Tokyo nursing home’s single rooms, no-diapers approach: The future for Singapore?

Tokyo nursing home’s single rooms, no-diapers approach: The future for Singapore?

State-funded Morinokaze Nursing Home believes in helping its residents to be self-reliant - and reflects the possibilities of what elderly care in Singapore could one day be like.

03:11
A state-funded nursing home that offers single bed rooms, automated bathtubs and bed sensors? In Tokyo, it’s a reality at Morinokaze. Read more here: Is this the future for Singapore homes?

TOKYO: Like many Japanese seniors, Toshiko Yamashita was living a quiet life alone – until she fell and broke her knee in 2015, and was admitted to Morinokaze Nursing Home.

She was depressed at losing her independence and mobility. But today, the 82-year-old is thriving under the care of the “warm and friendly” staff, and is even walking again.

She’s not the only senior who has undergone a transformation since stepping into the state-funded Morinokaze, which puts emphasis on the dignity and choices of its residents, rather than merely their medical issues or disabilities.

Director of Morinokaze nursing home, Takaya Saitou (extreme right) looks on as Toshiko Yamashita, 84, walks with an aid. (Photo: Lien Foundation) 

About half of its residents showed improvement over the course of a year. Targeted at seniors in the middle to lower income brackets, the nursing home is funded by the government.

Despite its prime location in Shibuya – a district better known for its shopping malls than nursing homes – Morinokaze provides ample living space. All 80 long-stay residents live in single rooms with attached toilets. There are also high-tech bath-tubs that allow them to bathe with minimal help from staff.

There are no diapers or bed restraints in use here. There is one care staff to every two residents, and residents pay between S$860 and S$2,200 a month after government subsidies and insurance deductions.

A staff at Morinokaze cleans a resident's room. Despite being located in space-starved Shibuya, each resident is given their own room at this state-funded nursing home. (Photo: Lien Foundation) 

All in all, it’s a living example of what elderly care in Singapore could soon be like.

The Jade Circle nursing home, which is due to be ready by end-2019, will be the first of its kind in Singapore with full-spectrum elderly services, single bed rooms and a no-diaper policy – catering to both subsidised and private patients.

TRAINING TO BE INDEPENDENT AGAIN

At Morinokaze, the high staff-to-resident ratio is aimed at the old folks’ rehabilitation with a view to becoming more self-reliant. All long-stay residents practise walking daily and have weekly rehabilitation sessions.

Physiotherapist Chihiro Tanaka says getting the old folks to do this is a tough task. “Most are terrified they will fall,” he said.

Residents are encouraged to work towards greater mobility and self-reliance at Morinokaze. (Photo: Morinokaze Nursing Home) 

So Morinokaze weaves rehabilitation opportunities into the residents’ daily routines. “Holding the hand rails and going to the toilet yourself, or learning to dress yourself again, can also be considered rehab,” said Mr Tanaka. “We are training them to be independent again.”

Said director Takaya Saitou, who has helmed Morinokaze since it opened five years ago: “We work with individual residents to set goals. For instance, someone might want to be able to go out and eat sushi again.”

NO DIAPERS FROM DAY 1

One other thing makes Morinokaze exceptional – there is not a diaper to be found.

Most nursing homes rely on diapers, though they can be humiliating for the old folks and can cause bed sores. “They are undignified for residents, and the staff finds the task of changing diapers menial,” said Mr Saitou.

So how has Morinokaze managed to do away with the one thing many nursing homes have come to see as a necessity?

The nursing home has a "no-diaper" policy, and residents are encouraged to use the toilet to relieve themselves naturally. (Photo: Lien Foundation)

By the combination of a good diet, frequent rehydration and exercise – all of which naturally encourage bowel movements in the elderly, who are often prone to constipation.  “No matter their condition, in the daytime we have the residents use the toilets in their rooms,” said Mr Saitou.

Contrast this to many care homes which rely on laxatives instead to ease the constipation – and thus have to use diapers to manage the resulting diarrhoea.

Indeed, up to half the residents referred to Morinokaze from other care homes or hospitals are on diapers when they arrive. “We take off diapers from the first day a resident comes to us,” said Mr Saitou.

There are 80 long stay residents at the nursing home. (Photo: Lien Foundation) 

Mr Saitou added: “At Morinokaze, we don’t think that health deteriorates just from aging. So we seek to improve the elderly’s health through our care."

And these efforts certainly seem to be paying off. “Just look at Yamashita-san,” said care worker Young Kyun Suk. “She could hardly move when she first came here. And now she is able to walk on her own.”

The Lien Foundation, a co-partner in the Jade Circle nursing home project, recently visited Morinokaze. This article is part of a CNA Insider series based on that study trip to Japan.

Watch: A look inside Morinokaze (3:11)

Source: CNA/yv

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