BLISS #6 Caring for People with Dementia in Japan

Koichiro Shogaki is a teacher of The Validation technique, a method of communication with older adults experiencing dementia. An American social worker, Naomi Feil, created this method. You may have seen a famous video of her singing hymns to a woman with Alzheimer’s disease. Shogaki is one of the first persons in Japan to be trained for it.

The Validation method focuses on empathy through understanding the feelings and the experiences of disoriented elderly. When they display troubling behaviors, our tendency is to try to change them. But Shougaki notes that it’s more important to try to understand the reasons behind such behaviors by putting ourselves in their shoes.  In a sense The Validation method challenges us, the caregivers, to change ourselves.

In Japan more than 4.6 million people are suffering from some form of dementia.  By 2025 one in five people will be over 65 years old, and nearly 7.3 million people are estimated to have dementia. So how to care for them is an important topic.

While the media and the medical community in Japan seem to focus on “prevention” and “cure” of dementia, Shogaki wants people to learn how to support those living with it.

“It’s not easy to use The Validation technique, because it takes time to change ourselves. But what’s important is to believe in yourself and keep practicing.”  Shogaki says.

You can listen to his interview here.

 

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BLISS #5 Hospice Music Therapy in Japan

In this episode of BLISS I speak with Hisako Nakayama, a music therapist, in Hokkaido, Japan.  She has been working at hospices for 15 years and advocating for music therapy through a NPO organization called “Wa Harmony”.  Her work has been featured in the NHK news this year.

In the interview Nakayama talks about many topics including the following:

• She was a pianist and a piano teacher for many years before becoming a music therapist. After her grandmother died at home, she became interested in hospice work.
• She feels that her relationship with music has changed dramatically since she became a music therapist.
• In Japan hospice care is available only for people with cancer and AIDS.  She believes it should be available for people with other illnesses including ALS.
• In recent years more people who have graduated from university with a degree in music are interested in music therapy, because they can’t make a living as music teachers. “That’s not a good reason to want to become a music therapist,” said Nakayama.
• As a former professor of music therapy in Sapporo Ōtani University, she has seen her former students give up on a career in music therapy. It’s very difficult to practice music therapy in Japan, because it’s not a established profession.
• What’s important in hospice work is empathy. “My motto is ‘If I were you.’ I want to try to put myself in your situation and imagine what it is like to be you,” she says.

You can listen to the episode here.

 

 

BLISS #4 Hope for Cancer Patients

There are only about 1000 oncologists in Japan (while there are over 14,000 of them in the U.S), and Noriyuki Katsumata, M.D. is one of them.  He is the professor of the department of medical oncology at Nippon Medical School.

Several years ago, a book written by a famous radiologist named Makoto Kondo became a best seller. His main message was to do “nothing” if you’re diagnosed with cancer, regardless of the type or stage of the cancer or the patient’s age:  no surgery, no radiation, no chemotherapy. His extreme view resonated with so many people in Japan who already had deep doubts about modern cancer treatment.  Since then, Kondo has written a number of bestsellers on the same topic.

This has presented a new challenge for oncologists like Katsumata. He often sees patients who followed Kondo’s advice and did nothing, and as a result their cancer has spread. By this time patients are remorseful about believing Kondo’s advice, but it’s too late to undo the damage.

“I don’t want to see any more patients in this situation. That’s why I’m speaking out about it,” said Katsumata. He has written books to explain how proper cancer treatment works, and why Kondo’s assertion is wrong and unethical.

Katsumata is also deeply concerned about what he calls the “terminal cancer business” widely spread in Japan where it’s legal for doctors to provide unapproved treatment to patients.

“For instance, if I tell you that a glass of water may cure your cancer and sell it to you for $10,000, I won’t get arrested or lose my license. If this was in the U.S, I’d be arrested,” said Katsumata.

Some doctors are taking advantage of patients with terminal illnesses who are desperate for a cure. Yet, some claim that these doctors are giving patients hope, and that it doesn’t hurt to try a “treatment” if it has a potential to cure an illness.

“The main problem here is that these doctors are not telling patients the truth. If they’re saying that these are non-approved treatments without evidence, that’s one thing. But they’re not saying that,” Katsumata said.

“Another problem is that they’re charging patients a huge amount of money. Treatments that have not been approved should be provided as a clinical trial, and it should be offered for free for participants.”

Katsumata is also a supporter of music therapy. He is a singer songwriter, a guitarist, and a pianist. In the Bliss interview, he sings a song he composed with his patient. The song is about finding joy and hope in small things (The song starts at 44:08).

“Working in medicine is tough. You see so many things that are not normal. But music brings me back to myself. When playing music I feel like a normal person again,” his voice softened as he talked about his love for music.

You can listen to the episode here.