I recently went to Japan and was part of a study tour of group homes in one area in the north – a region which is still recovering from the devastating tsunami 6 years ago.
There are thousands of group homes in Japan. Although all different, they do share many common characteristics. Here are some things which struck me:
They are small, with 8 or 9 residents.
A typical home has a central, multi-purpose, open-plan living area. There is an open kitchen at one end, and bedrooms clustered round. The bedrooms and gardens seemed very small to us – though this is normal in Japan. The spaces looked rather cluttered and messy – but I realised that does also feel quite homely.
Care staff don’t wear uniforms and are very flexible in what they do.
Staff and residents do many tasks together: caring, activities, cleaning and cooking. There is a relaxed attitude to ‘risk’ – big knives are used to prepare veg, and scissors to cut flowers. Residents have access to the kitchen when they are helping prepare meals. Apparently regulations are much more low-key and inspections much less frequent than in the UK – though this could have pros and cons of course.
Residents pursue traditional hobbies – often with one-to-one support. Arts, crafts and family photos were very visible around the homes – including origami and calligraphy. Japanese culture, festivals and seasons are very much part of group home life: we saw fish banners for Boys’ Day, and a cherry blossom collage for spring.
Some group homes are mixed: people with dementia, learning or physical disabilities all together. Some people just come in for daycare, respite, a meal or a bath.
Residents treat the homes very much as theirs. They welcomed us with Scottish flags, brought us tea, cut flowers for us, and assembled extra chairs.
Families and friends came in and out of the group homes. A neighbour brought in cherry blossom from his tree. He and others pop in and out regularly. Staff can bring their children. A harpist was visiting one of the group homes. She played and sang, first to the whole group, then to a lady who can no longer leave her bed.
We were invited to an evening bar, set up in a spare bedroom! Staff, residents, families, children and neighbours shared good food, drink and chatter.
Everyone is encouraged to keep moving and to go outside if possible. Pets add to the fun – one home had a very excitable billy goat! Residents often go out into the community too. They visit family shrines, help with street clean-ups, join singing lessons, and go to the shops. One lady we met makes soup for a local community café every week.
People don’t usually need to go into hospital at the end of their lives. Both staff and other residents help with their care. One resident was sleeping on a bed in the lounge in the daytime, while a carer worked quietly at a table nearby.
In June, we will be presenting our impressions of Japan – alongside other presentations about small-scale homes in Canada and Australia – to a group of people with dementia in Scotland. We will work with them to reflect on how the group home model might influence future development in Scotland.
One of those taking part in the study tour (and helping hugely with translation) was Mayumi Hayashi, currently an Exchange Fellow at Edinburgh University. She has written an excellent paper on this, do read it by clicking here.