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Marilyn G.'s Report from the 2004 Alzheimer Disease International (ADI) Conference in Kyoto, Japan

By Marilyn G. Truscott, Alzheimer Society of Canada
Written Nov. and Dec., 2004

As I sit at my dining room table on this early November day, looking out to our backyard garden, I can see our magenta and pink chrysanthemums vividly blooming. The frosts have killed all the other flowers in my yard at this late fall date, but the chrysanthemums, beautiful, enduring and strong, are still giving us a glorious display. Chrysanthemums are an important Japanese symbol which one often sees in their art and fabrics. In looking at these flowers in my back yard, I am reminded of the Alzheimer's Disease International(A.D.I.) Conference a short month ago, and the beautiful, enduring and strong impressions I gained of Japan and the Japanese people.

I have had the privilege to attend three A.D.I. conferences, each unique and wonderful, Barcelona in 2002, Santa Domingo in 2003, and now Kyoto in 2004. I hope that everyone involved in our Alzheimer Societies will some day get an opportunity to participate in one of these inspiring meetings.

Traveling to Japan

My husband, Bill, and I left Toronto very early on October 8 with great anticipation of the exciting trip ahead. But the trip did not get off to an auspicious beginning! Arriving in Vancouver we learned that our flight to Osaka was delayed indefinitely due to the worst typhoon of the year. Of course we had no interest in our plane flying over the Pacific with no guarantee of landing at the other side, so we waited patiently, pacing the Vancouver airport from end to end, filling in time with coffee and snacks. We worried about the damage for the Japanese people from this terrible storm. Finally, we were aloft!

The flight was smooth until we got close to Japan, and just as the flight attendants reached our row to serve breakfast, the plane started to tremble slightly. We had approached the edge of the typhoon winds, and the breakfast service would have to shut down. I estimated that only ten people on the plane had missed the breakfast serving, and we were two of those ten! We had to make do sharing our emergency supply of one nut and seed bar and a tiny piece of chocolate, the smell of bacon and eggs, orange juice and coffee tantalizing our noses from the rows around us. At last we landed, and the passage through Customs and Immigration was surprisingly quick. We searched for food. Our flights had been scheduled to land us in Osaka early in the afternoon. Now it was late in the evening, and the airport food services had closed. Our taxi shuttle service, booked to take us directly to our hotel in Kyoto was also closed. I sat down dejected and hungry beside the shuttle desk, wondering how we would spend the night. But our luck was changing! A lovely Japanese woman, a doctor from Kyoto, was also looking for the shuttle service. She had returned to Japan on our flight after a short holiday in Canada. We looked lost. Our Japanese angel asked if she could help translate, and with her little pieces of English she managed to arrange for us to share a taxi to Kyoto. We had a lovely ride in the dark of night, hearing about her travels in Canada, and learning about the landmarks of lights around. Finally we reached our hotel, the New Miyako Hotel. In the dark we had no idea where we were. Our lovely bedroom was a welcome sight! And we slept deeply to make up for the ten time zones we had flown through.

Saturday morning we woke to a gorgeous warm day in Kyoto. We opened our hotel drapes and were surprised to see that we were facing the Kyoto train station. We could see the bullet train (Shinkansen) going back and forth, as well as the slower trains. Across the street, at the train station is an enormous shopping mall, which extends for many blocks. Parts of this mall are ultra-modern, with the most creative architectural design, in one part there are escalators inside the building reaching 10 or more floors, but also outside the building. I had never seen an outdoor escalator before, not an appropriate device in our snowy, icy Canadian climate! The railway station area is surrounded by numerous cafes and restaurants (including a MacDonald’s). We were fascinated by the displays of menu items shown outside each dining shop; each platter beautifully decorated and priced. It was so easy to decide on a meal. We did not have to know Japanese; we simply pointed to the platters in the window that we wanted. We did not always know what we were eating, and I could not get translations of many of the vegetables. The spices, sauces and presentations of the dishes were so exotic, that we anticipated each meal with great excitement, wondering what we would be trying next. Certainly it would be seafood, if the choice was left up to my husband. We got to know the staff at a little café which seemed to be frequented by local working people, and early each morning we went there for smoked salmon, rice, a bowl of miso soup, mystery vegetables, an egg, and seaweed. Very nutritious, very delicious.

We found that the prices of meals varied wildly, and we could have a dinner platter for $7 U.S. each, or for $70 each. Or even higher. Our special breakfast cost less than $10 U.S. for both of us. We discovered that the Japanese are master bakers, and their breads and pastries are incredibly delicious. They bake sweet buns with all sorts of dried or fresh fruit and nut fillings, stuffed rolls and croissants with ham, cheese, sausage and vegetables. They make cheesecake in little squares and wedges with all sorts of fruits. Many of the pastries were works of art. We quickly realized that beauty of presentation is an important part of Japanese culture. Every day we bought a new variety of pastries to take back to our hotel room and try with bottled cold green tea. We tried many flavours of fruit drinks and flavoured teas and green teas from the drink dispensers located throughout the malls. But there were more treats yet to come!

We slowly recovered from jet lag, taking a quiet first day learning about our environs, walking around the area near our hotel. We also learned about Japanese modern technology and engineering. In some public washrooms there were hand dryers that you put your hands into downwards, they envelope your hands and are very fast end efficient. The toilet in our hotel had so many buttons and levers on it that it terrified me. I got Bill to test it out to see what all the buttons were for. Water squirts one way or another way, etc, depending on the button; you almost need a special course to understand how to use the toilet without drenching or drowning yourself. But once you get used to it, it’s another very ingenious device!

Our hotel room was lovely. It was compact, no space wasted, and we were given two single beds placed right close together. The chairs and beds were very low to the floor. There were very convenient, space-saving closets, so the room size, although small, was more than adequate. The hotel staff were most pleasant and helpful. And we found that treatment wherever we went. We merely had to stand at a street corner looking puzzled, and a friendly Japanese would come up to us and ask, “May I help you?” More often than not, our kindly helper would offer to take us in the direction we wanted to go, on the pretext that, “I’m going that way also”. We were given such courteous help, and smiles whenever we looked at anyone. Kyoto is a very friendly city.

We had to do some sight-seeing, of course! We knew from previous A.D.I. conferences that once the conference started we would not see any more of the city. We would have to crush in as much touring as possible in our remaining time before Thursday. We signed up at our hotel for morning and afternoon tours of Kyoto, full of highlights of the city. Kyoto is a fascinating city, with surprises at every turn. Squashed up against the traditional old-style Japanese homes and Shinto shrines you will see modern buildings of the most recent design. There is a lovely river running through the city, and many modern bridges, and then you will come across an old gate for a shrine or Buddhist temple. On the streets you will see Japanese women wearing chic high couture (from the designer clothing stores in the mall at the Station), or modern casual wear in fashion in Los Angeles, or the traditional kimono with fancy sash and belt, white stockings with split toe, and black thong shoes. So many contrasts, the ancient Japan and the modern Japan, living in harmony side-by-side.

I loved seeing the local women in their traditional formal dress. Bill and I went to a mall shop that sold new kimonos and sashes, finely woven in silk with delicate, complex patterns. These items sell for $250 U.S. to $2000 U.S. just for a sash around the waist. Hoping to buy a kimono for me to take home to Canada, we went to the Kyoto Handicraft Center to comb through the many shops that sell new kimonos (cotton, polyester, or silk), and antique kimonos. Prices for antique kimonos vary from $500 to $6000 U.S. and more, and most of these garments are indescribably beautiful, with hand-embroidery on flowers, dragons. It was a treat just to see them and touch them. I did end up with a pretty purple kimono with flowers all over, inside our budget ($50 U.S.). There were so many things to tempt us at the Handicraft Market: pottery, bells, wall-hangings, origami, carvings, sculpture. We easily found just the right gifts to take home! But there was more to see later in other shops.

I was particularly fascinated by the multitude of shrines and temples dotting the horizon, and lining the streets. Kyoto is said to have approximately 300 Shinto shrines and 1600 Buddhist temples. Our guide told us that Japanese people go to both, to Shinto shrines for blessings of good luck, prosperity, health, weddings, and other prayers for regular events in life, and they go to the Buddhist temples for funerals and serious prayer. We were very fortunate to come upon both a baby christening and a wedding ceremony at a Shinto shrine. The baby was wrapped in a traditional fancy red cloth, with the baby’s grandmother dressed in her lovely kimono. The wedding was a mix of eastern and western, bride wearing a flowing white gown, and bridesmaids in pale pink flowered kimonos. So picturesque to see this in the gardens of the shrine!

Kyoto is a very beautiful city. According to our guide, Kyoto used to be named Heian Kyo (“Peace Capital”) until the mid-700’s, and then became known as Kyoto (“Capital Capital”), when it was the Shogun’s palace and capital of Japan, before the capital moved to Tokyo. The Shogun ruled here but also went to the Imperial Palace in Tokyo, consequently there are many important buildings related to the Shogun.

We toured Higashi Honganji Temple, a beautiful wooden structure with ornate carved beams. While we were there a prayer service was ending, and we quietly got to see some of the Buddhist prayer ceremonies from the far edge of the tatami mats. In the Japanese temples and shrines, as well as the palace, one gets such a sense of space and simplicity. The floors were wide and generally clean dark wood or tatami mats, and the decorations were generally extremely ornate wood carvings in the structural elements of the buildings.

Nijo Castle, the Kyoto residence of the Tokugawa Shogun, was built in 1603, and it showed that simplicity of design, yet with considerable decoration in surprising places (doors, gates). Clean lines to the empty rooms, however the walls, ceilings and cornices were beautifully painted with traditional Japanese patterns and symbols, and there were flowers (Chrysanthemums for example) on the walls and ceilings and pine trees, blooming cherry trees, tigers, herons and falcons, and garden scenes on the large walls of most of the rooms. The huge delicate paintings of the trees seemed to bring the outdoor gardens into the open interior. I asked the guide about the fancy stamped and carved metalwork pieces (like medallions) placed at intervals on the walls boards, and was told that they were placed there to hide the joins between joists and large timbers. Wherever you looked there were unique designs, from the strong wooden gates and white plaster and cut stone walls, to the careful pruning of the pine trees and other trees and bushes. The Nijo Castle garden was very beautiful, with a pond of enormous Koi fish and waterlilies, and large rocks jutting out of the water surface.

We were glad of the bright sunlight when we saw Kinkakuji Temple, also called the “Golden Pavilion”, covered in gold leaf, and from our viewpoint across the wide pond the sunlight glinted off the roofs of the three tiers, like liquid gold. We walked around the beautiful pond and enjoyed the tranquility and beauty, as the Shogun must have done at the end of the 1300’s when he built the gardens. We were amazed at how much pruning was done to the trees and bushes, and how this enhanced their shapes. One very ancient pine tree was very extremely pruned and shaped, like a giant Bonsai tree; one branch had been encouraged to grow extremely long and was held up in place by a careful network of poles. The tree shape with its long branch was reminiscent of a ship, in which to travel to heaven.

The Heian Shrine (Peace Shrine) was another unusual site, with its reddish-orange (vermillion) pillars and bright green roofed buildings. It was built in Chinese style in the 1800’s, and at one entrance to the area there is an enormous gate with giant vermillion pillars. The ponds around the shrine are very beautiful and contrast starkly with the large graveled surface linking the buildings of the shrine.

Of all the places we toured, my favourite was Sanju-Sangen-Do Hall, a temple which is a National Treasure. This dark brown wooden building is as long as a soccer field. It contains a wonderful surprise: 1001 larger-than-life statues of the Buddhist deity, “Kannon”, carved in the 12th and 13th centuries. One of these statues is an enormous seated Buddha “Kannon”, and 500 of the Kannon statues stand on each side of it. Twenty-eight images in front of these Kannon statues are guardian deities, and there are also statues of the Thunder God and Wind God at each end of the hall. The statues were made from Japanese cypress, and the carvings are incredibly complex and detailed. I could have stood for hours looking at these statues, each one was so individual, with ten small heads in a crown around each head, and 20 little hands reaching out from behind each statue, holding various symbols.

Our last tour of a temple was to see the Kiyomizu Temple, a World Heritage Site, with a very high temple with many upswept roofs. At the site is a waterfall, which looked like a controlled spring from which one could get water to drink. Winding paths led around the temple and down into the ancient streets below. And our final treat of the day was to walk on the street leading down from the Kiyomizu Temple, a wonderful, colourful street lined with a variety of shops, selling gorgeous Japanese pottery (from little bowls to expensive art pieces), unusual bells and chimes (some of which will be singing in our garden next spring), sweets made of pressed fruits, pastries, many foods that we could not recognize, and shops selling green soft ice-cream. We just had to try the green ice-cream, flavoured with some kind of seaweed. It was delicious and very refreshing. Emboldened by our ice cream experience, we found another shop that sold cream puffs filled with green cream, same flavour, and enjoyed that.

But we still had more adventures ahead of us!

For days we had been watching the Shinkansen trains go back and forth. Bill said that he would love to have the experience of riding on a really fast train. Well, there was no time like the present, so we rushed over to the train station and found an information booth agent who could speak a few words of English. “We would like to go on the Shinkansen, not far, just to try riding the train. What is the nearest place we can go to and return from?” After a half hour of trying to make this amiable fellow understand what we wanted, he advised Nagoya, and took us over to the ticket agent, helped us buy tickets, and then took us right to the train track entrance area. That's an example of typical Japanese courtesy!

The Shinkansen was a great ride, very fast, these trains travel close to 200 km/hour, and they are so smooth and quiet that we felt very little motion and little noise. The train stops gently and quietly, like a skyscraper elevator coming down non-stop from the 100th floor and slowing abruptly to cradle itself gently to the ground floor level. The train stopped precisely at a marking line for each car, and left and arrived precisely on the scheduled time. Japanese efficiency and technology at its best! At over $100 U.S. each, this was definitely the most expensive 45 minute one-way ride we’ve ever had (or are likely to have), but it was worth the price! Where in Canada will we find a bullet train?!

At the Nagoya train station we found the information booth and looked at the Nagoya map. Where could we go within a 5 hour period before our return train to Kyoto? We carefully checked the map: temples, shrines, art galleries, museums; many choices. And then Bill spotted “Orchid Garden”. He knows how much I love flowers, so he bundled me into a taxi and off we went to tour the most beautiful orchid collection I’ve ever seen. The displays were stunning, indescribable, with Ikebana arrangements, garden pathways, outdoor ponds, and an atrium filled with orchids right up the walls. And the final part to tour was the sales area in the foyer. For $10 U.S. we could buy four large bunches of flowers, an amazing price by our Canadian standards. There were all kinds of choices: lilies, daisies, chrysanthemums, roses, etc; but I chose orchids. We went back to the train station loaded down with a huge bag of magenta and yellow dendrobium orchids and two pretty plastic vases. And so, for the rest of my stay in Japan I had a hotel room with two vases overflowing with orchids!

The Conference Begins

The next day was a quiet day, moving our luggage (and orchids!) to the Kyoto Takaragaike Prince Hotel, located right adjacent to the conference centre, in preparation for the A.D.I. conference, which would begin the morning of October 14th with the Council Meeting.

What a beautiful setting for a conference centre! The centre was also located close to the subway station, so it was very easy for people staying in other parts of the city to get to the conference. And it was easy for Bill and me to get back into the city centre for evening meals, to continue our exploration of Japanese cuisine.

On October 14th we walked the short distance from the Prince Hotel over to the Conference Centre very early to get our bearings there and find our meeting room. As the delegates trickled in slowly, at first and then in a crowd, I was able to catch up with old friends from the previous two ADI meetings and learn about others I was just now meeting, where they were from, what their roles and their goals were, and to hear about exciting research news and also activities in other countries. Bill and I exchanged greetings with our small group from the Alzheimer Society of Canada, Board President Carl Parsons and Executive Director Steve Rudin, and we prepared for the events ahead. The Council meeting formally began, and after everyone introduced themselves, the business meeting got underway.

Organizational items were decided on and announced, for example, the upcoming 2005 meeting being planned for Istanbul, Turkey, and the 2006 meeting for Berlin, Germany, and 2007 in Venezuela. After 2007, the ADI meetings will be held every second year, to reduce costs for the member countries. We heard about exciting World Alzheimer’s Day activities recently held in various countries. ADI plans to increase the visibility of World Alzheimer’s Day, and to help member countries to influence their policy makers to make provisions for the increasing impact of dementia in our aging populations. Some delegates shared their own experiences and goals in pressuring their governments to make change, such as declaring Alzheimer Disease to be a national health priority.

There was much discussion that all members should support the aim of including and consulting with people with dementia on issues affecting them, and ideas shared on ways to do this, and including people with dementia in committee and Board work.

Elections were held for some Council positions. Orien Reed (U.S.A.) became the new Chairman, and Dr. Daisy Acosta (Dominican Republic), Ruth Goldberg (Israel), and Wendy Fleming (New Zealand) were accepted to fill two Council vacancies.

Elizabeth Rimmer, ADI CEO, gave her Executive Summary and told us that 22 people with dementia were registered, sixteen from Japan and six from other countries, this being a record attendance. World Alzheimer’s Day had been a great success around the globe, however Alzheimer Disease needs to be made higher in priority by the public and governments. Steve Rudin (Canada) talked about the proposed world team Ascent of Mount Kilimanjaro being planned by our Alzheimer Society of British Columbia in Canada, and invited the ADI membership to put forward a prominent candidate from their countries to make a ten person team from around the globe to increase awareness of dementia and to raise funds world-wide. After many other items of routine business and interesting information, the meeting ended. But the social contacts continued that evening, as Council delegates joined again at the Kyoto Kukasi Hotel banquet room to celebrate the 20th Birthday Party of ADI. We enjoyed a Japanese buffet, speeches of congratulations, a little karaoke, and warm fellowship.

On Thursday, October 15th, the conference started in earnest. There were so many workshops to choose from, too often conflicts where attending one meant sacrificing many others. The talks were translated into English and Japanese, a great advantage for most of us because there was a huge number of delegates from Japan, and many of the speakers gave their talks in Japanese.

A number of talks and workshops touched on issues affecting people with dementia, and I tried to attend these as well as many research talks. Some topics that caught my special attention were the use of dementia advocates in the United Kingdom, to protect the interests of the person with dementia, even sometimes against the families’ wishes (Caroline Contley, U.K.); consultation methods developed for people with dementia and people with memory problems who live in care homes, to enable them to make their own decisions about their care (Sylvia Cox, Scotland); the development of the National Dementia organization in Scotland by and for people with dementia (Christine McGregor, Scotland); a description of a national conference held in London, England to get opinions from people with dementia about their priority needs (Karen Litherland, U.K.); and a unique interactive computer based tool to aid reminiscence and conversation (CIRCA) developed by a group in Dundee, Scotland (Gary Gowans and Jim Campbell et al, Scotland).

People with dementia participated in this conference in significant ways. Speeches were given by six people with Alzheimer Disease or a related disorder. Lynn Jackson (Canada) talked about her own journey with Frontal Temporal Lobe Dementia, and her decisions she has made for her later care. Doreen Cairns (Scotland) told us about her story, and about the importance of the Scottish Dementia Working Group (for people with dementia). Christine Bryden (Australia) chaired our session and also gave a persuasive talk about including people with dementia in making policy decisions. I gave a speech about the problems of dementia being an "invisible disease" (the "well" appearance on the outside often obscuring the great difficulties) and the need for open communications with others so that these difficulties can be appropriately supported.

In the Saturday Plenary Session, two speeches of major impact were given by Nakajama Ochi and by another man from Japan. These two men described their problems with early onset Alzheimer Disease and the way they have (along with their wives) learned to cope and to regain joyful lives. These two beautiful speeches ended with the delegates standing in a huge wave and clapping loud and long, tears streaming down their faces. I believe that these two important speeches, which were given rapt attention by the many Japanese news reporters in attendance, will have a long-lasting effect to educate the Japanese public about dementia, reduce stigma and fear, and open doors to Japanese people with dementia to regain more control and supports in their lives.

The other notable participation from a person with dementia was at the conference banquet, when a Japanese woman with Alzheimer Disease sang some traditional folk songs. Her beautiful, sweet voice left us in awe. I was so moved by her singing that I wrote a poem in her honour later that night.

Pretty Kimono Lady

Pretty Kimono Lady
Sweetly sing your song
In your pink kimono
Shining silks and snowy thongs.

Pretty gentle lady
Dark hair swept in a crown
Our hearts lift up to you
As our tears fall down.

Your lyric lilting folk songs
Reach out into the crowd
And soon the smiling faces
Sing back to you aloud.

Your ancient songs do move us
And touch us to the core
We cheer and clap and smile and laugh
And make you offer more.

Lovely Kimono Lady
Whose hand I’ll never touch
In truth a sister traveler
I know your life so much
Your new and daily struggles
And puzzlement and pain
But singing to us bravely
Recalls your self again.

How beautiful your music.
This moment I can stay
Inside a crystal bubble
Time still, fears far away.

Our banquet was great fun. Bill and I were fortunate to have a delightful Japanese psychiatrist seated at our table and he translated the words of the songs and explained the entertainment in excellent English for us. After our singer, a group of folk dancers swept in with their bright costumes, and eventually they had most of us on our feet doing a Japanese version of the "Conga line" in traditional Japanese folk style. This was a great way to get to know lots of people quickly, with everyone smiling and laughing at their joy of the energetic dancing.

Our group of People with Dementia was assigned a large sitting area away from the bustle of the hallways and speaking rooms. This was a welcome haven to rest in and to meet with others, including Myrna Blake from Singapore, and Kunio, Eicho and other Japanese delegates and their care-partners and families. The A.D.I. and Japanese organizers made full efforts to enable our participation and they provided us with some lovely young women who looked after our needs, brought in pastries and drinks, helped us with e-mail on the computer in the room, and translated Japanese and English for our members. With the translators and our heart-felt smiles, we were able to communicate very well with each other.

There were so many special highlights for me at this conference. The Yoshioka Rehabilitation Clinic in the Japanese Clinical Art Association had set up an inspiring display from their art therapy program called "12 Months of Art Therapy". As we walked through a maze of corridors we were surrounded by the results of twelve art projects beautifully framed and presented. Each project is simple in concept (requires no previous training) and takes few materials and only two hours of time start to finish. The goal is to engage all the five senses during the activities. As an avid hobbyist and amateur artist I found the projects fascinating and immediately wanted to try them all myself. Programs like this will be so stimulating and beneficial and I believe they should be used everywhere. Masatake Uno maintains that art therapy helps to strengthen a sense of self, bring people out of personal isolation, and gives dignity to their productive behaviour and improves their quality of life.

Because of my interest in the optimization of body, mind and spirit for the optimization of cognitive functioning and quality of life, and promoting creativity in people with dementia, I found many special moments throughout the conference. As well as wonderful talks and posters on horticulture, art, music and reminiscence therapy, the living environment was stressed, for example in a poster on the Community Alzheimer Healing Gardens in Boston (R.L. Wilcox, U.S.A.) which uses garden elements in structure, texture, colour and smell (herbs as well as flowers) to give joy and reminiscence to a long-term care home, and also Naochiko Hyaka’s (Japan) emphasis on habitat design making the outdoors an important part of the care home. There were many posters and talks on nutrition and non-pharmaceutical alternatives to promote healthy functioning (so important when at present we have so few effective medications available for Alzheimer Disease. Bill and I had many long discussions with Dr. Nancy Emerson Lombardo (U.S.A.) about her and her colleagues’ exciting poster on interventions in Alzheimer Disease using proper individual nutrition and nutritional supplements, exercise, social supports, cognitive retraining and stress management techniques (their Brain Wellness Program). We agreed with her on the great importance to feed and stimulate the brain to maximize function and quality of life.

Machiko Masuda (Japan) also stressed games and physical contact and encouragement to enhance attentiveness and judgment and slow progress of dementia. Other speakers (for example Kae Baba and Miyuki Takabayashi of Japan) also focused on preventing the advancement of dementia from the early stage.

Many workshops reported research results, biomedical research, pharmaceutical studies, development of neuropsychological testing and imaging techniques, and statistics on disease prevalence, as well as studies of quality of life for caregivers. My favourite topics were, of course, reports about new drugs in trials and studies on the effectiveness of the long-term use of our current Alzheimer medications. Other highlights of the meeting were to talk personally about their research with so many prominent international researchers, for example Dr. Howard Feldman (Canada) and Dr. Steven DeKosky (U.S.A.). It was particularly special to have a meeting with Dr. Atushi Murai and Dr. Nakao Fujimoto (Japan) and to learn about Dr. Fujimoto’s Memory Clinic. We discussed at length his system of using a Co-medical Assistant to do patient interviews and follow-up and to provide on-going liaison between him, his clinic and the community resources needed for the individual. This liaison is generally lacking for patients around the world, and a simple system of linking a doctor’s patients with services and help would be extremely beneficial, such as Dr. Fujimoto is using. In Canada we are working on liaison systems between doctor’s offices and the local Alzheimer Society offices and their access to local dementia services in various cities and regions in Canada, following the lead shown by the cities of Ottawa and Edmonton. My own local Society in Ontario will be launching a pilot project with doctors in early January.

I know that the educational aspect of the A.D.I. meeting in Kyoto will have long-reaching international effects. Christine Bryden stayed on in Japan after the meeting to give numerous interviews. The journalists at the meeting are still busy writing articles about dementia, and publishing them not only in Japan but world-wide. For example, a Japanese group was so taken with a powerful quote by Helen Keller which Lynn Jackson used as an example of how she herself lives, that they sent a team (reporter, translator and photographer) to Canada to spend dedicated time with Lynn and interview her friends and family for a long feature article syndicated widely internationally. This article should appear in the New Year. This team even came to Toronto on November 6th to attend "A Changing Melody", a conference for people with dementia and their care-partners sponsored by the Murray Alzheimer Research and Education Program, the Alzheimer Society of Ontario and the Alzheimer Society of Canada. This unique conference will be reported world-wide through the efforts of Japanese reporters as a direct result of the A.D.I. Conference. News groups have taken the speeches members of our groups presented in Kyoto and published them widely in the media in Japan. I feel very honoured that I have been part of this educational sweep, which may well change cultural attitudes in many parts of the world, particularly Japan and the Far East.

And so the conference ended. But the memories will continue, sparked from our photographs, and my obsessive note-taking, and the e-mails I receive from people I met in Kyoto. Perhaps it’s time to renew my passport and start planning for Turkey!

A grateful thanks to the staff at A.D.I. and the Japanese organizers, who made this wonderful conference happen. And a grateful thanks to the Alzheimer Society of Canada for making it possible for me to attend! I also want to thank my husband Bill for sharing my discovery and excitement of Japan and for his help in aiding my recollections and editing this report.

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