Abstract
Inclusion is the central policy keyword of the Basic Act on Dementia in Japan. This paper suggests that inclusion involves two dimensions: (a) including people with dementia into communities as members alongside others, and (b) recognizing “living with dementia” in later years as one of the natural life courses. Given Japan’s high prevalence of dementia and mild cognitive impairment, individual life design and community planning should reflect the latter perspective. Cognitive rehabilitation offers a primary paradigm for such planning. After clarifying key definitions, we propose a psychosocial support model grounded in cognitive rehabilitation. The model consists of four components and one overarching goal. These components are (1) supporting people with dementia, (2) supporting family members, (3) supporting human service professionals such as care workers, and (4) enhancing living environments and building dementia-friendly communities. The goal is to promote quality of life for all stakeholders, which includes people with dementia, their families, and professionals. Despite this framework, current Japanese medical and care systems lack adequate structures for seamless dementia support. As an example of this problem, I demonstrated that institutional support for maintaining cognitive functions and stabilizing conditions remains underdeveloped.
