Today I am honoured to be welcomed by the Mayor of Uji City, a city famous for its world heritage site including Ujigami Shrine and the Byodo-in Temple and producing Uji-cha, one of the most popular brands of Japanese green tea.
However there is another reason for visiting Uji City. In a declaration made by the Mayor in March 2015, the city is working towards ensuring that its residents enjoy the “longest healthy longevity in Japan” and developing “a dementia-friendly city.”
I am here today to meet the local health ministry, health and social care staff and people with dementia to hear more.
Uji city has a population of approximately 190,000 people, of which 48,000 peole (approx 25% of people aged 65 or over). Their vision for a dementia friendly city includes the following:
- A city which does not exclude people with dementia from the community
- A city which comes together as a community to support families providing care for people with dementia
- A city where people with dementia feel comfortable to talk about their condition
- A city where people with dementia can receive the medical treatment and care which are correctly suited to their respective symptoms while they are still at an early stage
- A city where people with dementia can participate in community activities
- A city where people with dementia can be themselves
- A city where people with dementia can live at ease
Dr Toshio Mori, a psychiatrist specialising in dementia, advises that overcoming obstacles that prevent people with dementia from arriving at medical treatment and care at an early stage is key to Uji City meeting its vision. He describes these obstacles as “entry problems” which can be as a result of a negative image of dementia, poverty, isolation, people with dementia refusing intervention, and complex family issues. He says that even when people with dementia arrive at a source of medical treatment or care, they can be excluded from receiving such treatment or care, for example due to the support frameworks being under developed or not yet available. Uji City is making great progress in tackling these entry problems and is receiving much attention internationally. As part of the dementia legacy event in Japan in 2014, G7 colleagues visited Uji City to hear about their vision and progress. I hear about some of the developments including approaches to identification of people who need support, specialist assessment tools, early stage intensive support visits, outreach support and of course the Lemon Cafe.
I am introduced to members of the dementia working group, people with dementia from a range of different professions and backgrounds but with the same ambition: to improve the lives of people with dementia and their families. One of the members represented Japan in the last Olympic Games in Tokyo, another a classical guitarist, a professor and a general manager. I am inspired as I hear from the members and their families about how they are being supported and supporting each other to live well with dementia.
I see a clip of them playing tennis together and I watch smiles around the room as everyone remembers these happy occasions. Most had never played tennis before but now they are bonded by friendship rather than a diagnosis of dementia. I hear about the Lemon Cafe and how this provides a place in the community for people with dementia and their families to come together. The lemon cafe is held in 6 locations throughout the city. Dr Mori tells me that the cafe provides a place where people who have concerns about dementia or family members can ‘casually’ seek advice without having to visit a medical or nursing facility. The cafe also acts as a forum for community residents and specialists to learn and develop a sound understanding of dementia by meeting and interacting with people with early-stage dementia. Dr Mori says “Together these objectives create a place in the community which bring together people with dementia, family caregivers, specialists, and community residents, which in turn develops into a visible care network.”
I watch a clip of the dementia working group and their families picking tea leaves on a day out with Dr Mori and colleagues. They are all having such fun and there is laughter and smiles around the room as we watch the clip. I then have a nice surprise as it is time for tea, but not just any tea, this is from the very leaves which were picked that day – the best tea I have had since arriving in Japan! As we drink our tea I ask people with dementia about the differences which are being made in Uji City. I feel moved as they reflect on their initial experiences of getting a diagnosis of dementia and coping with this diagnosis at a time when there were not the support mechanisms they have now. They tell me that the work they are doing now to support the changes in Uji City is not only benefiting them but also provides people with hope for the future. As we drink our tea together I am so grateful to have this experience of meeting such inspirational people who are testament that there is a positive life after a diagnosis of dementia.
Thank you to the wonderful staff at the Health Ministry at the City Hall in Uji, Dr Mori and the dementia working group for an amazing day!