When Dementia Training Is Mandatory

Shopping and elderly woman

Hiroyuki Yamamoto, 69, spends his mornings at a busy intersection in the city of Matsudo, near Tokyo, Japan, where he volunteers as a school crossing guard. One morning, he saw a disoriented woman crossing the street. He spoke to the woman, who was trying to get somewhere by foot that was four hours away by train. He recognized that the woman had several signs of dementia he’d learned about when he took his city’s dementia awareness training. Because of his training, Yamamoto knew exactly how to talk with and assist her, until her caregiver arrived. If he hadn’t known what to do, she could have gone missing, or worse.

At a Japanese shopping mall, Kanamaru Haruko, General CSR Division Manager of AEON (Japan’s largest retailer) explains how more and more shoppers with dementia were getting caught for shoplifting. According to Haruko, “(t)hey would leave the mall without paying for their purchases, and other times, they would eat food they had not paid for. Others would sometimes circle shops for hours on end, getting lost in the mall.” Similar to Yamamoto, Haruko and other employees are knowledgeable on the cognitive disease due to the extensive training thousands in Japan have received on how to deal with dementia. Because of this training, these employees are familiar with just what to do when those affected are wandering, buy the same items excessively, seem disoriented, and more.

Dementia Training in Japan Has Become National Policy

According to the Japan Times, 4.6 million of Japan’s silver generation have been diagnosed with dementia. This constitutes 15% of its elderly population. Within the next 10 years, at the country’s current rate of aging, the number of dementia patients is expected to reach 7 million. For comparison, in the U.S. approximately 5.2 million people currently have dementia, and that number is projected to triple by 2050, barring the development of medical breakthroughs to prevent or cure the disease.

To serve its elderly population better, Japan has made dementia training a national policy. And the country is on track to train 8 million people by the end of the next fiscal year.

The strategy was put together after Prime Minister Shinzo Abe spoke about dementia at an international conference held in Tokyo in 2014, and subsequently gave the order to the government. The mandatory training initiative expands on the Health, Labor and Welfare Ministry’s five-year program started in fiscal year 2013. The training is designed to educate Japan’s citizens and empower everybody to support and integrate dementia patients into a more inclusive society. The purpose of the training isn’t to make residents experts in dementia. It is just to support those with dementia, as well as their families, and make each town a town where it’s more comfortable for them to live.

The hope is that “interacting with people with dementia will become normal. It would be a familiar thing,” says Hidenori Kawashima, deputy director for dementia policy in Japan’s Ministry of Labor, Health, and Welfare. “So we wanted the plan: First, to create a structure in the local communities to support those with dementia and, second, to create a society where it will be natural for them to live.”

What Kind of Training Do Citizens Receive?

Japan’s Dementia Support Caravan Ninchisho Supporters Training educates citizens to understand how dementia patients live and view the world. The training takes a three-tiered approach: 1. Medical professionals specializing in dementia train Caravan-Mates in a 6-hour workshop; 2. Caravan-Mates train Ninchisho Supporters; 3. Ninchisho Supporters provide support within their community.

The Ninchisho Supporters Training for the public is held at schools and offices and for community groups across the country. The seminar covers the following key areas:

During the seminar, attendees learn about the disease itself, how it affects the lives of those living with dementia, and what they should know in order to effectively support people with dementia. Standard text and video materials are used nationwide for the seminars, with variations according to the attendee groups (for example, schoolchildren). By the end of the program, attendees are expected to have a good understanding of dementia, freeing themselves from any prejudice they may have, and to become supporters and advocates for those living with dementia in their everyday lives. Those who attend the seminars become Ninchisho Supporters and receive an Orange Ring bracelet.

● recognition of the symptoms of dementia;
● diagnosis and treatment;
● the role of each health care professional;
● prevention;
● attitudes towards people with dementia; and
● understanding of the caregiver experience.

Almost 5.5 million people in Japan had attended the seminar as of September 2014 and, by 2015, almost all local governments in Japan were running a dementia friendly community program

Currently, in the U.S., the Alzheimer’s Association offers both online and classroom training for professional care providers. Their training programs utilize the practice recommendations described in the Alzheimer’s Association Dementia Care Practice Recommendations which promote the principles of person-centered care.

The Alzheimer’s Association also offers the CARES® Dementia Care Online Training in the Basics™, Advanced Care™, Dementia-Related Behavior™, and Activities of Daily Living™. These training programs offer the additional option of the Alzheimer’s Association essentiALZ® certification, an online individual certification program providing recognition for knowledge of quality dementia care practices.

Lastly, Foundations of Dementia Care provides classroom training in critical care areas.

However, unlike Japan, the United States does not have a national public policy aiming to educate all Americans about the effects of dementia. In this political season, perhaps this is a topic that people should be talking about.

Medicaid Asset Protection

Mandatory dementia training isn’t an option in the United States at this time. So, what should you do to make sure your loved one with dementia is safe and well cared for, without going completely broke (Nursing homes in our area cost $10,000 – $14,000 a MONTH!)

At the Farr Law Firm, we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones.  We help protect the family’s hard-earned assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits such as Medicaid and Veterans Aid and Attendance. If your family is facing an aging crisis, please call us as soon as possible to make an appointment for an initial consultation:

Fairfax Dementia Planning: 703-691-1888
Fredericksburg Dementia Planning: 540-479-1435
Rockville Dementia Planning: 301-519-8041
DC Dementia Planning: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.