The Designing for Dementia Knowledge Library

S.K

Age:

83 years old （As of December 2019 interview）

Year of birth:

1936

Place of residence:

Numata City, Gunma Prefecture

Relatives living together:

Single room in a geriatric health care facility

Occupation:

Formerly self-employed (clothing retailer)

Age of onset:

About 75 years old

Age of diagnosis:

80 years old

Diagnosis:

Alzheimer type

Dementia rating scale?Mini-Mental State Examination（MMSE）
The most widely used screening test internationally for identifying dementia, in which questions are asked directly to subjects. The MMSE assesses cognitive functions with a series of questions/tasks related to orientation, memory, attention and calculation, language, giving commands and copying a picture. The test yields the highest score of 30 points, and, in general, those who score 23 points or lower are identified as suspected patients with dementia.Revised Hasegawa's Dementia Scale (HDS-R)
A screening test widely used in Japan for identifying dementia, in which questions are asked directly to subjects. It has 9 questions/tasks related to age, orientation, immediate memory and delayed recall of 3 words, calculation, backward digit span, memory of 5 objects and language fluency. The test yields the highest score of 30 points, and, in general, those who score 20 points or lower are identified as suspected patients with dementia.:

MMSE 3About （As of June 2017）

Using long-term care insurance:

Uses day services 7 times a week
(Regular day services: 4 times & shared day services at a group home: 3 times)

Past experiences

2015年（79）

Husband passed away and felt depressed. Realized that husband had been supporting S.K until then.
Hospitalized once around this time due to illness. (Family members think that cognitive functions deteriorated during the hospitalization.)

2015年（79）

Living at home, doing own household chores, after being discharged from the hospital.
A community welfare support member visited and noticed that S.K was trying to pay money, unable to understand the purpose of the visit.
The community welfare support member contacted the home care support center and S.K's second daughter and then began to coordinate with a hospital specializing in dementia.

2016年（80）

January: Got lost while out on shopping. The police took S.K back home.
Family members started to worry around this time about car accidents due to deteriorating eyesight and about household chores such as burning pots.

2016年（80）

May: Did not agree to visit the hospital as S.K was convinced that S.K was taking care of oneself without any problems. However, after six months of thinking how to take me to the hospital, family members proposed that they all have a medical check-up together.
Around this time, occasionally repeating the same things over and over again.

Diagnosis

2016年（80）

Diagnosed with dementia. (According to family members, S.K heard hardly anything because of poor hearing.)

2016年（80）

Started to use home care services, although feeling some reluctance to let people into home. Care manager, family members and others started to work together to adjust the environment so that S.K could continue living at home, which is S.K's preference.

2016年（80）

According to a care manager, S.K started to get gradually used to living with nursing care services, after 3 to 4 months.
Around this time, S.K enjoyed going to a convenience store 300 meters away from home to buy and eat favorite food.

2018年（82）

Even when getting lost while out, S.K had become acquainted with neighbors and police officers, who would say, "Let us go home" and take S.K home.
Family members often consulted care managers on how to support S.K, who the family felt was not appreciating being worried by the family.

2018年（82）

August: Care manager and family members came up with various measures to enable S.K to live at home (e.g., installing locks that can be unlocked from outside and adding lights in poorly lit areas considering the line of movement inside the house). While all efforts were being made, S.K was certified as long-term care level 3. Began to consider entering a special nursing care facility.

2019年（83）

May: Fell down at home. Around this time, began to have difficulty using the toilet, and a family member visited to discover S.K being unable to stand up after getting out of the toilet. Injured leg and was urgently admitted to the dementia ward of the elderly care facility.
In the facility, family members saw S.K crying in the evening, saying that S.K wants to go home, and felt pain. Family members visited the facility regularly.

2019年（83）

Started to help with wiping tables and cleaning up at the elderly care facility. Seeing S.K gradually becoming accustomed to life at the facility, family members and care manager are feeling some relief.