It may be a common ailment for our elderly population in the not-so-distant future. The health ministry’s latest estimate is that the number of people aged 65 or older suffering from dementia will reach 7 million in 2025, or one out of five people in that age group.
The government, which recently adopted a new strategy on measures against dementia, needs to follow through on the idea of ensuring a better quality of life for patients by heeding the wishes of sufferers and their families.
The new strategy was hastily put together in about two months after Prime Minister Shinzo Abe, who spoke at an international conference on the issue held in Tokyo in early November, gave the order to the government. It expands on the Health, Labor and Welfare Ministry’s five-year program started in fiscal 2013, which was based on the policy adopted by the previous Democratic Party of Japan-led administration.
It calls for introduction of dementia diagnosis training to enable early-stage treatment and care of the patients, as well as research and development of ways to prevent and treat the disease — with a goal of establishing a method for early diagnosis by the end of fiscal 2015 and starting clinical trials toward a cure by around 2020.
Dementia, a progressive neurological condition that tends to affect more people as they advance in age, has been linked to abnormalities in brain cells as well as lifestyle-related diseases such as diabetes and arteriosclerosis, but no cure has been established for the illness. Alzheimer’s is said to be the most prevalent type of dementia, affecting two-thirds of all patients, but the medicines currently available only slow the progression of the patients’ conditions.
There were an estimated 4.62 million patients in 2012, along with 4 million others who suffer from light cognitive disorders and have a risk of developing dementia symptoms, according to the health ministry.
In recent years, there have been alarming reports of dementia sufferers going missing after wandering away from their homes. Roughly 10,000 such cases are reported each year. Increasingly reports of patients falling victim to accidents and consumer-related fraud also have been highlighted as serious social problems.
The issue of people quitting jobs to care for their elderly relatives suffering from dementia has come to the fore, along with an increase in the number of younger-generation people developing the symptoms.
One characteristic of dementia treatment in Japan has been the large number of patients hospitalized at mental institutions. As of 2011, roughly 53,000 such patients were being treated at mental hospitals, with roughly 30,000 of them hospitalized for longer than a year. These figures are much higher than are reported in other advanced economies, where patients are more commonly cared for at their residences or at nursing homes for the elderly.
People involved in nursing care have long advocated a shift in emphasis to early-stage diagnosis and care, which could slow the progression of patients’ conditions and enable them to continue living with their families at their homes. It was only in the health ministry’s five-year program that support for home-care of dementia patients was set out as a new direction in the government’s policy.
The government’s updated strategy calls for having 60,000 doctors nationwide in training for early diagnosis by fiscal 2017, and expanding such training to dentists, pharmacists and nursing-care workers.
The government aims to set up a team of doctors and public-health nurses who would visit the homes of patients in the early stages of the illness to provide advice and support for them and their families at all of the nation’s municipalities beginning in fiscal 2018. At present, they are deployed in 41 cities and towns. Improved community-level support through closer cooperation by medical and nursing care services is included as a goal.
A major point of the strategy, which calls for “creating an environment for people with dementia to lead a better life,” is its stated emphasis on reflecting the viewpoints of patients and their families in government policy.
It is a welcome development, given that discussions on policies for medical and nursing-care systems in this country are mostly driven by government bureaucracy and the representatives of doctors and care-service providers.
It is not clear whether the opinions of dementia patients and their families have sufficiently been sounded out in devising the new strategy in just two months. Listening to the opinions of patients and their families will be an ongoing process that should not end with merely compiling a new policy. The government needs to follow through on its words and take effective steps to make that happen.
In the final stage of compiling the strategy, some words are said to have been added to the text to play up the roles of mental hospitals in the treatment of dementia patients — reportedly at the urging of Liberal Democratic Party lawmakers backed by hospital organizations.
This smacks of political pressure at work to water down the new direction in government policy. Whether the government is really committed to the new policies in dementia treatment and care of the patients will be tested when the strategy is implemented.