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Saturday, Oct. 6, 2012

EDITORIAL

Future of senile dementia

The health and welfare ministry says that the number of elderly people suffering from senile dementia and in need of nursing care has topped 3 million this year. As Japan's population continues to gray, the number of such elderly people will inevitably increase.

It is important that average citizens have a correct understanding of senile dementia. Cooperation between them and experts must deepen within communities. For such cooperation to go smoothly, the public sector needs to make serious efforts to strengthen community nursing care services.

As of this year, people aged 65 or older now number an estimated 30.8 million — an increase of about 7 million in the past 10 years. This increase and the fact that more people have started to visit medical institutions for treatment of senile dementia are believed to be responsible for an increase in the number of senile dementia cases. According to the health and welfare ministry, the number of elderly people with senile dementia who need nursing care has more than doubled in the past 10 years — from 1.49 million in 2002 to more than 3 million in 2012.

Using data for 2010, the ministry estimated that there were 2.8 million such people in 2010 and 3.05 million in 2012, the latter group accounting for 9.9 percent of people aged 65 or older. It predicts that the number of such people will further increase in the future — 3.45 million in 2015, accounting for 10.2 percent of people aged 65 or older, 4.1 million in 2020 (11.3 percent) and 4.7 million in 2025 (12.8 percent).

In 2010, an estimated 50 percent of elderly people with senile dementia were receiving nursing care at home — the same percentage as in 2002. The ministry thinks that being able to live in their own communities while receiving nursing care has a positive effect on senile dementia sufferers. Therefore, the ministry is pushing a policy of improving the treatment and nursing care of senile dementia sufferers in communities, and encouraging those who are receiving care in hospitals or nursing care facilities away from home to go back to their communities.

The ministry in August instructed prefectural governments to improve medical and nursing care of senile dementia sufferers in communities so that about half of such people who have been hospitalized at psychiatric wards will be able to go home within two months of the start of their hospitalization. Currently the goal is to have half of such patients return home within six months of the start of their hospitalization.

In 2008, about 75,000 senile dementia patients were hospitalized, and about 52,000 of them or about 70 percent were in psychiatric wards. The ministry hopes its new policy will reduce unnecessary medical costs.

Prefectural governments are supposed to work out medical treatment plans for fiscal 2013 through 2017 in accordance with the ministry's instruction. The ministry also has instructed them to establish a senile dementia medical treatment center staffed by experts and readily available for diagnosis and medical advice in each zone having about 60,000 people aged 65 or older. It is expected that about 300 such centers will be established across the nation. If everything goes as well as the ministry hopes, its policy is understandable. Nevertheless, there is the danger that senile dementia sufferers will be released from hospitals that provide psychiatric treatment after two months even if they should remain there because their communities lack sufficient care facilities.

The ministry should pay attention to the fact that there is a shortage of facilities in communities to treat senile dementia sufferers. Under the ministry's policy, an early support team composed of nurses and occupational therapists will visit families that are caring for senile dementia sufferers. Caring for a senile dementia sufferer places a heavy burden on family members . The public sector needs to establish more community facilities that can readily receive senile dementia sufferers when their condition becomes unmanageable for family members.

Senile dementia sufferers with serious conditions should receive care in hospitals, intensive-care nursing homes or group homes. Those who are less ill should regularly visit hospitals or nursing care facilities.

The ministry also needs to push a campaign to encourage community members to help senile dementia sufferers and their family members. This is important because senile dementia sufferers may act violently, speak abusively and wander about. Great efforts will be necessary to ensure that families taking care of senile dementia sufferers are not isolated in communities.

There are several types of senile dementia. Among them are Alzheimer's disease, caused by brain shrinkage related to accumulation of irregular proteins, and vascular dementia, caused by such diseases as cerebral infarction and a stroke. It is difficult to cure senile dementia but, depending on the type, when diagnosed early its progression can be slowed.

Discovery and treatment of senile dementia at an early stage by expert doctors is important, but there is a shortage of medical experts. There is also a tendency among elderly people and their family members to delay visiting doctors when symptoms of senile dementia begin to appear, thinking that they are a normal part of the aging process. Elderly people are strongly encouraged to seek medical attention as soon as possible after they begin to exhibit strange symptoms or behavior.

While the onset of senile dementia may not be preventable, studies have shown that regular exercise and mentally stimulating activities can slow or delay its development. Therefore elderly people should be encouraged to remain socially and physically active members of their communities.



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