Tokyo care center operator helps elderly people with dementia find fulfillment through work

Takayuki Maeda finishes wiping a windshield at a Honda dealership in Machida, western Tokyo, and approaches a group of elderly men washing cars alongside him and suggests they pick up a new ride.

“How about a second car ー a convertible like this one?” the 45-year-old jokes.

The conversation might seem like typical banter at a car dealership, but in fact none of the men are salespeople or customers.

Maeda runs a daytime nursing care facility for middle-aged and elderly clients with dementia and these are his clients. The car-washing initiative is part of a program by Maeda to give older people a chance to stay active and engage in work-like activities.

Maeda had never been interested in social work until he studied in New Zealand as an exchange student during his college days. When he went to visit the father in his host family at his wheelchair manufacturing company, he saw the father chatting cheerfully with an elderly client.

“It was like a scene from a movie,” Maeda said, adding that, for him, social services seemed like an ideal career path.

Born and raised in Kanagawa Prefecture, Maeda started working as a nursing care facility worker at a medical corporation in Tokyo in 2000 after he graduated from college. That gave him a firsthand look at how elderly people were treated at the psychiatric hospital he was assigned to work in.

At the hospital, elderly patients were tied to their beds while patients in wheelchairs were tied to railings to prevent them from moving.

He remembers the chief nurse yelling at him when he tried to release the restraints: “What the hell are you doing?”

Maeda was shocked. This was not the kind of work he had envisioned. He could not come to terms with patients being tied down and he continued to release patients’ restraints even as the chief nurse continued to yell at him. He was soon transferred to an affiliated in-home care support center.

Around the same time, the government launched a nursing care program touting the importance of ensuring the dignity of elderly patients and offering them various freedoms and services.

But that was not the reality on the ground. It was an unspoken rule that patients were required to follow all the instructions of the staff. Hoping to enact change, Maeda switched jobs and started working for another day center for elderly people, but there, too, he clashed with staff members who were restraining residents, claiming it was for their safety.

It was then that he met a patient in his 50s with early-onset dementia. “I want to work,” the patient said.

The man was still in good physical health and was not satisfied with the recreational activities the center offered. Maeda invited him to help with renovating an old house owned by the day center operator. The man was in his element.

Other regulars from the center joined, and the volunteer work expanded to include cleaning day cares for children and other tasks. Some of the participants began to ask for compensation, but at the time, people enrolled in nursing care programs were not allowed to be paid for work.

Maeda decided that needed to change and he began a five-year campaign for the ministry to allow such paid work.

His efforts bore fruit. In 2011, the Health, Labor, and Welfare Ministry decided to permit paid activities for people enrolled in nursing care programs. The following year, Maeda started a nonprofit organization to provide day care services for people with dementia at a private house in Machida. He called his group “Days BLG!” with “BLG” being an acronym for Barrier, Life and Gathering.

Akiyoshi Torigai, 78, a former engineer at a major electronics manufacturer and regularly visits the center, joked: “They made me work from my first day here but that’s okay. I enjoy working with my friends.”

The car-washing program at the Honda dealership came to fruition after an 18-month negotiation by Maeda. The monthly ¥20,000 pay is shared among all the volunteers.

Working opportunities are not the only thing Maeda is focused on. He also makes sure that those who attend his center are treated as equals and able to make their own choices.

Every morning, staff members and about 10 elderly people at the center plan activities for the day and decide on lunch menus.

While most daytime care centers for the elderly mainly attract women, at Maeda’s center, 80% of the users are men.

The opportunity to work isn’t the only thing that stands out for Maeda’s center.

Normally, welfare service providers offer transport using white minivans, with the name of the service provider written on the side of the vehicle.

Maeda initially picked up his patients in a BMW car. Now he drives a black van.

White vans “just seemed spiritless,” he says.

Maeda now makes regular trips around the country and is hoping to expand his organization to 100 locations nationwide. In 2019, he established a company named 100BLG Inc. The company has offered its know-how to more than 10 nursing facilities in prefectures including Miyagi, Shiga and Kagawa.

Given that the number of unmarried people in Japan is increasing and that even married people could end up alone if they don’t have any children, the number of people living alone with dementia is expected to increase in the future.

“Dementia isn’t something one should hide nor something one should be scared of,” Maeda said. “Even if they make mistakes at times, people can continue to live in the community and contribute by using whatever skills they have.”

In the past, Maeda was treated as an anomaly by his co-workers. But now, rules and regulations appear to be catching up.

In 2019, the central government included a new clause in guidelines for facilities offering services for elderly people with dementia. The clause stipulates that users of day care services should be able to contribute to society.

“Change is already happening,” Maeda said.

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