[Dementia tends to become an impediment to continued homecare - "staying home until death" even with dementia].

With the rate of aging rising each year, the number of patients with dementia increases. The latest study released by the Ministry of Health, Labour and Welfare estimated that, as of 2012, there were a total of 3.05 million people with dementia in Japan, with 10% of aged 65 and over, 15% of aged 70 and over, 20% of aged 75 and over, and 40% of aged 85 and over. Dementia includes Alzheimer's disease, which makes up the most cases, dementia with Lewy bodies, frontotemporal dementia, and cerebrovascular dementia which is caused by a cerebral infarction or cerebral hemorrhage. Hypothyroidism, normal pressure hydrocephalus, and depression also impair cognitive functions, and therefore these pathological conditions are easily mistaken for dementia. Methods that can easily distinguish between these diseases have been devised. Early and accurate diagnoses are very important for patients and their families as there are a number of diseases that can be treated. In addition, although Japan only has medicines that delay the advance of Alzheimer's disease, in recent years, efforts have been made to prevent the onset of Alzheimer's disease through reducing the potential for diabetes, high blood pressure, obesity, and depression, quitting smoking, and improving physical and intellectual activities. At the annual meeting last year, we reported the results of a survey at our health counseling center on the quality of life a person wants as dementia progresses. The survey had some surprising results: two-thirds of the people surveyed preferred to be in a group home or an advanced medical center, rather than in their own homes. One-third of the respondents expressed a desire to be at home. The survey showed that if possible, a person diagnosed with dementia will stay at home, however, where this is not possible, they have no choice other than to resign themselves to leaving home. Furthermore, patients with dementia feel that the medication that will allow them to continue their lifestyle at home for long periods is limited. Home care for dementia is said to be more difficult than palliative care at home for patients with terminal cancer. This paper reports on one case in which medication was not and could not be used because the symptoms were too severe. However, home care could be continued by preventing the patient 's wife from feeling isolated and being able to cope with the prolonged crisis through the environmental improvement.