As we walk down the street in Suginami one of Tokyos suburbs, all the houses in the street look the same. We stop outside one of the houses and my colleagues inform me that we have now arrived at the day care centre for people with dementia. There is a small sign at the door which is the only indication that this is no ordinary house! I have come here with colleagues from the Ministry of Health in Japan and Ms Yumi Shindo from the Dementia Care Research and Training Centre in Tokyo.
We receive a warm welcome at the door from Shimada, Kawai and Okumura (Director and staff from Professional Works Day Centre). We exchange our shoes for slippers and we go upstairs to a traditional Japanese style room with a low table and cushions on the floor. We exchange business cards and make introductions. The house was built 40 years ago and was once the family home of the day centre director. People of all ages and stages of dementia attend the Professional Works Day Centre. These are people from the local area and many of them have lived in the same style of house so the layout is familiar to them are as the people who have been their neighbours. People arrive for 10 am and leave at 5 pm. We see photographs of the people undertaking daily activities. The centre has its own transport so they are often out and about going shopping or for a picnic.
What is special about this day centre is that there is no pre-planned itinerary or list of activities, the people with dementia themselves decide how they would like to spend their day and the 5 members of staff are there to support their needs. People can have a bath and this can be at the time that suits the person rather than as part of a schedule.
We enter the main room of the house with an open plan kitchen, dinner table and seating areas. There is a quiet area which can be screened off if required should anyone need quiet space or privacy. We meet a 101 aged lady who is folding small towels which she is placing into a basket, the staff thank her for her help and she smiles. There is a real sense of people supporting and helping each other and of people feeling valued by contributing to meaningful activities. At a small table a man is listening to 60s music – this is music he has chosen himself and is enjoying this whilst drinking his tea which he pours from a traditional Japanese teapot. He smiles and makes a joke about having shaved if he had known I was coming. I advise him that beards are the height of UK fashion these days! We get our photo taken together. Another lady decides it’s too nice a day to be inside and her and a member of staff go outside to chat in the sunshine. At the table, a few of the ladies decide they would like to make pancakes. The member of staff asks the ladies what they need for their pancakes and they go to the fridge and choose their ingredients together. The hot plate is set up on the table within easy reach of the ladies, and the ladies begin to put together their pancake mix. One lady decides to whisk her mixture with chopsticks. There is such joy on these ladies’ faces as they chat together. People of differing abilities support each other. Each person around the table has a contribution to make to the pancakes and they use scissors and a knife without panic from care staff. One lady is struggling to reach the pancakes and despite being frail, she stands up and has great joy in flipping over the pancakes. The staff do not take over, they are there to support and to ask questions to prompt people to come up with their own solutuions, promoting a sense of independence. The staff explain that these tasks have been done by people all of their lives and so they know what they are doing and now just need a bit of encouragement and support to continue to do the things they enjoy.
As we leave the day centre after saying our goodbyes I reflect with colleagues on how homely the environment is. It just feels like a group of neighbours meeting to catch up at one of their houses, but this is certainly no ordinary house and the compassion and patience shown by staff is so palpable in supporting people to do what matters to them without any pre-planned schedule or checklist.
Thank you to Yumi for organising such a fascinating visit, for translating for me and to the staff at Professional Works for their warm welcome.