When Gustav Standell first visited Japan from his native Sweden in 1997, he found nursing homes hidden away in the countryside looking more like hospitals than homes.
“There was no privacy and it was impossible to live anything resembling a normal daily life,” he told HelloCare.
But Mr Standell knew that the situation had been the same in Sweden up until the 1970s, and the Swedish system had been able to change.
Japan’s system was also on the verge of change, and in the 1990s, many working in the Japanese aged care industry looked to Sweden for inspiration.
Thousands of Japanese aged care experts visited Scandinavian countries in the 1990s to investigate a “community-based” model of aged care.
Today, Japan and Sweden’s aged care and dementia care systems are “very similar”, said Mr Standell, who is now the CEO of Japan’s exclusive Maihama Club Nursing Home.
A ‘Community-based Integrated Care System’ provides health care, nursing care, prevention, housing and livelihood support all within the local community, Mr Standell said.
‘Municipal Committees’ ensure cooperation between different providers, such as hospitals, clinics, nursing homes, and home care.
A ‘Dementia Supporters Program’ teaches children, students, adults – anyone in the community – the basics of dementia care and promotes understanding.
One of the most successful features of the Japanese system are the local Dementia Cafes, which create a “relaxed environment” for those living with dementia to meet up with family, to discuss care needs, or simply to have a good time!
‘Simulated training programs’ are performed to show people ways to to quickly find people living with dementia who may have walked outside their usual domain.
‘Dementia Working Groups’ are led and run by people living with dementia, and create local platforms where their voices can be heard directly.
Community-based Integrated Care Systems have been taken up by more than 11 million people across Japan.
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The YouTube video at the top of this article shows two example of community-based care in Japan at two exclusive nursing homes, The Maihama Club and Orix Nursing home.
Residents are encouraged to recreate their own lives as much as possible at the facilities, to foster a sense of comfort and familiarity. Residents can bring their own furniture into their rooms.
They are encouraged to keep taking part in activities they enjoy. Beauty salons, calligraphy classes, tea ceremonies, shopping, and music-making sessions are all available to residents.
Single or couple rooms are available.
Chefs prepare food on site, and know the preferences of all the residents. Some chefs have a background working in Michelin star restaurants!
“A good meal can be, for some of our residents, the number one joy of the day,” Mr Standell says in the video.
The building is designed with large, low windows, so even those residents in wheelchairs can see the views outside.
“The great achievement [in Japan] is that it is today fully possible to live your entire life in the local community, whether you have dementia and are in need of end-of-life care, or not.
“This was not possible in Japan until the 90s,” Mr Standell said.
In Sweden, the aged care system is funded by the government through taxation. In Japan, aged care is financed through a combination of taxes and long-term care insurance.
Mr Standell said all too often the attitude in society is that if you are diagnosed with dementia, “life is somehow over”.
But he says a community-based approach can greatly improve the quality of life for people living with dementia.
Their attitude tends to become, “My life is meaningful, and I will live my life with pride until the end,” Mr Standell said.
The way we care for older people in Australia and those living with dementia has also evolved in recent years, Mr Standell said, but added he’d like to see community-based approaches become the “standard”.
This topic will be covered at the a, Future of Home and Community Care: The Swedish-Japanese Approach to Enabling Community Ageing-in-Place, being held 12-13 March 2019, Melbourne. For more information visit their website.
Very interesting reading about the facility in Japan; and Sweden has a great reputation of getting it right for the residents in their facilities; I am curious about the staffing levels in these facilities; do they employ many staff to meet the needs of the residents, it often sounds great, beautiful well appointed modern building, but never enough care staff on the ground to meet basic needs, as they are needed. I would love to see more facilities in Australia that put their residents needs first before profits, ensuring that there is enough staff on any given shift to take mum and dad to the toilet when they need to go, to ensure meals are completed no matter how long it takes and not whipped away because the kitchen staff are waiting to clean the dining room.
The Swedish-Japanese approach sounds awesome.