On a moderately crowded train, I’ve just woken up after dozing off, but I can’t remember where I am or where I’m going. Apart from the noise of the moving train, it’s quiet, and the other passengers are half asleep, fiddling with their phones or spacing out.
I realize I was supposed to get off somewhere … but where? At the next station, passengers disembark. We start moving again. As the train picks up speed, I feel increasingly nervous. Should I get off at the next stop? The train comes to a slow halt, and some people rise and head for the doors. I feel compelled to follow. I’m on a station platform, but at which station? Where am I?
This is what unfolds in one of the virtual reality dementia simulations created by Silver Wood Corp., which operates apartment complexes for the elderly.
I recently wore a VR headset and goggles to watch the video at the Silver Wood head office in Tokyo. Though the clip lasted only about five minutes, it was an amazingly immersive experience. I could feel myself growing tense as the train passed a station and sped up. When I stepped out of the train, my fear and anxiety levels reached a climax, and tears welled up.
“People’s expressions are completely different before and after they see the video,” said Tadamichi Shimogawara, president of Silver Wood.
The 46-year-old started making VR simulations about dementia last year, feeling they would be an effective tool to change the overwhelmingly negative image of the progressive illness, which is characterized by memory loss and declines in other cognitive functions.
According to a 2015 health ministry-commissioned study, 4.62 million people in Japan were estimated to have dementia as of 2012, a number projected to swell to 7 million, or 1 in 5 people over age 65, by 2025.
Shimogawara long ran a family business making construction materials; it was only seven or eight years ago that he started building and renting apartments for the elderly in and around Tokyo. As he studied how to best serve the occupants, about 60 percent of whom have dementia, he said he found that conventional housing and care arrangements were robbing them of freedom and independence.
In conventional housing for people with dementia, he said, doors are locked to prevent residents from wandering outside and getting involved in an accident.
“But if you were someone with dementia, would you want to be stopped from going outside?” he said.
Shimogawara said he was also put off by the way many care facilities treat elderly residents as if they were small children, putting up cheesy birthday announcements on the walls, having them sing children’s songs or tossing otedama (bean bags) for recreation. “Why children’s songs? Some people might want to listen to the Beatles instead,” he said.
“Many facilities also go overboard with care. They would do everything for the residents, because it’s easier for them that way. I feel such bad practices have ended up worsening the conditions of people with dementia. And by confining people in the facilities, giving them little freedom to interact with society, many of us (people without dementia) only see dementia in a negative light and have only fears about developing it.”
At Silver Wood’s 12 complexes for seniors, the doors are always open, with occupants given complete freedom to go outside.
“For some people it takes about an hour to get to a nearby convenience store — a distance covered by us in five minutes — as they walk slowly and get lost sometimes,” Shimogawara said. “But that’s OK. We will never put tags or sensors on them either; we will go looking for them only if they don’t return in two or three hours.”
All Silver Wood facilities are also equipped with low-priced candy stores, with residents serving as clerks. The premises are always busy with local children stopping by, Shimogawara said.
The VR project came out of his belief that, with creative ideas and adequate support, people with dementia can live happily and with dignity.
“When we talk about dementia, we often talk from the perspective of how to deal with these people who cause trouble to society,” he said. “But in reality, if we put ourselves in their shoes, it becomes clear that they are not trying to wreak havoc on society; they are just having difficulties (with certain tasks).”
The simulations do not intend to present a definitive form of dementia, Shimogawara said, though they were created with ample input from — and interviews with — people with the illness. Rather, they are aimed at helping viewers expand their imagination so they can empathize with sufferers more and start thinking about how to live with dementia instead of how to prevent it.
So far, the firm has shown the videos to more than 10,000 people at various viewing events across the country, at the request of municipal governments, medical institutions, nursing care operators and even some corporations.
The firm, where all but one of the six VR video production members had no previous background in cinematography, has created eight short simulations so far, including six on dementia. The other two are not related to dementia, or even an illness. One is a video documenting the life of a working mother in Japan, aimed at conveying the challenges of juggling a family and a career. The other is about an elderly person approaching the end of life, who is taken to an emergency room for over-the-top life-saving procedures, like CPR that results in fractured bones. The latter video is intended to help families discuss end-of-life choices, Shimogawara said.
He said that in the future he wants to investigate various social issues around the world and create VR videos about what he finds.
“I feel VR has a huge potential to change society,” he said.
A Matter of Health covers current research, technology and policy issues relating to health in Japan.