Nursing Technology for Care With Dignity

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Estimates suggest that 1.4 billion people worldwide will be aged 60 or older by 2030.

Nursing facilities in Japan are looking after older people using a new approach, created by younger generations.

Wow. It's an incredibly beautiful nursing care facility.

This nursing home has implemented the latest technology in Japan, the world's most aged country.

The introduction of such technology isn't just improving efficiency, but most importantly, it's also enabling residents to receive better care and to improve the overall quality of life and their happiness.

So let's take a look at why that is and the roles it's playing.

This nursing home has 160 residents.

Each caregiver looks after 10 residents during the day and 20 overnight, helping them with meals and going to the toilet,

checking up on them at night, and handling unexpected incidents.

Most residents are either bedridden or rely on wheelchairs.

Caregivers are in charge of a wide range of tasks.

Such facilities face the challenge of reducing their staff's workload while improving the quality of care they provide to the residents.

Stretch out your arms and lean sideways.

This facility aims to decrease the burden on its caregivers with the help of digital equipment.

It has tested at least 150 types of digital nursing care devices and has helped to develop new ones.

Mr. Miyamoto, it's such a great pleasure to meet you.

It's nice to meet you too.

The facility is headed by Miyamoto Takashi.

He began by improving the overnight monitoring of the residents, a task that put a major burden on the caregivers.

He did this by introducing sleep sensors.

So, what's going on with the screen? What is it actually showing?

This shows whether or not
the residents are sleeping well.

Blue means deep sleep.
Yellow means the resident is awake.

Underneath each mattress is a sheet-type sensor that measures the state of sleep.

It can detect when the residents roll over in their sleep, and catch subtle movements of their bodies as they breathe.

This enables the caregivers to see in real time whether the residents are asleep or awake, and if they're sitting up or away from the bed.

Mr. Miyamoto, before you introduce the sleep sensor, what sort of problem is on task?

To check on the residents, the caregivers would
have to visit their rooms again and again.

But that would often keep the residents
awake or disrupt their sleep.

It also kept the caregivers busy and
unable to attend to other tasks.

Overnight monitoring of
the residents was a huge burden.

The caregivers used to check on residents once every hour during the night.

But with the introduction of the sensors, they no longer need to make regular visits.

The sensors show how the residents are doing.
Without anyone dropping by, they can sleep better.

The caregivers' workload is also lighter.
It's a win-win situation.

This system has also led to a review of how to care for each resident.

This woman in her 80s is becoming increasingly inactive due to dementia and a general decline in bodily functions.

She used to do things on her own,
such as going to the restroom.

She'd also sometimes eat meals by herself.

These days, she hardly talks with the staff, and has difficulty communicating.

She also eats less than before.

Would you like some more?

Are you full?

When a team of caregivers analyzed her sleep data, they noticed something.

The data show she lies in bed, awake for
long periods. She's not sleeping enough.

This is two weeks' worth of the woman's bedtime data.

Blue indicates that she's asleep, yellow means she's awake in bed, and gray is for when she's away from her bed.

The data shows that she hardly slept on some days.

Her days and nights have flipped for some reason.

There must be a reason why she slept
during the day just on that day.

Taniguchi pointed out that the woman slept in the morning one day.

The team noticed that on the previous afternoon, she was away from her bed.

Normally, she would lie in bed awake in the afternoons.

The members decided to review records of her activities for that day.

She fell asleep in the living room that afternoon.
This may have disrupted her sleep at night.

By comparing the sleep data with information on her activities, the team concluded that her afternoon living room nap had ended up disrupting her daily routine,

and kept her awake at night.

Given her tendency to doze off,
she needs more stimulus.

She could take a walk on the rooftop
and feel the coolness or warmth of the air.

She might see airplanes flying by.
Such stimuli can prevent napping.

The woman has difficulty going for walks on her own, so the team decided to take her outside for some sun whenever possible.

Exposure to the sun helps to reset the body clock.

That's Haneda Airport.

Look! A plane is taking off. Over there!

The caregivers say the sleep data from the sensors have helped them to review the way they provide care, and this has led to better sleep in more than half of the residents.

So what sort of changes did you bring about them?

Give me some specific examples of the exact changes that it's brought about.

When residents get a good night's sleep,
they become able to get up on their own, and eat without assistance.

As such things happen every day,
their innate abilities are restored.

They start doing what they can on their own.
Good sleep can help to make that happen.

I guess when you're looking at somebody's sleep data, I would imagine that everyone has individualized care as well.

Having data allows us to take concrete action.

Before this, the caregivers relied on
their intuition when helping residents.

Now, they analyze data, set goals
and see the results expressed numerically.

We can customize care for each resident.
That's the best thing about having data.

Protecting residents from falls is another major challenge.

To deal with the issue, this facility installed another type of sensor on the ceilings of the residents' rooms.

This video shows a resident slipping and falling while trying to get into a wheelchair.

There used to be many falls during the night,
but we only did rounds once every hour or two.

We wouldn't notice them right away.

The ceiling sensor is equipped with artificial intelligence that analyzes the residents' movements.

When the residents get out of bed or otherwise do something that could lead to a fall, the sensor detects it, and the system notifies the caregivers.

The sensor doesn't just send a notification.

Caregivers can keep an eye on the residents through a live camera feed and take action to prevent a fall.

A notification arrived, saying that a resident had gotten out of bed.

A caregiver rushed to the person's room.

Anything wrong?

I'm putting on my shoes.

This woman couldn't sleep and was trying to leave her room.

Her legs were weak, and she was at risk of falling.

The caregiver decided to put her in a wheelchair and take her where she wanted to go.

- Let's stay together.
- Thank you.

The caregiver stayed with the woman until she was ready to go back to sleep.

And I saw there was a video of one of your residents getting up in the middle of the night.

I would imagine that how is it - how do you feel it is, from the resident side of having that amazing care?

Must be quite, you know, very unique.

The residents feel at ease when
the staff come to see them.

If something happens, the live feed helps the
staff to figure out which resident to help first.

This helps to reduce the number of accidents.

We might also look at the footage and
adjust furniture layout to prevent tripping.

We may move the bed closer
to the restroom, for example.

We can try different things to
prevent and reduce accidents.

Are there any issues with privacy? For example, privacy of the patients?

The sensor keeps a recording
only when it detects an accident.

The employees can't control the system
to see what the residents are doing.

Also, the residents' faces are
not shown in the recordings.

This technology provides both
privacy and safety for the residents.

Recordings begin one minute before a resident's fall and end one minute after it.

This allows the staff to explain transparently the cause of the fall to the resident's family, while protecting the person's privacy.

The introduction of such equipment has led to a 40 percent drop in the time the caregivers spend on nighttime monitoring.

As a result, they can talk to the residents more often, getting to know them and providing more personalized care.

How do you feel?

Not bad.

I see.

Please eat a lot and stay healthy.

Because I think with technology, sometimes it has this very cold impression.

Cold. But you know, there's so much warmth behind it as well, which I think that's the other thing which really impressed me,

because it's when you're dealing with residents in a nursing home, it's, you know, it's that warmth that really comes through.

People often think of technology as
cold. But that's not true.

It allows us to offer support so that
the residents can live the way they want to.

What are your goals in terms of improving nursing care, using the latest technologies?

By analyzing data provided by these technologies,
we hope to pursue ideal nursing care.

In this way, more people can receive
good care and live happily in old age.

We aim to create an ideal model of a care package
in the fast-aging country that is Japan.

Our dream is to make it
available around the world.

In nursing care, toileting assistance is said to be the most challenging task.

It requires sensitivity to the dignity of the people receiving care.

Sano Shinichi works at a nursing home in Tokyo.

He has years of experience changing residents' diapers.

Nursing facilities handle toilet support
at fixed hours. We do it 5 times a day.

Even if a resident has a bowel movement,
the staff won't notice unless it leaks.

If the resident passes a stool
right after toilet support, they could be wearing a soiled diaper
for 4 hours or longer.

It takes about 10 minutes for a caregiver to change a diaper.

Because they have many other tasks to complete, they have no choice but to change diapers at fixed times.

However, wearing a soiled diaper for hours can cause the skin to peel on the buttocks and raise the risk of infectious diseases.

And if excrement leaks from the diaper, it's a major burden on the caregivers.

If the bed sheet gets soiled, it can
take up to 1 hour to clean.

We'd like to avoid stool leaks by all means.

Entrepreneur Wie Yoshimi stepped in, eager to make it easier for caregivers to provide toileting assistance.

A caregiver said, "I want to see the inside of a
diaper without undoing it." That's how it began.

Wie took on the challenge of creating a sensor that detects excretion and alerts caregivers to it.

This device has hollow tubes passing through a sheet.

The smells of excrement pass through the holes.

When the sensor detects the odors, the system sends the excretion data to computers and other devices.

While at university, Wie began to think of ways to detect excretion without undoing a diaper.

She focused on odor sensors.

Odor sensors are contained in devices that are part of our daily lives, such as air conditioners and air purifiers.

Wie, who was studying nursing-care robots at the time, thought of using an odor sensor to detect excretion.

In 2011, while in her final year at the university, she launched a company with her classmates and began full-scale deployment.

The most important part of developing the idea was to gather data about people's excretion and identify the type of excretion by the odor it produced.

We needed data, so we had to
check what was excreted.

This required us to undo
the diapers of older people.

But at first, we had a hard time
getting caregivers to agree to this.

We couldn't even do experiments.

Wie eventually decided to conduct trials on herself.

She donned diapers and started collecting data about the odors of her excretions.

Wie conducted experiments under the same conditions as the people receiving care.

She would wear a diaper every night and check to see how the sensor responded.

She even had her diapers changed by someone else.

I'd sometimes come to my senses
and remember I was a 24-year-old female.

I would think, "Is this something
a girl in her 20s should be doing?"

There was one point that Wie was insistent on.

I believe that caregivers want
the people they take care of to be happy.

They told me they don't want to attach machines
to people's bodies. I took that to heart.

Odor sensors that could detect excretion were already commercially available.

However, they had to be worn.

To respond to the earnest wishes of caregivers, Wie spent eight years to develop a device that didn't have to be attached to the body.

It was put to practical use in 2019.

A nursing home that introduced this sensor noticed its benefits in just one month.

A resident who complained of pain in the buttocks started feeling better.

We've been changing soiled diapers right away.

That has improved the condition of the residents'
buttocks, resulting in fewer complaints of pain.

People sleep better, so they stay awake during
the day and pay more attention to their meals.

Are you done eating? Was it good?

We didn't think diaper changes could lead to such
improvements. Honestly, we're quite surprised.

This sensor is being used at 80 locations across Japan.

A facility in Singapore is also considering introducing the device.

I'd like caregivers to think of
this odor sensor as a partner.

Not just a tool, but a new partner
in providing the ideal care.

I believe technology can be used
to improve nursing care in many ways.

Robotics can provide better ways
for people to support each other.

I want to keep working in the field.

The amazing array of technologies being introduced today result from the passion of young leaders of the Japanese nursing home sector to improve the quality of life

for people receiving care and to preserve their dignity until the end of their lives.

And as the Japanese population ages rapidly, I hope that such innovative endeavors will bring more smiles to the faces of those in care.

Now, it's time for tips on how older people living alone can easily make their meals more vitamin-rich.

Culinary researcher Tanishima Seiko will explain how.

So today on the program, we're going to learn some super easy, simple recipes using incredibly vitamin C-rich ingredient, which today is actually Yuzu.

Yuzu isn't just a popular ingredient in Japanese cuisine.

People in Japan have long loved the citrus fruit, even adding it to bathwater.

Yuzu is such as a hot popular Japanese citrus fruit at the moment.

It smells wonderful.

There's no substitute for this aroma.

Let's make a Yuzu sauce, which can liven up bland everyday meals.

If you can't find yuzu, you can use lemon or lime instead.

First, grate the yuzu peel.

The white part is bitter. The green part
has the nice aroma and is rich in vitamins.

Next, squeeze the juice and mix it with the grated zest.

That's it. The sauce is ready in no time!

Keep the yuzu mixture in a storage bag to prevent exposure to air.

It can be enjoyed all year round.

Freeze the sauce like this, and it's easy
to get just the amount you need each time.

You can mix it with other seasonings
to make a variety of dishes.

Variations of this yuzu mixture can be used for all kinds of dishes.

One example is carpaccio made with sea bream.

Pour the yuzu mixture and olive oil over raw slices, or sashimi, of sea bream.

The strong aroma of yuzu will help you to cut down on salt.

Gosh, it is so incredibly flavorful and incredibly tasty.

Yuzu is so powerful. It's mixed with olive oil,
but you can definitely taste yuzu.

Delicious and easy to make.

The yuzu mixture is very handy.

Next is a sauce for a meat dish.

Add mayonnaise and soy sauce to the yuzu mixture.

Adding mayonnaise is an easy way to make a rich sauce.

Stir-fry thinly sliced pork.

Pork is packed with vitamins.

Eating it with the yuzu sauce will provide many health benefits.

The mayonnaise will add body to the dish, while the refreshing flavor of yuzu will make it more enjoyable and easy to eat.

There's a perfect variation of the mixture for steamed vegetables.

People who live alone may have a hard time using up all the vegetables they buy.

But steaming is an easy and healthy way to eat more of them.

Mix the yuzu mixture with soy sauce and dashi stock.

This creates what's called "ponzu," a popular Japanese sauce full of a rich flavor known as umami.

So good.

I think I would have this with everything.

I know. It goes well with anything.

Thank you so much for today.

Thank you very much.