Early care for people with dementia eyed

JAPAN - The Health, Labor and Welfare Ministry plans to implement from next fiscal year measures to provide at-home care for people suffering from dementia to cope with the rapidly increasing number of people with the condition.

The new measures aim to enable people with dementia to live at home for as long as possible, by having teams of specialists visit their homes during the initial stages of the condition.

The ministry also hopes the measures will keep dementia sufferers from developing progressively worsening conditions that require long-term hospitalization.

The ministry will compile a five-year plan for the measures, which local governments will incorporate into their medical and nursing care plans.

Dementia refers to a typically progressive condition characterized by memory loss and deteriorated cognition due to the death or improper functioning of brain cells as a result of diseases or other causes.

There are several types of dementia, including Alzheimer's disease.

The government estimates that there were 2.08 million people suffering from dementia in 2010, and projects this number will rise to 3.53 million in 2030--indicating that about 10 per cent of elderly people will have the condition.

A central pillar of the new measures is the creation of teams comprising dementia specialists such as nurses, health care workers and therapists to provide care to people in the early stages of the condition.

The ministry plans to deploy these teams to about 4,000 nursing care consultation counters of local governments nationwide. The teams will visit the homes of elderly people who have shown symptoms of dementia, conduct interviews with them or family members and refer them to medical institutions if necessary.

For elderly people with the condition whose cognitive abilities remain intact, the team will explain how they expect the symptoms to develop and advise them on managing their assets and nursing care options.

The teams also will help them improve their living conditions, making such changes as replacing gas stoves with electric ones, and offer psychiatric care for family members of dementia sufferers.

Another pillar of the plan is "near-home" medical facilities for dementia patients, which will collaborate with the specialist teams. The ministry plans to designate 300 clinics and small and midsize hospitals for the purpose.

There have been many cases in which dementia sufferers whose symptoms escalated to include wandering and violent behavior were asked to leave nursing care facilities, and were subsequently hospitalized.

To prevent this, the specialist teams will not only visit the homes of dementia sufferers, but also relevant facilities to improve the quality of treatment and care. As a result, the ministry also will consider whether to raise medical service fees at these facilities.

These measures to deploy teams of specialists and designate near-home medical centers will be reflected in municipal governments' nursing care insurance plans and prefectural governments' regional medical care plans.

The ministry will begin trials of the system in several areas across the country this year and will produce manuals on available assistance methods.

Following the trials, the ministry aims to introduce the measures across the country. But a major obstacle remains over how to secure and develop the necessary human resources.

Britain launched a similar initiative in 2009. As a result, the number of hospitalizations due to dementia in areas where the measures were implemented was one-third that in areas without the measures.

As there have been past cases in which excessive medication has resulted in worsening symptoms, the ministry also will draw up guidelines for treatment using medication.