taxi operators have taken part in the program, in which local government workers with the knowledge offer guidance to their employees about symptoms and how to deal with people suffering from dementia. Major retailer Aeon Co. has reportedly had roughly 40,000 of its employees and part-time workers at its shops across the country join the program, so that they can help dementia sufferers who get lost when they visit its stores.

It is urged that these and other efforts are shared and spread nationwide to minimize the hazards for elderly people with dementia and to ease the burden on their families.

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