“Taiseikai-Style” Care to Improve Problematic Behaviors Associated with Dementia and Let People Live True to Themselves

ORGANIZATION: Taiseikai Group
LOCATION: Japan

2021 HAPI 2nd Prize Winner

Societal understanding of dementia remains low, and the behavioral disorders associated with dementia, known as behavioral and psychological symptoms of dementia (BPSD), can sometimes lead to situations where people with dementia are confined to bed using controversial containment and restraint techniques. These techniques are intended to reduce the person’s mobility to protect them from potential harm, but at the same time, the use of physical restraints tends to dehumanize people with dementia, robbing them of their rights and dignity and creating further psychological stress. Furthermore, prolonged use can cause the deterioration of body functions, which can result in some loss of physical functions that would not otherwise have been lost. The Taiseikai Group, a medical corporation in Japan, made a commitment in 2002 to protect the dignity and health of people with dementia by using zero physical restraints in their facilities through the creation of the “Taisekei Style” of care. The Taiseikai Style combines care content and supportive methods to alleviate behavioral disorders, enabling people with dementia to lead peaceful lives without the need for physical restraints and live true to themselves in the community with which they are familiar. Taiseikei-Style care was developed at Uchida Hospital, a part of the Taiseikai Group. The hospital offers care that is provided from the perspective of rehabilitation, life assistance, and the development of social roles that match patients’ lifestyles and backgrounds. This enables the patients to spend their hospitalization period in peace and to return to their communities in a happier state.

Taiseikai found that care using the “Taiseikai Style” considerably alleviated BPSD in over 80 percent of dementia cases within one week of hospitalization, which also lessened the burden on caregivers and staff. Most importantly, the patients became calmer, enabling them to spend peaceful days in the hospital or in many cases, to return to their lives in their community. 

In addition to medical care routines, Taiseikai has established a comprehensive system to support people with dementia living in the community in a concerted public-private effort with municipalities, social welfare councils, police, elementary schools, and local citizens. Taiseikai community activities include mock missing persons exercises, as people with dementia can be prone to wandering. They offer accident prevention measures to support people in driving automobiles or in giving up their driver’s license if appropriate, they help people in transitioning to long-term care insurance, and so on. They have also created activities for people in rehabilitation or who have been discharged from the hospital to support them in identifying social roles to play. 

Implementing the Taiseikai Style requires buy-in from staff at all levels. Rather than just telling staff not to use physical restraints because it robs people of human dignity, they have found it is more persuasive to have managers share evidence of the effectiveness of the Taiseikai Style care and give staff a clear understanding of how it benefits both the patient and the caregiver. 

Over the past 20 years, the Taiseikai Group has continued to carry out research and analysis to improve their techniques and have broadly shared their findings through publications, site visits, and lectures. The significant impact of the “Taiseikai Style” has made it possible for society to pursue an environment where people with dementia are respected as individuals with their own rights.

KEYS TO SUCCESS

  • The innovation was developed with a clear and understandable goal for providing care without the use of physical restraints. 
  • Instead of taking a top-down approach for imposing this goal, evidence-based techniques were used for staff training to achieve buy-in.
  • A person-centered approach is used that emphasizes the human dignity of people with dementia; service providers are conscious of the life and background of the people they care for and prepare surroundings that enable these people to live in a way that’s true to themselves.
  • Establishing both public and private partners in the community raises awareness and ensures that people with dementia continue to receive support after being discharged from hospital.
KEYWORDS: Ageism, Caregiving, Dementia

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