Toward a society where people with dementia ‘living alone’ or ‘being a minority group’ can live well

Abstract

Dear Editor, In 2009, the UK government declared that they were pursuing the groundbreaking concept of ‘living well with dementia’ as a national strategy, at the end of a long flight powered by only the singleengine of ‘dementia prevention’. Following this idea, the Japanese government announced their national dementia strategy, called the New Orange Plan, for the promotion of communities friendly for the elderly, including persons with dementia. In the national dementia strategy, the building of dementia cafés is encouraged to strengthen support for daily life and families in the community. We highly appreciate that the Japanese government is in the process of creating places where people with dementia can interact with society. However, although empirical data are lacking, from a clinical perspective, people with dementia who are living alone often tend to be secluded. In addition, people with dementia who belong to minority groups (e.g., sexual minorities, refugees, immigrants) are less likely to participate in such places. On the other hand, the UK Alzheimer’s Society, which has been promoting living well with dementia, is reaching out to people with dementia who are living alone and those with lesbian, gay, bisexual, transgender, and questioning backgrounds. In addition, Dementia Australia is focusing on support for people with dementia who belong to culturally and linguistically diverse groups. Recently, we had the opportunity to give a lecture on living well with dementia to 48 local welfare commissioners (12 men, 36 women). As part of data collection for a reaction paper we asked if there were any places or activities in the community where the following people could participate: (i) people with dementia who live with their families; (ii) people with dementia who live alone; and (iii) people with dementia who belong to a minority group. The percentages of those who answered ‘yes’ to these questions were 36%, 32%, and 17%, respectively. These results require careful interpretation. First, only about one-third of the respondents knew of any places or activities that people with dementia who live with their families could go or participate in. Because we lacked controls, we could not judge whether this result was high or low compared with the general population. Second, in the case of people with dementia who live alone, the number of places or activities that they can participate in is smaller. Third, people with dementia who belong to a minority group are typically excluded according to the rights of social participation. We believe that psychiatry serves the most disadvantaged and misunderstood individuals in society. Japanese society is now gradually moving toward having dementia-friendly communities where people with dementia can live well; however, the focus is still needed on people with dementia who live alone or are in a minority group because these individuals are often excluded from society.