The 3rd Nikkei Super Active Society Conference“Social Participation” Session

1(Pictured: a medically underserved marginal village in Hitachi Omiya, Ibaraki Prefecture)

Monday, 15 November 2021

Chairman, Medical Corporation Hakujinkai, Director, Shimuraomiya Hospital

Implementing a hospital-centric community development strategy and

promoting elderly people’s social participation

The Concept of the “Community-based Integrated Care System” (2019)

A system that facilitates cohabitation between multiple generations, in which people who require support with social activities and participation (e.g. children, infants, elderly people who are physically frail or in need of aged care support, people with dementia, people with disabilities and their families, and people who are estranged for other reasons) are able to live as independently as possible in their hometown while receiving various forms of support (including temporary hospitalisation or relocation to aged care facilities) until their final moments

(Chairman Shigeru Tanaka, Saitama Prefectural University) 2

The role of smaller community-focused hospitals and clinics

Coordination with larger

acute care hospitals

Coordination with

aged care facilities

Coordination with

Government Bodies

Dispatching personnel to

medical associations

Home care support

provided by clinics

Community

development

Smaller community-focused hospitals and clinics

Outpatient visits (primary doctor)Hospitalisation

Home care support

3

Hitachi Omiya City, Ibaraki Prefecture

■Population：38,541 （as of 1 August 2021）■Proportion of Elderly People：37.43％

■Proportion of Elderly People in each

Former City / Village:

Omiya：32.32％Yamagata：45.12％Miwa：48.80％Ogawa：44.83％Gozenyama：45.14％

Tokyo

Approx. 130ｋｍ

〈The Goals of the Shimura Freude Group〉

①Enrichment of community-focused medical care

②Establishing a community general care system ⇒ Measures against super aging

③Increasing the ratio of care services

④Expanding the service coverage areas to include the city areas

⑤Promoting the employment of elderly people ⇒more independent elderly people ⇒ measure against super aging

⑥Childbirth/childcare support ⇒Continuation & increase in women’s employment⇒ Measures against population decline

⑦Operating nursing schools⇒Developing local human resources

⑧Links between hospitals & local shops⇒ Increased foot traffic at local shopping districts

⑨Community building centred on medical institutions⇒ making the community a safe space for elderly citizens

making the community a more vibrant place

⑩Making a receptacle for super aging in metropolitan areas⇒ multi-generational CCRC

〝Small-to-medium-sized hospitals share

the same fate as the local community.”

5

The need for hospital-centric

community building

Shirosato

Population: 24,300

% Elderly People: 32.32%

Core Organisation: Shimura Omiya Hospital

Population: 5,441

% Elderly People: 45.12%

Core Organisation: Freude Home Care

Support Centre, Yamagata BranchPopulation: 2,818

% Elderly People: 48.8%

Core Organisation: Freude Home Care

Support Centre, Miwa Branch

Population: 2,931

% Elderly People: 44.83%

Core Organisation: Freude Home Care

Support Centre, Ogawa Branch

Population: 3,123

% Elderly People: 45.14%

Core Organisation: Long-Term Care Facility

Gozenyama Freude Garden

Population: 17,686

% Elderly People: 31.6%

Core Organisation: Freude Home Care Support

Centre, Shirosato Branch

6

Miwa(Former Town)

Ogawa (Former Village)

Gozenyama(Former Village)

Omiya (Former Town)

Yamagata(Former Town)

Community General Care Systems in each Former Town or Village

（Hitachi Omiya City and Shirosato）

Example: Ogawa District

（as of 1 August 2021)

Hitachi Omiya City’s Local Invigoration Project: “Freude DAN”

－VISION－

①Forging relationships between people within the local community

②Providing opportunities for people to enrich their lives

③Creating safe spaces where anyone can stop by and discuss any matters

④Making the local area a happy place by cherishing the city and its people

Formation of Freude DAN(10 December 2010)

Project Team Members:Occupational therapists / certified care workers / specialist counsellors for welfare equipment / care support professionals / nutritionists / nurses / etc.

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Community Cafe ＢＡＨＮＨＯＦ（Invigoration of local area / Link between hospitals & local shops ）

Community Cafe ＢＡＨＮＨＯＦOn the street in front of Hitachi Omiya Station

200m from hospital

As a gait training destination or a recreational area As an art gallery for works by elderly peopleAs a social space for high-schoolers and locals

Let’s walk there!

OPENED ON

06/02/2012

8

The Local Network surrounding “Freude DAN” and “BAHNHOF”

9

Possible ActivitiesAssisting Freude Health Classes

Farm work / car washing / sweeping / repairing / mowing lawns

Furnishing wood decks / cleaning / walking / cleaning baths

Washing / exchanging light bulbs / repairing wheelchairs / handyman / etc.

Drying hair after baths

Preparing lunch

Just chattingCleaningfacilities

５月３１日現在

10

1 10

2388

161191

210 232

0

50

100

150

200

250

Overview of the Shimura Freude Group’s Emergency Community Support Team

1111

Developments in the Shimura Freude Group’s Emergency Community Support

Formation of the SFG Emergency Community Support Team

（April 2020）Significant changes

in external

environment

Due to COVID-19

ＷＩＴＨCOVID-19

（As of April 2021）The SFG Emergency Community Support Team will continue to exist.

Understanding the

locals’ needs

The locals’ needs New Services Offered

Wanting to partake in small gatherings while

taking measures against infectious diseases

Dementia Prevention Café

(bookings essential)

Wanting to exerciseMachinaka Salon

(Online classes)

Wanting to gather information, even with

COVID-19 restrictions

Online broadcasts of

Locals’ Health Lessons

Wanting to buy groceries & everyday items by

oneself

Door-to-door sales facilitated by each

Support Centre

Wanting to do their own shoppingStation Morning Markets

Rakuichi Online Store

Wanting help with shoppingShopping services

Making use of Freude Supporters

Wanting to eat delicious foodFood deliveries / takeaway lunches

Station Night Markets

Wanting fun experiences Rakuichi Spin-Off

Understanding needs & continuing to offer services even during

the COVID-19 pandemic12

Community Living: A Concept

Community

Designer

Community

General

Support

Centre

Early Dementia

Support Team

In-home care

support centres

Dementia Medical Centre

Tier 2 Council

Community

General Support

Centre

Tier 2 SC※

In-home care

support centre

Disability

Support

Consultation

Centre

Medical institutions

Care Insurance

Businesses

Disability Welfare Services

Local Public

Health

Nurses

All-generation Community

General Care Meeting

Identifying issues

Solving issuesTier 1 Council (Council of Social Welfare) Tier 1 SC

Administrative Jurisdiction

Suggesting

government policies

※SC = Lifestyle Support Coordinator

市民

市民

市民 市

民

市民

市民

市民

市民

市民

市民 Freude Home Care

Support Centre

General

Childcare

Support Centre

Freude supporter

Proactive members

of SFG facilities

Small, Small Hubs

Backing up self-help and

mutual assistance

Ho

me

Ca

re C

on

su

ltatio

n C

en

tres

Point 1

Point 2

市民=locals

Construction of a Multi-generational Platform（2021 Collaborative Project with Citizens）

○○ District

Small, Small Hub＝Multi-generational Platform

・Atsumare

・Marche

・Shopping Support

・Collaboration with Tier 2

Councils = further specification

・Autonomous Disaster

Prevention Groups (in the future…)

・Watch-over

・Hubs for children

・Isolation Prevention

We will clarify boundaries in order to execute various initiatives effectively while keeping citizens in mind. By being a part of this, participants will gain a sense of belonging within the region, which would become a catalyst for developing civic pride. Freude DAN, the Home Care Support Centre and the Ward Leader must work together in order to make this initiative a success. Each organisationwill become a cog in the machine, make the community a more vibrant place, and will help kickstart citizen-centric activities.

Themed Communities

Themed Online Communities

Main focus of this initiative

Using this initiative as a

building block for

communities (multi-

generational platforms)

This community may have

applications in other initiatives

and businesses

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Government

・Wants to harbor resident-centric activities

・Wants to promote health and preventative care

・Can easily contact ward leaders

Private Sector

・Can’t be involved with self-governing

organisations (ordinary diets) easily

・Can offer professional health-related support

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Omiya(Former Town)

Yamagata(Former Town)

栄

南

中富

抽ヶ台

上町

下町

大宮第７

大宮第８

野中

姥賀高渡

野中

田子内

東野

Development of Small, Small Hubs

野口第1

野口第2

野口第3

野口平

門井

下伊勢畑

上伊勢畑

檜山

長倉

野田

秋田

中居

金井

那賀

下小瀬小玉

国長

下郷

本郷

宿

川西

西根

大岩

小舟

湯河内

小松

吉丸

入本郷

千田

氷之沢

下檜沢第1

下檜沢第2

上檜沢

高部第１

高部第２

小田野

鷲子

八田

若林

上大賀

久慈岡

岩崎

鷹巣

小祝

辰ノ口

塩原

小倉

富岡

下岩瀬

上岩瀬

根本

泉

宇留野台

宇留野圷

下村田

上村田

石沢

小場

小野

三美

西塩子

北塩子

大宮照田

山方第１

山方第２

山方第３

野上第１

野上第２

舟生

諸沢西

諸沢東

西野内

小貫

照山

盛金

久隆

家和楽

照田

長田

長沢

地域見守り協力隊やフロイデサポーターの関わり※目的を理解して活動していただいている人などがある地区

予防事業実施地区

地域活動参加多世代交流拠点やクデ・カフェ事業

区長の理解

深化した地区※地域住民が主体となって、地域活性化にむけて活動を開始した地

域

8Districts１７Districts

３９Districts

１３Districts

１５Districts

Miwa(Former Town)

Ogawa (Former Village)

Gozenyama(Former Village)

Participating in Society while you’re still active

City

Former Towns/Villages

Districts and Ordinary

Diets

Neighborhood

Individual

Small Hubs

Small, SmallHubs

※4

【Individuals and Activity Tiers】

Healthy Weak Needing Care

Continuing life at home ※1

Salon Activities

Breakwater 1 Breakwater 2

“AtsumareClasses” for

Preventive Care※2

Freude Supporters

Dementia Prevention Cafe

Exercise Cafe

Tier 2 Council ※3

Marche

Wellness Boosting Lessons for the young-old

Tier 1 Council ※3

Rakuichi

Distributing health-related info on LINE and YouTube

Medical Services,

Care Insurance Services,Disability

Services, etc.

※1 Even if someone lives alone, they can contribute to society by watching over the neighborhood in their front yard.

※2 Hitachi Omiya City Preventative Care Classes

※3 Hitachi Omiya City’s initiatives for preparing life support frameworks

※4 Hitachi Omiya City’s Collaborative Project with Citizens SHIMURA FREUDE GROUP

Furthering General Community Care & Turning Small-and-medium Hospitals into “Health Hubs”

17

Thank you for listening!

Streets in front of hospital after power grid was moved underground Freude Rehabilitation Park