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No country has an older population than Japan. More than a quarter of the people there are 65 or older, and that number is growing. So are cases of Alzheimer's disease and other forms of dementia, and that means more cases of seniors wandering off and getting lost. Every year thousands of Japan's elderly go missing. Too often they're found dead or not at all. NPR's Ina Jaffe covers aging, and she visited a city near Tokyo that's trying to provide a safety net for these vulnerable people.
INA JAFFE, BYLINE: You can often find Hiroyuko Yamamoto at this busy intersection in the morning. The 69-year-old resident of the city of Matsudo volunteers as a crossing guard for school children. But one rainy day, it was an old woman who caught his attention.
HIROYUKI YAMAMOTO: (Through interpreter) She was pushing a bicycle. She didn't have an umbrella, and she said she wanted to go to Kami-Suwa.
JAFFE: That's almost four hours away by train, so it was one sign that this woman was really confused. But Yamamoto noticed other signs because he'd received training in dementia awareness.
YAMAMOTO: (Through interpreter) The manual for the training I received tells you how to identify people with dementia. It says one of the ways you can identify them is that they don't have an umbrella when it's raining, and also their clothes are not buttoned correctly and so on.
JAFFE: Yamamoto is a volunteer with the city of Matsudo's Orange Patrol. Its formal title translates awkwardly into English as troop that calls out to the elderly. But that accurately describes what they do. Yamamoto says that just a simple, hello, what a nice day, can tell you if someone is OK or needs help. Fortunately for the woman with the bicycle, his training covered not only how to recognize the signs of dementia but how to interact with someone who has it.
YAMAMOTO: (Through interpreter) So we sat here on the bench that morning to stay out of the rain. I talked to her about things that, according to the training manual, wouldn't upset her. I also spoke in a gentle way. So she stayed and talked with me while we waited for the police to arrive.
JAFFE: If it hadn't been for the chance encounter with Yamamoto, this woman might have gone missing, who knows for how long? According to the national police, last year more than 12,000 people with dementia were reported missing. That's a number that's been increasing year by year. Most of the missing were found alive within a week. But 479 were found dead, and 150 people were never found.
This problem was one of the reasons why six years ago Matsudo began training its residents to identify and interact with people who have dementia. Pharmacist Takayuki Yoshida has taken the training. He frequently encounters customers with memory problems.
TAKAYUKI YOSHIDA: (Through interpreter) Even after I gave the medication to them, they'd come back and say they didn't get the drugs.
JAFFE: But now he knows he should contact their doctor. It's a similar story at a post office across town. Workers there also help people with financial transactions. Hiroki Yaita says taking the dementia awareness training helped him understand what it really meant when an older customer said their bankbook had been stolen.
HIROKI YAITA: (Through interpreter) When it happened three or four times, we'd think maybe the person has dementia, and we would talk to the family about that possibility.
JAFFE: Most training sessions last just 60 to 90 minutes, but the purpose of the training isn't to make everyone an expert, says Tadashi Watanabe, chief of Matsudo's Welfare and Longevity Department. It's just supposed to make Matsudo a safe and welcoming place for people with dementia.
TADASHI WATANABE: (Through interpreter) I feel it's very important for more people to have a good understanding of dementia. Some don't, and they act inappropriately toward people with dementia. In Matsudo, we want to support those with dementia as well as their families and make this a town where it's more comfortable for them to live.
JAFFE: Some communities in the United States are trying something like this, but in Japan, it's now national policy. Last year the Japanese government launched a wide-ranging plan to deal with the expected onslaught of dementia cases. It includes medical research and prevention and nursing services. The country is also on track for training 8 million people in dementia awareness by the end of the next fiscal year.
Hidenori Kawashima is the deputy director for dementia policy in Japan's Ministry of Labor, Health and Welfare. He says there will probably be more than 7 million people with dementia by 2025, but that should not be seen as a threat.
HIDENORI KAWASHIMA: (Through interpreter) It would be normal then for everyone to interact with people with dementia. It'd be a familiar thing. 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.
JAFFE: No government plan can keep people with dementia from wandering, but in Japan, the hope is there eventually will be entire communities prepared to keep them safe when they do. Ina Jaffe, NPR News.
[POST-BROADCAST CORRECTION: In the audio of this story, we give Hiroyuki Yamamoto's first name as Hiroyuko.]
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