CJ Rivera is a BSN student. During winter quarter in 2023, she traveled to Japan as part of the Keio University Short-Term Nursing and Medical Care Studies Program to learn about challenges of an aging society. UW students attending the program were supported by the Center for Global Health Nursing and the de Tornyay Center for Healthy Aging.
Why did you choose nursing?
Both of my parents are LPNs, so I had early exposure to what nursing was aside from the medical management aspect of it. I found interest in the way that I could align my passions for health equity, social justice, connecting with others, and caring for the human body through nursing.
What interests you about healthy aging?
When I got my CNA In 2020, I started off working in memory care. Before that, I had no prior health care experience with a geriatric population, and I found that I really liked it. I want to be able to use my career in nursing to help vulnerable populations, and right now, I believe geriatrics is the one that I connect to the most. Additionally, my grandma has dementia and lives at home with me, and I have found unique strategies to make caring for her easier on the both of us. Being a family caregiver has taught me a myriad of ways that I can recreate a more comfortable aging process for people that don’t have the privilege of aging at home.
What do you like about working with older adults?
I loved hearing about people’s life stories, and I feel like it was the easiest population to practice narrative medicine with, which is where you treat people and not just the disease or their disability. I appreciated their company and found the care that I was providing to be extremely rewarding.
What interested you in the Keio University program?
I’ve never travelled out of the country before, and I knew that Japan is known as the “super-aged” society. If I ever did get an opportunity to study aging from abroad, I would want to do it in a place that is known for having the healthiest elderly people.
Also, having a personal connection to Asian culture, I wanted to see the lifestyle differences between aging in East Asia, and then aging as a Southeast Asian in the US. I was curious about what factors of their daily life like activity levels, diet, etc. possibly contribute to their extended life spans.
What was the most interesting experience of your trip for you?
We went to a complex of houses that are owned by a health care company called Aoi Care. We got to meet the owner of Aoi Care and tour the community of around four houses that are just for elderly people. There was one house that was just for elderly people with Alzheimer’s and dementia. We were allowed to go inside while the residents were there, and see what their day to day life is like. It was just for a couple of hours, but I thought it was so special because the care was very holistic compared to aging in a facility in the US.
They lacked a lot of the strict rules that facilities for elderly people have in the US. They didn’t lock the doors, so the residents could roam freely around the community. They also didn’t have scheduled meal times. They were allowed to use appliances like stoves, kettles, irons, etc. Their food was also cooked by a traditional Japanese chef who uses dashi powder to increase the appetite and food intake of the residents. Rather than having a dietitian or a nutritionist prepare healthy meals, they found that eating culturally familiar and traditional flavors actually helped the residents increase their nutrition more readily, which is important to maintain as you age.
Did anything surprise you?
We got to shadow nurses at Keio University Hospital, and I think I was surprised at how similar the workflow and dynamic was to working in a hospital in the US. The US healthcare system has such a bad reputation, so I thought I was going to go there and see a complete change, and it really wasn’t that different. The nurse to patient ratios, equipment, and documentation were all very similar to the US. I was also surprised to hear that similar nursing stress levels and staffing crises are present in China, South Korea, and the UK when discussing the nursing workforce with the other students participating in the program from those countries.
What was the most interesting thing that you learned?
We learned about a free program called dementia supporter training. It’s basically the same as those training modules that you do every time you get a new job, but anyone in the general public can do them to learn how to care for people with dementia, since such a huge portion of their population is elderly. It was interesting to realize that in Japan, they try to normalize dementia. But in the US, it’s pretty taboo. It’s something that you don’t want people to know about. You don’t want people to talk to your elderly parents or grandparents that have dementia because it can be embarrassing.
I learned that the shame aspect of dementia comes from the majority of people being uninformed about what it is, or how it manifests in elderly people. Since we try to hide our aging population in the US, people don’t get the chance to understand dementia, but in Japan there’s no shame aspect of dementia and aging because their elderly are still acknowledged as members of society.
Is there anything else that you’d like to share?
I want to encourage other students to apply for opportunities like this. If they see like a global health learning opportunity come up in an email, open it up and actually read through it, because you never know what you might be able to get out of it! This program really expanded my world view of aging, and healthcare in general and I am excited to see how it influences my perceptions of other related experiences in the future.