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Community nurse in mountain village strives to care for elderly on daily basis

In this file photo dated Aug. 17, 2018, a community nurse, right, talks with an elderly woman along with a doctor in a village in the western Japan prefecture of Nara on Aug. 17, 2018. (Mainichi)

YAMAZOE, Nara -- Inside an old one-story facility surrounded by tea trees in this mountain village in western Japan, Natsue Nakaue was chatting amicably with elderly residents. "Active people tend to pass away really suddenly," said Nakaue, 42, as she prepared coffee and tea for the seniors while continuing small talk with smiles.

Nakaue is a community nurse, and her chitchat was part of an activity to prevent diseases or find illnesses early. While working at a nursing facility in the village of Yamazoe in northeastern Nara Prefecture, Nakaue has been seeing older residents twice or three times every week during the morning since June as a volunteer.

She came to this home village of her husband in 2009 when she got married, leaving a residential neighborhood in the western part of the prefecture. What she has found out with a sense of alarm was the thinning out of human relations in this small community of some 3,600 people, which had traditionally enjoyed strong ties among its denizens.

Here is Nakaue's observation: Motorization has allowed people to go far, to suburban supermarkets and big hospitals in cities. On the other hand, daily contact among residents at local shops and other locations has decreased rapidly, and people now know less about their neighbors. Nakaue's view was shared by Shinsuke Nomura, 61, who reopened his almost closed clinic in the spring of this year, and the two launched the meetings with the elderly every week.

Aiko Fukuyama, 84, came to a recent meeting organized by the nurse and the doctor. "People I know keep dying one after another," complained Fukuyama. "These days, I am only talking to the TV." Fukuyama used to be an active walker, but nowadays tends to stay home. "Auntie, you should go out more often," advised Nomura. "Natchan (Nakaue) will go pick you up." Fukuyama replied, "I got used to living alone but it is still lonely. I feel happy when people care about me."

Kazutaka Fujita, 77, and Hiroshi Fujii, 80, were at the gathering too. They've known each other for decades, but this was their first time in almost 30 years to sit knee to knee and have intimate talks. "Seeing each other is important. It makes you feel like you are remembering something important," said Fujii with a smile.

Nakaue received special training this spring as a community nurse following her career in hospitals and teaching at a school of nursing. She is busy raising her 6-year-old son, but she still thinks that she wants to do her part for the community.

"I want to take down the barrier separating residents from medicine," Nakaue emphasized. But "community nursing" and "health counseling" are words too big for some residents, who tend to stay away from such services. "We just want to talk about many things and support people to be healthy," she said.

The greying of the Japanese population has been continuing for years, but the year 2025 will be a watershed moment, because all baby boomers born between 1947 and 1949 after the end of World War II will turn 75 or older. The government is making preparations so that people will be able to go to places they are used to even when they become ill or need nursing care.

It is important to establish a system that will allow elderly people to have access to medical and nursing care without living in specialized facilities. But it's more important to secure their homes, provide preventive care and support their daily lives. Community nurses like Nakaue have a critical role to play in the area of disease prevention.

With less than 10 years until 2025, the system to support the growing elderly population is far from complete, and each and every community has to come up with their own ideas to care for their senior members.

(Japanese original by Akira Inou, Nara Bureau)

This is Part 2 of a series.

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