Blogs and senile dementia

With very large numbers of people living beyond the age of 80 the Japanese have a series of initiatives designed to reduce the incidence of senile dementia. Besides the community clubs for the elderly they also have a Silver Centres which supply 70+ aged workers for jobs such as tidying up the roadside verges or clearing out streams . Japanese society does not have the charity culture of the UK which provides so many people with a worthwhile voluntary activity, nor, in the cities does it have allotments.

There are daytime television programmes dedicated to exercises for the aged and you will have seen the adverts for Japanese computer games to exercise your mind on a daily basis. These are yet other examples of how the Japanese are tackling the risk of senile dementia. Me, I write a blog.

A sign of age

Drivers in Japan from their 75th birthday need to display a momiji (Japanese maple leaf) sign of autumnal red and gold on the windscreen or on the back of the car whenever they get behind the wheel. There is no rule as to where the sign should be put which means that it can get overlooked. Presumably the thinking is that, like learners, elderly drivers need to be identified so that the other road users will drive more defensively. There will come a time if it hasn't already when momiji signs considerably outnumber learner signs as the elderly have perhaps 15 to 20 years to display whilst learners are usually finished within six months.


As the display of these signs will be soon compulsory it will be interesting to see if "age discrimination" issues arise or whether insurance is declared invalid if an elderly person has an accident when no momoji sign is displayed.

After 75 no one fails a driving test

Awaji Island, where I am currently staying, is linked by very grand bridges to the main Japanese island Honshu in the North and one of the three other main islands , Shikoku in the South. This rural area is famous for its onions and chrysanthemums. It has a slowly declining population, first because like the urban areas of Japan the birth rate is below replacement level, but also because many young people do not want to be farmers and leave for the bright lights of Kobe and Osaka.

The small population of Awaji and its relative isolation until the bridges came means that there are no railways and in most areas only three buses a day. This means that old people have to drive if they want to go anywhere.

In Japan you have to take a driving test every 3 years from the age of 75. In Awaji those about to be tested are told that "no one fails"! Those who have had so many accidents that they can no longer get insurance have the government as insurer of last resort. There are no convictions for dangerous driving such as facing your friend in the passenger seat whilst driving on the wrong side of the road. As Awaji people drive rather slowly, 40 mph is really going some, it appears that the accidents that occur are not usually severe. However there are almost no pavements in the villages and the chances of being run down would be high except that when they see you walking ( I have done 11 kilometres in the last 2 days) the drivers cross into the other side of the road if there is nothing coming.

In many ways this deliberate fudging by the authorities is a humane response to the difficulties old people face in getting about. It will be allowed until someone runs over a school party and then the authorities will start enforcing proper tests. Maybe there should be silver roads where super senior citizens can drive, knowing that the risks to children have been properly accounted for.

Some 80 year olds still have mothers

In Kobe, last Saturday, where I am visiting with my wife, 4 of the 9 dinner guests, all aged over 60, had mothers still living. Amazingly not one but two of them, one aged 80, have mothers aged over 100. The other two mothers are 94 and 90 next January (this last is my mother ). The only other Brit present lost his mother when she was 98, so we represented at that table the future, not just of Japan but probably of all developed societies.


As I travel around Japan over the next two weeks I shall be looking for examples of how Japanese society, the world leader in the number and percentage of senior citizens, is managing its aged population risks. The Japanese joke that once someone gets to 90 they forget how to die.

One hand is better than two.

Following on from the Nansen blog and hearkening back to an earlier one about Will Rogers I came across the following pithy bit of advice in Anne Fadiman's marvellous little book " ex libris", culled from a naval manual ,

"Do not touch cold metal with moist bare hands.If you should inadvertently stick a hand to cold metal, urinate on the metal to warm it and save some inches of skin.If you stick both hands,you'd better bring a friend along."

Nansen and the Polar risks

Great programme last night on Nansen's voyage in his ship,the Fram, in an effort to reach the North Pole by using the movement of the Polar ice cap to ferry them there. The voyage started in 1893 and was completed over 3 years later .

The attempt was full of wonderfully inventive risk management ideas - the Fram was designed so that the pressure of the ice would, instead of squeezing it until it cracked, push it up and out on top of the ice. There was a wind driven propellor mounted on the mast to produce electricity. The food was varied which contributed to the health of the crew and helped relieve the monotony of the Arctic nights. Nansen had studied how the Inuit survived in the Arctic and used their techniques of building a shelter when he and a single companion had attempted to make it by dog sled to the North Pole. They turned their sleds into kayaks when, realising they were being taken away from the Pole by the movement of the ice ,they turned their attention to finding a way back, not to the Fram whose position after several weeks of ice movement was completely unknown to them' but to the nearest inhabited island.

Three and a half years after the Fram set out Nansen and all his companions returned safe, having made numerous important discoveries, including the existence of a deep ocean under the polar ice cap, but yet unable to claim the title of first men to the North Pole.

Truly the Norwegians were the pre-eminent risk managers of polar exploration.

Here is the map of Nansen's voyage.
http://www.fram.museum.no/en/default.asp?page=142

90 years on

On this day, Armistice Day, the 90th anniversary of the ending of the first World War watching Henry Allingham at 112 laying his wreath at the Cenotaph the final words of King Lear came to mind

"The oldest hath borne most: we that are young,
Shall never see so much, nor live so long."

Florence Nightingale sets the standard for ERM

On Tuesday this week I went to the Florence Nightingale Museum, just across Westminster Bridge from the Houses of Parliament, tucked behind St Thomas' Hospital to view their archives which they very generously made available.

FN didn't go in for snappy titles but her "Notes on matters affecting the Health,Efficiency, and hospital administration of the British Army" packs many punches that a tabloid editor would relish. Some she borrowed

"If you don't send shoes, the army can't march." Wellington.

Some she coined herself

" But habit and ignorance make all men in all professions wonderfully acquiescent in evils, which, if once known and felt are remediable."

What comes across is that no detail relating to her subject was too small to be considered and then improvements proposed. In three hours of reading I noted her observations and proposals on sanitation, barracks and hospital construction, ventilation,statistics' use and veracity, medical education, clothing and equipment, laundries, procurement, diet, cooking facilities ( bread should be baked by the regiment), recreation and discipline, sick transport,climatic considerations, finance, malingering ( there isn't any to speak of), soldiers' wives and their treatment, the need to remit soldiers' pay home and then, as you would expect, proposals for nurses and their training.

There really was nothing that escaped her eye, except perhaps mental health issues and probably that is covered in another volume. If you want to understand how thorough enterprise risk management could be you need look no farther than this book.

Cleaning up anthrax

The tragic death of a drum maker from anthrax, reported on today's news, raises the issue of who is qualified to decontaminate the site.

Probably in this case someone from the Porton Down laboratories will be given the job. In the event of a major outbreak of anthrax or an equivalently nasty disease then the public authorities would be very stretched. There are a few private experts and if you had need of one then Jeff Charlton at http://www.999team.org/ is among the best. No I am not on a retainer, but this kind of capability deserves wider recognition.