| Kanoko Matsuyama |
OSAKA, Japan (WP-BLOOM) — Asayo Sakai banged on the front door, demanding to be let out.
She was at her daughter’s apartment, where Asayo has lived for the past six years. She has no memory of how she got there or what she’s doing there.
As her daughter, Akiko, blocked the way, Asayo, 87 and suffering from dementia, lashed out, hitting and biting.
The scene repeated itself with agonising predictability for a solid year until one day Akiko, exhausted, gave in and opened the door, letting Asayo wander the streets of Osaka’s busy financial centre in western Japan.
“I thought, get out of here, if that’s what you want,” Akiko said. “Mom turned into a monster and I couldn’t handle her. I thought my life was over.”
What happened next taught Akiko things she never knew about her mother — and herself.
Asayo’s walks lasted hours upon hours and into the early morning. At first, her daughter followed from a safe distance.
When police assured her they’d try to keep an eye on Asayo, she let her mom roam around the city alone.
It was a risky act of desperation. Yet Akiko soon discovered within her own neighbourhood how Japan is trying to become more dementia-friendly.
In 2013, the government started a programme that helps families and communities deal with dementia sufferers on their own. Businesses are helping as well.
Asayo’s story provides a glimpse of where Japan’s policies may be headed, how far the country still has to go, and the extent to which it is providing a roadmap for other countries.
Akiko is among the tens of thousands of Japanese grown children and other caretakers who, lacking access to nursing homes or sufficient help at home, have been pushed to their psychological limits.
“People are desperate to find ways to handle dementia patients,” said Hiroko Sugawara, who runs a government-funded educational campaign on dementia.
That dynamic has given rise to a growing elderly care crisis in Japan, where an estimated 10,000 seniors with dementia go missing a year. Some disappear for years, others never return or are eventually found dead.
Caretakers have snapped, injuring or even killing their loved ones. In 2012, 27 seniors in Japan were murdered or died from neglect, although it’s unclear how many suffered from dementia.
The number of seniors abused by family members jumped 21 per cent to more than 15,000 in 2012 from 2006, half of whom suffered from the condition, according to a Japan Health Ministry survey.
While other countries are ageing, none have done so as rapidly as Japan, where an estimated eight million people suffer from dementia or show early signs of developing the disease. That’s about six per cent of Japan’s population.
By 2060, 40 per cent of Japanese will be over 65, up from 24 per cent today, according to National Institute of Population and Social Security Research. And as the population ages, the proportion of tax-paying workers will decrease relative to the swelling ranks of dependent seniors.
Funding for the stay-at-home programme, at just US$31 million this fiscal year, is low compared with spending on the disease by other developed countries.
At the same time, the government has been raising premiums and reducing access to state-funded services as part of a broader effort to reduce spending, adding to caretakers’ difficulties.
Yet the concept of care that is more humane and less expensive than locking up patients in nursing homes is one that experts say holds promise.
As families struggle with their loved ones at home, businesses are also striving to adapt as shoppers age.
Dementia patients tend to buy the same products over and over again, said Kimika Tsukada, a manager of social affairs at Aeon Co, Japan’s largest retailer. They open food packages in stores, eat without paying, and get lost in shopping malls, Tsukada said.
Banks also pose a challenge for forgetful seniors.
Elderly customers forget PINs for ATMs or where they’ve put passbooks, said Yuriko Asahara, for two decades a Tokyo suburban branch manager of Japan Post Holdings, the country’s biggest holder of bank deposits.
Asahara recalled a 76-year-old woman who lost her passbook nine times in a few weeks. She has been regularly accused over a 20-year period of stealing money by another woman now in her 80s.
The growing number of elderly with dementia wandering Japan’s stores have resulted in some unusual caregiving arrangements.
Asahara sometimes helps customers who’ve lost their way get home. Or she helps them replace missing keys, or decipher complicated utility bills.
Both Aeon and Japan Post Holdings have programmes to teach sales clerks and staff how to handle customers who show signs of dementia. Retail and bank employees are among the 5.4 million Japanese who have taken the government-funded courses.