An awareness post on the new Chinese coronavirus nCov-2019
Worries are spreading across not just East-Asia but globally
There are increasing worries spreading across Japan regarding the new Chinese coronavirus (names nCoV-2019) and its ability to infect both animals and humans. Specifically, the worry is about the virus’s ability to become a pandemic.
To highlight the seriousness of this issue, Japanese prime minister Shinzo Abe has stated that “please take every possible precaution,” which has lead to a public awareness campaign on this issue (it has appeared not just on Japanese news but day-time television as well) and a full traveller screening programme at each Japanese airport.
Current estimates suggest that around 400 people are known to have contracted nCov-2019 and the current death-toll is (at time of writing) at 4 deaths- but why is the global community (and indeed Japan) so concerned about this virus? The answer is simple- uncontrollability.
Chinese new year is soon to be upon us, which is the time in which most Chinese people travel- both nationally and internationally- which has the potential to ignite a new global pandemic. Global pandemics are most often caused when: a disease can be easily spread across the world with high movement and when the disease has been shown to cross the species barrier.
These prerequisites have already been met in nCov-2019. Initial cases first appeared in Wuhan, China in a market with high frequency animal contact and since this time, the diseases have been spread from person-to-person.
Chinese authorities are already taking action against this outbreak by ordering the use of facial masks in Beijing hospital, and controlling the number of people entering and leaving Wuhan (where the disease was discovered). Currently, this virus doesn’t appear to have mutated and the CDC and WHO are working on the virus but it is still early days.
Current reports suggest that initial symptoms mimic a common cold with some pneumonia-like symptoms. Initial symptoms include fever, cough, tightness of the chest and shortness of breath- the most concerning of which is the tightness of chest- which initially can be easily misdiagnosed.
Current countries with nCov-2019 patients are China, Japan (the person had just returned from Wuhan), Korea, the USA (a traveller had visited Wuhan), Thailand, and more regionally in China from Beijing, to Taiwan.
The international community is highly aware of the potential for this and infection disease control procedures are underway both in China and around the world to deal with the threat of this virus.
The best advice is to be prepared- use masks in Asia (especially in China) but don’t worry- there is nothing major (currently). Life in Wuhan is ongoing without interruption- life before this virus was discovered. While this virus has the potential to become serious, measures are already underway.
If you have been travelling in China and are experiencing symptoms, please call your doctor- and get their advice. Don’t just turn up in person. While you could just have influenza, they may want to take precautions. There is no data to suggest if some people are more susceptible than others or if it is more damaging to people with compromised immune systems.
Current screening procedures at airports just involve walking in front of a thermal camera. If there is anything wrong- you may be taken to an isolation area until tests are performed. From there, a treatment plan may be started or general health advice given.
Thank you for reading and happy and safe exploring.
Part of the resolution series looking at the entire journey- not just the start!
Japan, it seems, does lend its self to the concept of New Year’s resolutions due to the fact it is an obsession here. There are many products which promise to help with one’s health, or elixirs that “are a ground breaking innovation that well help with X and Y and you won’t believe that you have live without it before”- like every other country!
But no matter how much you are willing to change, it is important to note that “good things come to those who wait”- the irony of using a beer tag line to promote healthy living is not lost on me. However, that it is important to know that a New Year’s resolution is a promise to change your lifestyle- for the better and from now on.
The point is, no matter if you are constantly failing to keep your New’s years resolution, if you are determined to see through to the end, you must work on it each and every day. That is not to say that if your goal is to develop the body of your dreams, it means going to the gym each and every day- not is an impossibility when just starting out.
No matter where you are in your ‘New Year’s resolution journey’, it is important to know where you are up to and what you actually know. What I will always recommend is research (and research allowed me to fix my laptop- which means I can use more than 1 tab at once- woot!).
Researching allows you to know what is (in this case) good for you and what is not- is eating pizza forbidden if you want to lose weight and gain mass? No, but you need to eat everything in moderation and ensure that you are otherwise healthy. Is drinking soda bad and thus forbidden? Yes, but you can still enjoy the occasional glass of soda in moderation.
Having the opportunity to know or learn to know what is good and bad is invaluable and will help. It is not yet 2 weeks into the New Year- so don’t worry if everything has gone awry- it does not matter. As long as you are trying and intending to change- that is all that matters. If your resolution takes 6 months to really start- it takes 6 months- don’t worry about it.
If you move to Japan in that time, don’t worry they have (seemingly) an entire culture surrounding health living and a health life style- from gyms, to products, to well-being services etc.
It’s going to be interesting once I move back to the UK and I believe that it’ll take more effort in being healthy and maintaining my now healthy lifestyle- perhaps that should me my New Year’s resolution: preparing for my life post-repatriation (starting on April first).
Don’t worry- I will not stop posting about Japan- I have so many experiences and things to research and post that content will not be stopping anytime soon.
Thanks for reading and keep up the resolution. Happy exploring.
An awareness and resolution post, looking into global vaccinations including proving Karens of the world wrong! Also, vaccinaion programs in Japan
While scrolling through social media, there have been several posts suggesting that a pandemic is to occur this decade. There have been major epidemics and thus pandemics in the 1720s, 1820s, 1920s with the 2020s to possibly follow. But what disease if any would be the probable cause?
Firstly: terminology. An epidemic is when a disease affects a great number of people in an area or country. A pandemic is a global epidemic- simple. Previous examples of pandemic diseases are SARS, avian influenza, Ebola, small pox, yellow fever, TB, leprosy, Spanish flu etc.- there are an awful lot of examples.
While many countries are doing a lot to combat this, there is certainly more that can be done. However, not every country is able to prepare to a similar level- which is part of the problem.
In some LMICs (lower to middle income countries), are more prone to starting a pandemic due to very high contact with animals along with poor access to medical facilities. In addition to this, these countries are usually unable to invest large amounts into epidemic preparedness.
There are many challenges facing the global community with regard to pandemics and one of the more worrying examples is increased antibiotic resistance which a disease can develop if, for example, a person does not complete a dose of antibiotics correctly, if antibiotics are over prescribed and if the disease mutates.
I do have to note that antibiotics will NOT work for viruses at all- if you have influenza antibiotics are as useful as tick tacks- but at least tic tacks will freshen your breath.
One thing that increases the risk of an ID (infectious disease) mutating is lack of immunization. Immunization helps protect a population from a disease by introducing them to either a dead or ‘live’ disease via an injection. The body’s immune system then works to counter act the disease and produces antibodies which are then ‘saved’ in the body. Some time later, if a person comes into contact with the actual disease, their body is already ready and prepared to fight off this disease.
Many people suffer or die from preventable diseases because they are not immunized. A 2015 case in Japan featured a 10-month-old boy who caught Japanese encephalitis and although he did live, his arms and legs have been severely paralysed. There are many cases of people catching and dying from measles.
The elephant in the room
Some people (we’ll call the Karens) are against immunization because of several reasons including: possible side effects including the adverse medical reactions, the introduction of harmful chemicals (including aluminium and mercury), and there being “no point” in being immunized because the diseases that people are immunized from are ‘no longer a risk’.
I know that I have set up a straw-man argument against the Karens of the world but I shall enjoy using this argument flaw method regardless.
Number 1: immunizations cause adverse medical effects
Most people will cite the study that “showed” a link between the MMR vaccine and autism. Simply put there is NO link between the two- in any way. The review into this study was produced by the WHO (World Health Organization) who’s only bias is the promotion of global health.
Other people may look at the “link” between the DTP vaccine and SIDS (sudden infant death syndrome) and while it seems to be directly related to one another, this is again false. If there were a true link between the 2 factors, the number of SIDS deaths would be astronomically higher. The SIDS deaths were by chance but people have a need point to a cause of death and the vaccine was chosen.
In fact, several studies have shown that the DTP vaccine actually reduces the chance of SIDS deaths.
Number 2: the introduction of harmful chemicals
Many Karens will also say that “vaccines contain harmful chemicals that will harm me/ my child, so I’m not going to vaccinate. It’s my choice.”
The first question for the Karens of the world is: do you drink from soda cans, or live near a road, or smoke? Yes, you already take in 4 times the aluminium that is allowed in a vaccine.
Other harmful chemicals that may exist within a vaccine usually only exist in trace amounts which help with the bodies autoimmune response and only in certain vaccinations. However, using mercury and formaldehyde as examples- mercury acting as a preservative- in tiny amounts and in a safe compound- and formaldehyde used to render certain viruses such as polio inactive for use in vaccines, more harmful chemicals are ingested in everyday life than via vaccines.
If we look at mercury, and ignoring the fact it has been eliminated from most vaccines since 2001, 69 mcg of mercury is ingested in 1 can of tuna while 25 mcg of mercury is taken in with one influenza injection.
Regarding formaldehyde (the highly carcinogenic, environmentally toxic chemical used in embalming), is extremely common in the environment. Most apples contain more formaldehyde than in the “Hepatitis B, DTaP and polio vaccines together”- a little FYI, this includes organic apples as formaldehyde is a naturally occurring chemical and the human body produces it as part of metabolism which is then converted into carbon dioxide and exhaled.
Pont 3: there is no point in vaccinations as the diseases that are being vaccinated against are no longer a threat
This one is the easiest to disprove to the Karens of the world and can be done with just one world: measles.
Need a bit more? The WHO reports on disease prevalence and outbreaks globally and has reported such trends as the highest measles’ prevalence are in countries with low vaccination rates and there are ongoing out breaks (Angola, Cameroon, Chad, Kazakhstan, Nigeria, Philippines, South Sudan, Sudan and Thailand). While the data from 2019 is still provisional (to be finalized by July 2020), there were some serious trends that appeared when comparing the first 6 months of 2018 and 2019.
The US reported over 90,000 cases of measles at the start of 2019- the highest in 25 years
From 2018 to 2019 measles prevalence has increased:
900% in the WHO Africa region
120% in the European region
50% in the Eastern Mediterranean region
230% in the western Pacific region
Additionally, the WHO reports that fewer than 10% of measles cases are actually reported.
The final jolly bit will be just one number- the number of people that died from measles in 2018. Please remember the measles is mostly a preventable disease- so most of these deaths if not all were preventable.
So Karens of the world, there is no reason not to be vaccinated- not even ignorance will save you!
Vaccination in Japan
There are 2 types of vaccines in Japan: voluntary and routine vaccinations. Routine vaccinations are free if you take your child to a clinic within the time frame. Some voluntary vaccines may be routine vaccines in some prefectures.
Voluntary vaccinations are paid for out-of-pocket- and there is quite the list (see below). It is also important to note that out of the 15 vaccinations, 5 are ‘live’ vaccines which depending on pre-existing medical conditions, you may not be able to take.
The ministry of health has a vaccination programme in place for children under 1 to be inoculated free of charge, and they’ll receive 19 shots in total (including boosters) but not every family is able to go to a clinic regally and if an appointment is missed, the remaining shots must be paid for by the parent.
An additional problem regarding vaccinations in Japan is the lack of combined vaccinations. In the UK, most children receive the MMR vaccine but in Japan the Mumps vaccine is routine while the MR vaccine (measles and Rubella) is voluntary. One way to increase total vaccination rates would be to have a greater availability to combination vaccines but Japan wants to protect domestic vaccination production rather than import vaccines which are seen by many to be better.
A full vaccination schedule (in English) is available on the further information page.
It’s been quite a month- even if you disregard the 2 weeks when I was unable to post.
I hope awareness month did prove to be useful and don’t worry- I’ll continue to post topics that I believe need more attention but this will also include global topics- not just Japan.
Now January, and as said in the “goodbye Japan” post, I will be leaving Japan this year which is not something I planned for but is something that I must do. But don’t worry, you will only see this change in April. So, in the meantime, please expect some posts about leaving Japan.
Now resolutions: for many people the new year is a time for change and renewal but most people fail their resolutions as they try to do too much, too soon. What I will post will be a step-by-step guide to being health in Japan. It’ll start small and build up and I will be following this as well.
For January 1st, the first step is simple: get up at the same time most days. A steady sleep schedule is required as a foundation for a healthy lifestyle. What I have discovered during my life in Japan is simple- Japan operates on Japanese time and most places are open during the day with few things being open outside the 9-5 life.
Additionally, a sleep schedule allows a regular sleep pattern and reduces the chances of some NCDs (non-commutable diseases) such as high blood pressure, diabetes (if you saw my previous post I’m not diabetic woot!), risk of heart disease etc. Furthermore, sleep deprivation can contribute towards loss of balance, mood changes, loss of libido (sex-drive), weakened immunity, and memory issues.
Do all of that sound like a fun time to you? No, well get some sleep! The practise of getting enough sleep is called “sleep health” and getting enough sleep is a global problem- mostly in HDCs (highly-developed countries i.e. the US, UK, Germany, Japan etc). Some things you can do improve your sleep health is reducing screen-time before bed-time, exercise daily, and have a relaxing bedtime ritual.
It is something I am working on as well- don’t worry I’m no where near perfect either!
2019 a year in review
2019 has been a hectic year for me and a lot has happened. It was the year I came back to Japan as a working professional instead of an exchange student- which has been an interesting experience, and I am very happy I did so. However, my ambitions for my future lie beyond Japan- so it is also the year that, in some respects, I must forget about Japan.
Coming to Japan, I was a smoker and extremely overweight (read obese). When I came to Japan on the 4th of January, I was 128 kg and at time of writing I am 97.5 kg- a definite improvement but there is still a lot more work to be done!
With regard to smoking, again at time of writing, I have not smoked for 6 months, 5 days and 1 hour- and I don’t miss it. It will take a lot of time for my body to recover from the abuse I put it under, but I’m going in the right direction.
The other resolution that is popular is exercising more and again I accomplished that. Exercise has become an important part of my life because strangely, it is when I do my best thinking- about my future, about my life currently and about future posts and plot points for my stories I write.
Alas, 2019 also brought about challenges including the deaths of my Uncle Kevin and my Grandmother. I knew before coming to Japan that I could be unable to say goodbye if someone died- but facing this reality was completely different. Additionally, my last remaining grandparent, my Nana, has been diagnosed with stage 3/4 Parkinson’s disease (which is the reason for my repatriation in April).
Furthermore, there was a period of time that my father and sister faced challenges that I have been unable to help them with including hospitalization, medical emergencies, problems with hosing, social isolation and depression- things that I would have been able to help with. Finally, I would have been able to help my cousins (or at least offer help) when their father died.
While I have experienced some brilliant things in Japan, I feel I have also experienced hardships as well. So please be aware of this if you are coming to Japan- there will be positives and negatives as well.
My final note on 2019: it’s been a mixed bag but I think many other people also feel this way as well.
How was 2019 for you? Good, bad, or indifferent?
Thank you for reading and happy exploring in 2020.
If you are at all concerned with the well-being of a friend or family member, please ring 999 and ask for a “welfare check” to be performed. I have spent New Year’s Eve with a friend at A&E for physiological help and they are still here!
Japanese helpline numbers
Tell Japan (Suicide and general help)
English and Japanese
Foreign Residents’ Advisory Center
Health and Medical Information Center
Emergency Translation Services
Tokyo Employment Service Center for Foreigners
English or Chinese
Legal Counseling Center for Foreigners
English, Chinese , or Spanish
*English may be available in major cities
If any of these numbers are useful for you, please do use them. I hope that they will not be needed but better safe than sorry.
Thank you for reading and happy (and safe) exploring.
A guide to Parkinson’s disease and the costs in Japan
Parkinson’s disease is quite a common NCD in Japan with over 150,000 people who suffer from the disease in Japan. But what exactly is it?
Parkinson’s disease is a progressive nervous system disorder is caused by the loss of dopamine production in the part of the brain called the substantia nigra- part of the midbrain.
Parkinson’s disease is not a life shortening disease alone but many sufferes also develop dementia separately which can be life-shortening.
Parkinson’s is comprised of 5 stages and early symptoms of the disease include:
A tremor in a hand, leg, finger
Bradykinesia: sudden stiffness with often a ‘mask-like’ expression
Loss of balance
problem with swallowing
memory issues including dementia
Basic treatments for Parkinson include medications which when taken convert to dopamine and help the body cope with loss of production, a healthy and balanced diet. However, as the disease progresses, patients will often decline physically.
Loss of independence
Late stage Parkinson’s patients will likely require around the clock care as they become unable to complete simple household tasks such as cooking, cleaning or washing.
About 40% of stage 5 patents will have a form of dementia as well as more common symptoms such as loss of bladder control, frequent mood changes, respiratory problems, less responsiveness to dopaminergic medications (dopamine replacement medications), dysphasia (inability to understand language), dysarthria (the inability to speak) etc.
Some late stage patients have described it as being a “drooling vegetable” but each person with the disease is different- and each treatment plan is different.
Many universities in Japan are studying Parkinson’s disease and are running clinical trials including Kyoto University (who have transplanted iPS cells [induced Pluripotent Stem aka non-specific stem cells] to supplement dopamine-emitting neurons), and Tokyo Metropolitan University of medical science (looking at the effects of adiponectin [a protein produced by fat cells with many effects] on neurodegeneration).
The costs of PD in Japan is high. Curative care (treatment which looks towards a cure- even if not possible) is around 500 USD a month. Palliative PD care or PD care requiring a care home is significantly higher and estimates are hard to find in Japan.
With a monthly cost of around 500 USD and an annual cost of around 6000 USD, it is estimated that 90% of this cost is from PD medication- but this is mainly for earlier stages. For patients in later stages and for patients who have had PD for more than 10 years, the costs are between 550 and 600 USD a month. Costs do change with symptoms. If a patient requires pain medication, the costs are higher; if the medication is “wearing off”, the costs are higher.
One problem with PD costs in Japan is that there is very little research. One article I used (see further links page) doesn’t consider long term care home costs. But the costs are comparable to the cost of PD in the US, UK, or Germany.
Basic care home costs in Japan are around 40,000 JPY a month for basic care needs which is 446,000 JPY a year. This would be in addition to direct PD care costs. Please note, the care home cost is for a basic level of care only- PD would require a lot more care and thus expense.
In order to combat this costs, it is estimated but the JT that around 470,000 people left their jobs between 2007 and 2012 to help care for elderly relatives which does reduce costs but by how much is yet to be determined.
Although this is not applicable to me, for many people coming to another country can cause anxiety because they have allergies. Sometimes allergy some minor things like hay fever for example however some people can have major anaphylactic reactions to certain products.
This post is to fold the first post this post will be a guide on how to navigate Japanese food labels and restaurants. The second part of this post will be an awareness post on allergies in Japan.
Under Japanese law there are 7 foods or ingredients that must be labelled on food packaging and these are: shrimp (えび), crab (かに), wheat (小麦), buckwheat (そば or 蕎麦), eggs(卵), milk (乳), and peanuts (落花生).
There are more foods that may cause a deathly reaction and an epipen to be used and that is the first problem: what are you allergic to? Because there are so many other allergens, you must look up in Japanese, ideally before you travel, what you are allergic to. A handy phrase would be:
______アレルギーがあります。I’m allergic to_____.
A person I know who moved to Japan is allergic to bananas and must be careful with any confectionery product because it’s an ingredient that is used everywhere.
In restaurants, the 7 allergens will be listed in Japanese on the menu if not apparent e.g. “egg salad” contains egg. If you are allergic to anything else, research before you arrive. Most menus are available online and even if you only have the ingredient that you are allergic to, you can usually see if they have it.
Additionally you can ask! If you don’t speak Japanese, use the phrase above and the waiter/waitress will help you out.
In addition to the 7, there are an additional 20 ingredients that can voluntary be put on packaging. These 20 can roughly be separated into 4 groups: nuts (walnuts, cashews etc), fruits (oranges, bananas etc.), meat (pork, fish roe etc.), and other (gelatine). This is down to the manufacturer of each product and you need to be aware of this fact when buying food.
Furthermore, there is always a risk of cross-contamination because even though there are extremely high standards of food manufacturing in Japan, allergies seem to be the exception rather than the rule.
The reaction to allegies
Japan is becoming more aware of allergens and allergies as the number of sufferers increases globally. One brilliant example of this is Mos Burger. This fast food chain has released a range of low allergen products in an effort to allow people with severe allergies to still enjoy their food.
According to the ministry for health, it is estimated that around half of the Japanese population have some sort of reaction to some foods.
Japan is known for having a hey fever problem and there are many medications for this and others. There are 5 types of medicines for allergies in Japan:
• General allergy medicines (the best I would say is Claritin EX [loratadine 10mg] which is a pharmacy only product, or contac Z [cetirizine HCl 10mg]- if you can take these. There are many other ones but the list of contras(contra indications e.g. Don’t take if you have X or not for people who are Y) does get quite long. • Eye drops. Many people use medicated eye drops to stop an inflammatory reaction occurring. • Eye washes. None medicated option to clean the eye of irritants • Nadal sprays. To stop the airways reacting to allergens or to prevent this reaction • Epi pen.
I hope this guide is helpful if your travelling to Japan.
This week I along with one of my colleagues went to a clinic and got the winter flu vaccine. The winter flu is said to be exceptionally terrible this year and it requires, in some cases, an entire week off work- no thank you.
As part of the visit I had a chat with the doctors and I need further tests. The ironic thing is that one of my awareness topics (diabetes) is something I am now being tested for along with hypertension (high blood pressure).
The vaccine costs ¥3300 (regardless of insurance) and an extremely common side effect is a localised rash and fatigue, both of which I had.
I would recommend getting the vaccine if you haven’t already had it. Additionally, if your at a clinic, spend an extra ¥1000 and get a diabetes test.
Thank you for reading and happy exploring
Quick note, my laptop has broken (thank you window’s update) and is stuck in a boot loop, and my recovery disk broke, so posts may be slower or shorter for a time.
Let’s look at diabetes in Japan in a bit more detail.
Diabetes Millitus is an extremely common non-commutable disease (NCD) that exists in every country- and Japan is no exception. In fact, diabetes has been on the rise in Japan and it is getting the recognition it deserves.
Diabetes in Japanese is 糖尿病 which is read as [too/nyou/byou] and is made up of 3 kanji: 糖- sugar,尿- urine, and 病- sickness so it is a decent translation.
There are a suspected 10 million people who suffer from diabetes in Japan but there are only 78.7% of men who receive treatment and 74.1% of women who receive treatment- but the difficulty is there are an additional 10 million who are at risk of becoming a diabetic. Additionally there are more than 300,000 people who regularly undergo dialysis.
There are 2 main types of diabetes which are simply called:
Type 1 is an immunodeficiency disorder (which means the body attacks its’ self) where the immune system is destroying pancreatic beta-cells that are responsible for producing insulin. People with type 1 diabetes need to inject insulin for survival.
Type 2 can be a few things but it is generally the body’s inability to cope. For example, the body either in unable to cope with the amount of insulin it produces (i.e. too little) or the insulin it does produce cannot properly interact with receptors on the cell membrane and take in sugar.
Other types can include gestational diabetes- diabetes during pregnancy, diabetes which is due to other conditions e.g. endocrine disorders, liver disease, drug or chemically induced etc.
Additionally, there is idiopathic diabetes is diabetes without a known cause. Idiopathic comes from 2 Greek words: ἴδιος (one’s own) and πάθος (suffering).
In Japan, a singular blood test is not enough to be diagnosed as a diabetic. One of the required symptoms of diabetes is chronic hypoglycemia or long-term high blood sugar (慢性低血糖).
After this symptom has been observed and a HbA1c test performed (which gives the average blood sugar level over a 3 month period), further tests are performed which are:
a fasting blood test. Diabetes is suspected if the result is greater than 126mg/ dl (which is greater than 27.0 mmol/l )
An oral glucose tolerance test (a 2h test) and if the result is greater than 200mg/ dl (or greater than 1.11 mmol/l)
The Japanese problem
With the westernization of Japan and the influence of the Japanese diet, in addition to reduced physical activity- Asia and Japan are going to be the epicenter of global diabetes.
Japan has sugar in everything and the Japanese diet is extremely carbohydrate heavy (rice) which encourages poor control and helps the development of type 2 diabetes. Additionally, the estimated cost for diabetic treatment is 400,000 JPY a year and even with the national health insurance discount, this is a whopping 120,000 JPY a year. While this is cheap for Americans in Japan, anyone from a country with a funded health system, this is an extraordinary expense.
Diabetes education and awareness
There are a few diabetes organisations in Japan that are actively working to promote health living and help people who have already been diagnosed with diabetes. However, there is still a lot more to be done. The main source for this information is the Japanese diabetes society (information in English and Japanese). Please check out the “further information” page for further links and reading.
Thank you for reading and happy exploring.
Final note, the following is a list of diabetes vocabulary and the Japanese translation.
A difficult topic to talk or write about but: an overview of palliative care in Japan
This is a difficult topic. This is a guide which should able to give you some guidance if you need it. This guide does NOT offer mental or spiritual advice, just an overview on palliative care.
You may be wondering why the warning- simple: dealing with either life shortening illnesses or end of life care is hard to experience. I have seen family members go through this and it is never easy. This guide should be helpful and it will include my opinions, and where to find help in Japan. If you do comment, please remember this is an extremely difficult topic- everyone has their own opinions and needs.
What is palliative care?
Palliative care helps individuals and families that are dealing with life-shortening illness and end of life care. Life shortening illnesses could be ALS, cancer, motor-neuron disease etc. End of life care is usually helping with pain management, emotional, physical, and spiritual support to those whose time is limited.
What you must remember is that everyone has different needs and wishes. Some end of life treatment plans may include hospice care, home care or hospital care. Additionally, palliative care seeks to neither hasten nor post-pone death. It simple seeks to improve the quality of life.
In developing countries at time of diagnosis 80% of cancer is incurable and the only thing left is palliative care- which is still a ‘new’ concept in may countries but millions of people are seeing the benefits of it.
The best resource I have found to show the benefits of this is a YouTube video. Please check out the ‘further resources’ page for the link.
Going to a hospice does not mean a place to die, for many it is a place to live before death. If you are in a position where palliative care is necessary- remember you are still alive and there are still bills to pay, things to do- life does not stop.
Hospice care takes these worries away from a person at a time when they’re usually extremely tired and don’t have much energy. For cancer patients, they can (and usually do) outlive their prognosis and are discharged from hospice care and in extremely rare circumstances return to a normal life (this is from a terminal prognosis).
For others, it is a place to help prepare one’s self and the family for the end.
Japanese hospice care
There are an estimated 300 hospice programs in Japan since the start of the program in the 1970’s.
Hospice care works with one basic principle: quantity rather than quality. For end-of-life treatment, emotional support and pain relief is at the heart of care. However, the hospice movement was a late movement in Japan. Many other countries had programs and support systems in place before Japan and in some respects Japan is catching up.
Therefore, end-of-life treatment in Japan primordially takes place in hospitals, and at home.
The Japanese hospice palliative care foundation looks to improve the image of palliative care in Japan as it is only seen as a place to die not as a place to live.
Home hospice care starts with a care plan with one member becoming the leader of a persons care. Doctors, nurses, people who supply medical equipment etc come together with the patient and family to talk about their goals of care, what they would like and what their family would like.
Home hospice treatment is supported by doctors and nurses trained in palliative care to ensure that (especially in Japan) terminal cancer patients have all the support they need. Home hospice care is becoming even more important in Japan due to 2 factors: an aging population and a short-fall of hospital beds.
Another reason for the rise of home hospice care is cost. For people under 70, a hospice can cost 469,000 JPY a month with a 70% reduction- this could be as little as 93,000 JPY a month- which is still, in my opinion, an unreasonable amount of money. For those over 70, hospice care costs 57,600 JPY a month- which is still expensive. Home care is cheaper- just a consultation fee, medical equipment fees and care support costs are needed.
However, home hospice care is not what most Japanese want. Many Japanese do not wish to be a burden on their families and would prefer to experience hospice care in a hospital setting. This is one of the things that the Japan Home Hospice Association is trying to combat.
There are brilliant resources in Japanese and English- the English resources are more limited. The key focus of this article was awareness and to give you a better understanding of what palliative care in and what your options are if you are researching it.