In any other café, Tadashi Iida would be a terrible waiter. Unless he immediately writes them down, he gets the orders wrong and brings green tea instead of white coffee. He frequently gets confused over the change, handing back to customers all the money they have just given him. He puts the cups on the table with trembling hands.
None of this is surprising, because 65-year-old Iida suffers from dementia. None of it matters, either, because almost everyone else here is in the same situation. The Master’s Café in the town of Hannan, central Japan, is run by, and for, people with Alzheimer’s disease, and on Thursday afternoon it was doing great business.
“As time passes, I forget more and more,” Iida says, as 25 people, most of them elderly, sit at tables laughing and talking. “My car keys, switching off the heater, where I put my wallet. But here I know the faces and the names and I can relax. I feel cheerful — when I’m here I can completely lose track of time.”
Rates of senility are increasing in rich countries across the world, but nowhere is the situation more extreme than in Japan. As the world’s most long-lived nation, it also has the highest proportion of people with dementia — 2.3 per cent of the total population in 2015, according to the OECD.
Last year, Tokyo’s NLI Research Institute said that such figures were an underestimate, and that the number of people living with dementia in Japan is upwards of 9.5 million. Either way, it is certain to increase. Projecting the figures into the future, based on trends in the ageing population, the institute estimates that by 2070 46 per cent of the elderly, a total of 18 million people, could have the condition.
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Japanese police report that 18,700 people with dementia went missing in 2022, almost double the figure for ten years earlier. Most of them were found, but 500 died and 300 were never found.
The Japanese government has made vague promises for a “national project” on dementia and is canvassing the opinions of experts, sufferers and their families. In the meantime, all over Japan organisations, communities and companies are searching for their own ways of addressing the problem.
Unsurprisingly, technological solutions are emerging. Ridgelinez, a subsidiary of Fujitsu, is developing artificial intelligence technology that will use surveillance cameras to identify people with dementia, in the hope of alerting police and caregivers before they get lost or cause themselves injury.
Alzheimer’s patients often walk with a distinctive shuffle and with short steps. The AI, which is intended to be in use in 2027, will recognise such distinctive movements via video footage from cameras on the street or in shops.
The system, which was originally devised to judge the performance of athletes in gymnastics competitions, will be trained to monitor the movement of 20 body parts, including the head, hips and knees.
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Iruma, a town north of Tokyo, distributes tiny stickers bearing square QR codes which are attached to the fingernails of people with dementia. The codes can be scanned by police, revealing personal details and addresses and making it easier to return people home.
Other towns in Japan provide small trackers that can be attached to the shoes of an elderly person, and which reveal his or her presence on a mobile phone. The fingernail stickers, which do not wash off for two weeks, have the advantage of working even for those who have wandered off in bare feet.
Accidents involving elderly drivers are increasing on the roads. In 2017 the law was strengthened, compelling elderly drivers to be tested for dementia if they are caught committing traffic violations such as crossing a red light or driving on the wrong side of the road.
Only those who fail such a test can have their licence taken away. In order to reduce the number of wobbly drivers who have not yet been stopped by police, businesses have offered incentives to those who voluntarily give up their licences, from restaurants giving away free bowls of noodles to a firm of undertakers offering cheap funerals. A stonemason in the town of Tsushima promised a discount on tombstones to elderly people who get off the roads.
The Master’s Café meets a simpler need, experienced by many people with dementia and their families — that of companionship. Once a week, a team of people with dementia, including Iida and the café’s “master”, a 93-year-old retired noodle chef Toshimichi Nakata, gather to serve a simple menu of bread and soft drinks for 100 yen (52p) each.
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Other similar cafés have sprung up across the country, including a pop-up café in Tokyo called the Restaurant of Mistaken Orders. According to Yayoi Oka, a local councillor who helps to run the café in Hannan, its goal is to break through the isolation that often enfolds dementia sufferers and their carers and families.
“The important thing is to protect people’s dignity as human beings, and to make sure that dementia is not misunderstood,” she says. “A dementia diagnosis doesn’t mean that a person suddenly changes. I don’t object to the development of technology. But in the end as people, we can only really be helped by other people.”
