New Orange Plan


The New Orange Plan is based on the approach of the “Integrated Community Care System”. It is made with a focus on what is necessary for the persons with dementia to live in a pleasant and familiarized environment, as how they hope to be as long as possible, in order to promote the development of an age and dementia-friendly community. This plan consists of 7 pillars, including 6 measure provisions and 1 principle provision of “Prioritizing the standpoint of persons with dementia and their families”, with each measure provision linked to specific systems.

Raising awareness and promoting understanding of dementia

Aim to raise awareness of dementia, to reconfirm, as a society as a whole that dementia is a common disease.Aim to raise awareness of dementia, to reconfirm, as a society as a whole that dementia is a common disease.

●Specific example1: “Dementia Supporters” training programTraining dementia supporters who have the correct knowledge and understanding of dementia, and aid the persons with dementia and their families in the community and in the workplaces.

Aim: 12million dementia supporters by 2020


Providing healthcare and long-term care services in a timely and appropriate manner as the stages of dementia progress

Aim to have a well collaborated healthcare and long-term care services to provide a timely and appropriate service dependent of the stage of dementia progression. Especially focused on early diagnosis and interventions, and to build a system that consistently provide an appropriate service at the suitable facility instead of stereotyped life in the medical institutions and in nursing homes due to Behavioral and Psychological Symptoms of Dementia and Physical complications.Aim to have a well collaborated healthcare and long-term care services to provide a timely and appropriate service dependent of the stage of dementia progression. Especially focused on early diagnosis and interventions, and to build a system that consistently provide an appropriate service at the suitable facility instead of stereotyped life in the medical institutions and in nursing homes due to Behavioral and Psychological Symptoms of Dementia and Physical complications.

●Specific example 1: Training for primary care doctors to improve their capability to respond to dementia

Primary care doctors are known as doctors that are reliable doctors  who are the first point of contact, and can give advice on any health concerns, and introduce patients to a more specific medical center when required. The prefectures and designated cities implement and operate training for these primary care doctors who adopt various field of specialty, in order to improving their ability to respond to dementia and for them to become the mediator between the patient and a medical specialist.

[Aim] Have 75,000 primary care doctors who have completed the training by 2020

●Specific example 2: Dementia Support doctors

These doctors exist between the primary care doctors and the dementia specialist doctors. The training project is underway since 2005 in hopes that they will become the promotor of regional corporation. The training course, comparable with the primary care doctor training courses, are centered around the prefectures and designated cities. The dementia support doctors are not primary care doctors. The aim of the program is to train dementia support doctors who can take leadership during regional coordination within the dementia specialist and specialized medical institutions.

[Aim] Have 10,000 dementia support doctors by 2020

Specific example 3: Medical Centre for Dementia

This institution is the medical institution which will take on the role of the base for the dementia medical provider system within the community that can give a differential diagnosis. These are divided into three categories, which are [basic type], [community type] and the [clinic type], dependent on the function, the number of hospital beds and by the arrangement of the doctors. All the three types will have the medical facility that enable the overall examination related to differential diagnosis.

[Aim] 500 Medical Centre for Dementia (aiming to set at least 1 center in the secondary medical areas)

Specific example 4: Initial-phase Intensive Support Team

This is a team consisting of several specialized professions, such as doctors and nurses. They support independent living by visiting the people with dementia and people who are suspected of dementia from the appeal by their families, assess their condition, and carry out a comprehensive and a concentrated initial support to the families (for around 6 months). It has been set up in every municipality since 2018.

●Specific example 5: Dementia care pathway

This is a pathway shows the flow of providing an appropriate service depending on the condition of persons with dementia. Every municipality take on the responsibility for the implementation, and they aim to build a seamless support framework by understanding the local resources, and by building a cross-occupational coordinated framework according to the stage of progress of dementia and timeline.

●Specific example 6: Community Dementia Support Promotion Member

As they mainly take on the role of construction of healthcare and long–term care support network, support to improve the capability to respond to dementia, give advisory support, and constructing the support framework they are allocated in each municipalities. Being a medical or welfare professional, or being recognized by the municipalities as having an equal level of knowledge and experience is the pre-requirement.


Reinforcement of Measures for Younger Onset Dementia

In many cases younger onset dementia can result in issues such as maintenance of employment and daily living, children’s educational expenses, in addition to the issues that are common with dementia of elderlies. Therefore, a response specialized for younger onset dementia was considered necessary, and so a counseling service counter for people with younger onset dementia and their families were set up in every prefecture. Furthermore, support for the families with a younger onset dementia, their care worker, and the companies that employ them are essential.

  • Specific example 1: National younger onset Dementia call center, younger-onset dementia coordinator
  • Specific example 2: Younger onset Dementia handbook, guidebook

Support for those looking after people with dementia

Due to the idea that direct support for the careers will lead to the improved quality of life of people with dementia, reducing the physical and mental burden on the individuals looking after people with dementia is required.

  • Specific example 1: Alzheimer Café

This type of café has been set up all over the country as a place for people with dementia and their families to share information, and exchange opinions with the community, supporters, and professionals. Although this is mainly held by the community comprehensive care center, in some cases it is held by local NPOs and private enterprises that put effort into elderly support.


Creating age and dementia-friendly community

An age and dementia-friendly community can be promoted by establishing daily life support (Soft side), and a comfortable environment to live in (Hard side), supporting and securing one’s safety for employment and society participation.


Promoting research and development and disseminating the results, of prevention, diagnosis, cure, rehabilitation model, and care model for dementia

Promotion of research and development for prevention, diagnosis, cure, rehabilitation model, and care model for dementia is possible through the elucidation of the clinical state of the diseases that becomes the cause of dementia, and the mechanisms behind the behaviors and BPSD that result from dementia.


Prioritizing the standpoint of persons with dementia and their families

Prioritizing the standpoint of persons with dementia and their families is raised as a principle, common for all statements above. In the recent years, people with dementia and their families has participated in some of the meetings about dementia that are held by governmental and self-governing bodies. Moreover, opportunities for people with dementia and their families to take initiative and to take part in community building such as “personal meeting” has increased in various regions.


References

  1. Japan Medical Association “Recommendations on having a primary care doctor” https://www.med.or.jp/people/kakari/ (Accessed:July 10, 2018)