Dementia cafes in Japan: Nurturing hope and dignity amidst an aging society

J-STORIES - Japan, characterized as a “super aging” society with 29% of its population over 65-years-old is viewing dementia cafes as a solution to keep its elderly population healthy and reduce social service spending.

Dementia cafes are managed by volunteers supporting people with cognitive decline who entertain customers such as playing the piano or wait staff. The concept has taken off leading to a high of 8000 registered cafes in the country according to Japan’s Dementia Care Information network. Tokyo, Japan’s affluent capital, alone has over 600 cafes located in the 23 wards with a population close to 14 million.

D-cafe, located in Meguro-ward, Tokyo     Source: D friends Machida — D-cafe, located in Meguro-ward, Tokyo Source: D friends Machida

The cafes provide a social role for people with early-on-set Alzheimer’s. They are mostly registered on a non-profit basis and operate in private houses, museums and in tourist areas, but many are also “POP-UP'' style. In all of these cafes, mistakes are viewed humorously by everyone.

Fostering the concept of living with dementia is a major government policy landmark that is keen to curb public welfare spending against declining tax resources. Japan’s “Baby Boomers” are currently in their seventies and official estimates of elderly people with dementia are expected to climb to 7 million, about 20% of the population aged 60 and over by 2025. The Japanese government estimates that by delaying the onset of dementia in people in their 70s by one year from the current rate, the proportion of people with dementia would decrease by about 10%. The government has set a target to increase that percentage to 16% by 2025.

Customers experiencing a pottery event     Photo by Suvendrini Kakuchi — Customers experiencing a pottery event Photo by Suvendrini Kakuchi

The expansion of dementia cafes, supported by local government budgets, are seen as an innovative way to, albeit long-term, meet that goal. In 2019, the central government drew up a framework with “prevention” and “harmonious living” as its two pillars. Dementia Cafes are modeled after the Alzheimer Cafes, a movement that began in the Netherlands in 1997.

Ongoing research has pointed to changes in brain functions when people with dementia are socially engaged. Leading the studies is expert, Professor Satoko Hotta, who in 2018 launched “Designing for Dementia Hub” at the Keio University Graduate School of Health Management.

Its project data reveals a growth in confidence and independence in people with cognitive decline when they are socially active and allowed to live in their own communities. The research showed that affected people started to go for walks alone or expressed their opinions rather than staying silent that worsened their symptoms.

D-cafe's shop board     Source: D friends Machida — D-cafe's shop board Source: D friends Machida

In addition, family members and caregivers participating in Hotta’s research linked the changes in people under their care to also easing their own burden, such as shifting to home care instead of residents in nursing homes. The Keio University project is in collaboration with people with dementia, care givers, doctors, families, businesses and municipalities.

D-café in Meguro-ward, central Tokyo, is a non-profit business and the recipient of a subsidy by the Tokyo Metropolitan government under its official five-year Orange Plan, promoting integrated community-based solutions for dementia.

Volunteers supporting Dementia Cafes     Photo by Suvendrini Kakuchi — Volunteers supporting Dementia Cafes Photo by Suvendrini Kakuchi

Hiromichi Takeuchi, the owner of D-café, explained in an interview that his cafe is supporting people with memory loss and volunteers. “We provide a relaxed cafe-style environment to encourage dialogue which is important to end the debilitating isolation of people with dementia. The participation of their families and supporters has also raised awareness of the need to accept people in their care as they are.” he said.

In 2022, the government's budget for Dementia Prevention and Support for Dementia People in Society climbed from 12.7 billion yen ($89.2 million) to 13.2 billion yen ($92.7 million) this year, according to the Ministry of Health and Welfare.

Leadership by the government has also created a new Basic Act for Dementia to Promote Creation of an Inclusive Society in 2023. The legislature states the rights of people with dementia to live with hope and dignity. Japan has also designated the third Monday of September as Respect for the Aged when seminars for awareness raising are held.

Customers at D-cafe     Source: D friends Machida — Customers at D-cafe Source: D friends Machida

Another major concern for Japan is dealing with the severe lack of caregivers, estimated to reach only 320,000 by 2025. Dementia Cafes that have reduced dependency on institutional care are recognized as a breakthrough.

Japan's culture of caring for the elderly is also a key in the success of Dementia Cafes in the country. According to a U.K. observation study report titled, “Lessons from Japan,” published in 2017, experts described their visits to Dementia Cafes in Tokyo as exceptional, citing the warm support by volunteers that has weakened the stigma against Alzheimer’s.

Research data reveals a growth in confidence and independence in people with cognitive decline when they are socially active and allowed to live in their own communities.      Photo by Suvendrini Kakuchi — Research data reveals a growth in confidence and independence in people with cognitive decline when they are socially active and allowed to live in their own communities. Photo by Suvendrini Kakuchi

Takeuchi added that Dementia Cafes are crucial to contribute to the development of a diverse society that accepts differently able persons. “Our D-café services are having a positive effect. Many families have stopped paying for additional medical treatment and have reduced visits to nursing facilities,” he said.