Visit to Lacura Group, Hokkaido, Japan

I invited myself to Summer in Hokkaido July 2015 and was very fortunate to meet up with my counterparts doing Eldercare services in Hokkaido. I subsequently visited 5 of their group's care facilities. I thanked Ms Shizuka Asanuma and Mr Yasutomi Akabori for their warm reception of picking us up at our hotels and driving us to visit so many of their high quality facilities. It was an eye opener, especially their latest facility, which is so unlike Singapore and so patient oriented. 

However, it is not to say Singapore are unable to support such facilities. The way Eldercare services is funded is very different. In Japan, there is a nationwide program for a complex funding system that is calculated by location whereby everyone aged 40 and above must contribute into a pool of national run "insurance" policy . When they are older and frail, requiring help for activities of daily living, they will be reviewed and if eligible, checked into one of these assisted living facility or what we call nursing homes in Singapore. The monthly cost of will be of a co-payment system, where the state run insurance pool will pay 90% of the cost. However, the policy might be altered in coming days and some form of MEANS testing, like in Singapore, may be implemented and the payout will cut to 80% for those with superior resources. In Japan, they do not have a domestic worker system which can be retrained to a stay in carer system like Lotus Eldercare. We run similar processes but essentially home based for our clients. This domestic worker system allows more dependent elderly to still stay in their own homes. We do not have a insurance system that pays for such services and those cannot afford are MEANS tested up to 80% for these types of institutionalised services. Thus, our support system is not as extensively built like that in Japan and it is either mainly in Government subsidised charity run nursing facilities or totally private nursing homes (some with portable subsidies.)

Located up the northern slopes of Sapporo with great view of the capital city, it is based in a more up market residential area in Sapporo, Hokkaido Japan.

Assisted living facilities in Japan are usually small, less than 50 to 100 beds. This particular one houses only 39 patients. Pricing wise depending on the size of the rooms, some can be huge and basically it is liken a studio apartment inside for every patient with an attached toilet with care givers and nursing services. In Singapore, we are usually ward based and we should be called Nursing Wards and not nursing homes essentially. 

Mr Akabori San first invited me for lunch in their newest assisted facility and told me we were having French cuisine. I have known Mr Akabori as kind of a joker and thought he must be kidding me again. Expecting to eat a package meal or perhaps a Japanese bento set in their administrative office, I was genuinely  shocked when they showed me the private dining room in their nursing home at level 4 (top floor). Overlooking the Sapporo city, I am suddenly teleported to a Michelin Star restaurant. It turns out they have a retired master chef who had worked in big Tokyo hotel kitchens retiring back home to Hokkaido. He wants to continue to be active and contribute to people in his hometown upon retirement. Hence, he joined this facility as Chief Chef and continue to delight people with his masterpieces. 

I was sat in the private dining room and given a menu, unfortunately in French and Japanese. Nevertheless, I knew anything served will be of high standards and I was not disappointed subsequently!

I will say this is the BEST meal I had in any nursing facility in the world!

Apart from the Dinning area, there is an area for residents to have their meals with an outdoor garden to have their meals outside in bright sunny summer days or cool summer nights. Here are some photos of the dining area.

Food are catered to requirements and calories properly accounted for. Usually calories count per day for the resident is 1600 Kcal.

This assisted care facility has specially created private spaces for residents and their visiting relatives. The lobby is a very welcoming space which is then led into a nice large living space (See above). There are many such private spaces spawning around the whole facility at every level. Every resident can choose their favourite corners to relax and meet their visitors.

Rooms are charged between SGD $2400 to $5500 by the size of the rooms, all inclusive (consumables, food etc) and every resident gets one or even two (one bedroom one living room). The charges are cheaper than those in Tokyo and one of the main customer base will be those from main island of Japan. All the rooms are equipped with barrier free toilets with grab bars and handles. Some rooms even have there own kitchenette for relatives or visitors to cook in. There are a few visitors room which can be rented out for short time for palliative cases.

I was told the floor plan of such assisted living is usually L shaped as shown with the nursing counter at the corner.

Going for long soaks in heated water is one of the simplest enjoyment in the Japanese culture. What is an accommodation without such installations! Here are some of the baths offered in this assisted living. Normally nursing homes only allow residents to have baths around 2 to 3 times weekly. This premium home as no restrictions, residents can use their facilities anytime!

There are more than 1 baths in this nursing home.

There are also bathrooms catering for more dependent, bed bound patients. With great views to the Sapporo City outside the window!

The above picture shows a secret hidden corridor and the accommodation of the staff, led in by a door in the main corridor and out of resident's view.

Every level is marked by colour coding on the corners, for example, the picture below showed 3rd floor.

The group started when this particular building was built and those moved in where IADL dependent elderly. The people in charge subsequently decided to renovate and convert the condominiums into a care home with eldercare services. 

Residents are housed in apartments and each will have their rooms and a living room with a attached toilets. There will be activities in the ground level and meals are taken in the dining area, each seat reserved and the meals customised to the needs of the older person. Calories are counted and special dietary needs like diabetic meals or gout prevention meals are prepared accordingly.

The ground floor is an activities area and kind of like a school, with all the artistic works of the resident pinned on the noticeboard together with their monthly newsletter which the children or close families of the residents will be given. The whole feel is more of a fun college hall rather than a eldercare home! There is lots of good vibes in it!

And of course, an area for exercise!

The only telltale signs that this is a eldercare facilities instead of a college hall is the hand washing basin!

The entrance to each apartment, 2 per floor, is entered from this lift and staircase with a ramp fitting. The apartments are not barrier free, idea being to give more challenges to the older person more exercises, with many grab bars aiding of course! In total, the facility can accommodate 125 older individuals.

The rooms are exactly like any other apartments. Rooms are serviced and residents are all assisted in their IADLs.

Residents can decorate their own rooms and it is a true nursing HOME!

The area is north of Sapporo, a mere 30 mins drive from central city.