By Yui Tateishi
About a dozen people line up in front of the restaurant, even before it opens at 11:30. They are getting lost in conversation, being lively inside the restaurant. Nine older women in off-white aprons are serving dishes and clearing the tables.
“I would like to order a drink,” says a man sitting with another man.
“Would you like to drink alcohol?” 87-year-old Ms. Tomiko Nishimoto asks.
“I came here by car,” he replies,
“You need to come here on foot next time,” she says, and she has worked lively with smiling.
Conversely, “Why did you just bring me up here, even though my feet hurt?” 81-year-old, Mrs. T asks. Several days later, she read about this event on the Kochi newspaper, and then she foams with anger. “I am not dementia, shame on me!” she said.
Ms. Tomiko is a patient with advanced dementia. The group home “Tsukushi-no-Sato” is a home for her.
“Why are you turning on the light of my house? What are you thinking?” she asks the staff angrily every night.
On the other hand, Mrs. T is an incipient of dementia, so she could read books and often write a diary. She doesn’t want to acknowledge that she is dementia.
Although they are the contrastive types of demented patients, they are the same nursing care level 1. Nursing care level is the criterion of how much care do they need. Those levels divided into five stages. The higher the level, the more care become to need. “The number of times they could get the service” and “The maximum payment pertaining to an allowance for preventing long-term care service” are different by the level.
The two women participated in this event that opened just one day and first in Shikoku in 2019 May 5th at Kochi City Culture-Plaza Cul-Port the first-floor Restaurant “Tendre Table.” The professionals are in charge of cooking, and about 30 volunteers supported them.
The care manager of “Tsukushi-no-Sato” Ms. Yuriko Yamasaki said about two importance of this event.
First, “Earning money” is significant for the people who were working in the past. They spurred on by interacting with a lot of people. Dementia patients forget their experiences, but the pleasant emotions are memorable.
Second, “It was a great learning opportunity for us. We failed Mrs. T.” She said. It hurt Mrs. T’s pride because it was a time to realize that she could not do as she used to work in the dining room.
The current situation of dementia in Japan is serious. According to Cabinet Office, in 2012, the number of elderly dementia patients was 4.62 million (morbidity prevalence rate 15.0%), it shows that one out of seven over 65 years old people. Its population is estimated to be about 7 million in 2025, and it means that one in five. Dementia people are expected to increase.
In 2019 June 18th, according to the Ministry of Health, Labor and Welfare, the government decided a new outline to enhance the dementia countermeasures. They set the target period for 2025 that the baby-boom generation will be over 75 years old as I have said above. The two main components of “Prevention” and “Coexistence” are indispensable in this outline.
There are two things suggested that might prevent dementia. First, exercise will prevent lifestyle-related diseases such as diabetes and high blood pressure. Next, reduce social isolation by maintaining participating in society.
To help people cope with dementia, there are four things to do. First, train supporters of dementia. Second, expand the course for employee of retail business, public transport, and financial organization. Next, promote the understanding of older adults that contain dementia people through school education. Finally, “to keep everyone informed about the community general support center and medical center of the demented patient.”
Amid the severe situation that the Japanese government raises the alarm, what do we need? Ms. Yamasaki says two important things.
First, to continually be conscious of income’s origin as for the staff members. In “Tsukushi-no-Sato,” there are 18 users, and the cost is 70-100 thousand yen per person a month. Therefore, sales are less than 1800 thousand yen a month. However, there are 18 regular staffs, and sales are not enough to pay a salary for them. But it is greatly assisted by nursing care on sickness insurance.
“I realized that most of our salary comes from public money after I became an administrator.” Ms. Yamasaki said. Complicated and hard work is not only the nursing care profession but also a childcare worker and so on. There are some companies habitually flouts labor regulations. “We are blessed,” Ms. Yamasaki said. To know these things and to consider how we should use this money through working are essential for nursing care staff.
Second, to think it will be all right. The number of Alzheimer’s is most common in dementia patients. Usually, a human’s sight will get worse, and legs will start to weaken with the advance of age. Alzheimer is not the only thing we need to fear.
The cause of Alzheimer is that the frontal lobe filled with Amyloid beta, and that will change, then the brain atrophy will be progressing. Therefore, professions make advances in studies of Alzheimer that the way not to filled with Amyloid bate and not to change. Thus, dementia is projected to heal several years later.
On the other hand, Dr. Bredesen, the former professor of California, finds the novel therapeutics that called “ReCODE.” He says that 90% recovery of a cognitive function looks promising in the case of early Alzheimer. The therapeutics so far were just able to delay the progression of Alzheimer. But this new method heals “The 36 cause of Alzheimer” by improvement in our lifestyle of “meal, sleep, and exercise.”
Ms. Yamasaki spread the information about dementia through “Tsukushi Cafe” that held once in a month in Tsukushi-no-Sato. It is a 7th anniversary this July, and a time to talk over a cup of tea.
That is not just a place to talk. For instance, professionals such as doctor or city worker give a lecture, or the husband of one of the patient’s daughter does a magic trick. Also, they could do exercise together for their health that called “100 years exercise” started in Kochi. (Please refer to following three PDF about 100 years exercise)
We do not have to be afraid of dementia. By increasing the environment that accepts something even if it is a little difficult, and the people who could think it is not a problem.
“My dream is that patients could tell pharmacists the part of the brain affected, such as frontal cortex, lobus occipitalis, and then receive medicine as easily as medicine for colds or knee pain,” Ms. Yamasaki said.
September 21st, that day is World Alzheimer’s Day. On that day, the event is going to hold again in the cafeterias of Tosa Rehabilitation College. “I know that it may sound imprudent, but I am looking for to go with users,” Ms. Yamasaki said.
“Thank you for coming,” “Where do you live?” “I am sorry that I cannot make tea.”, Ms. Tomiko talks to me incessantly in “Tsukushi-no-Sato” as their home. Dementia women surely will make customers smile next month, too.
“Aging Situation,” Cabinet Office, July 6th, 2019
“100 years exercise,” Health and Welfare Department of Kochi City, July 20th, 2019