Tamami Aida
Professor of the Department of Occupational Therapy,
Faculty of Health Sciences, Mejiro University

The 2024 World Congress on Rehabilitation (WCR 2024) took place in Abu Dhabi from September 23 to 25, 2024. I presented on ‘Online Multidisciplinary Consultation by Community Members for Those with Cognitive Impairments Caused by Acquired Brain Injury.’ I later talked about the presentation’s outline at the 23rd Rehakyo Café (1:30 PM – 3:30 PM, Friday, November 22, 2024). This article reports on the content of my talk at the Rehakyo Café and my responses to questions about the lives of people living in Abu Dhabi, along with supplementary information.

WCR 2024, organized by the Rehabilitation International (RI), the International Social Security Association (ISSA), and the Zayed Higher Organization for People of Determination (ZHO), was the first RI conference held in the Middle East. The venue, Abu Dhabi National Exhibition Centre (ADNEC), connects to nearby hotels, ensuring safe passage around the clock. The GARA dinner was held the night before the conference and was attended by representatives from the host organizations, RI committee members from respective countries, and conference speakers. The United Arab Emirates (UAE) refers to persons with disabilities as ‘people of determination’ to honor their achievements in diverse fields. ZHO aims to support the people of determination by utilizing global technological advancements in artificial intelligence to empower them in all aspects of public life.

The following is an introduction to my presentation. Cognitive impairments caused by acquired brain injuries or cerebrovascular diseases encompass challenges, such as memory loss, attention deficits, and social behavior disorders. Since 2012, individuals with these cognitive impairments have been eligible for highly specialized consultation support and for applying for the psychosocial disability welfare certificate. People living with these impairments have appeared in many TV dramas in recent years, leading to increased recognition among the general public. However, disparities still exist between regions that provide advanced support and those that do not. Social recognition of these cognitive impairments is crucial because affected individuals need support from different systems, including medical care, aged care, disability welfare, and education. Individuals with cognitive impairments resulting from acquired brain injuries often struggle with instrumental activities of daily living (IADL), which are essential for social engagement, including working, performing household chores, going out, interacting with others, and managing finances, rather than basic activities of daily living (ADL). Since these cognitive impairments are not always visible, professional care workers and family members may find it difficult to understand. As a result, those individuals are less likely to receive social support, and it is often assumed that they struggle to participate fully in society.

I am working to establish a community rehabilitation network for individuals with cognitive impairments due to acquired brain injuries in Itabashi Ward, a northern area of Tokyo. Our group includes hospital staff, disability welfare service providers, aged care providers, and local people with disabilities, along with their families. The goal is to promote social participation for people living with these cognitive impairments by setting up a collaborative network covering medical care, aged care, and disability welfare services within the community where we live. Our activities primarily involve organizing support worker liaison meetings, family exchange gatherings, case study review sessions, and addressing the challenges faced by these impaired individuals in our community.

Individuals living with cognitive impairments caused by acquired brain injuries often need assistance from multiple social welfare systems, which complicates the process to get the necessary support. To tackle this issue, we trialed the Cognitive Impairments Crowd Community (CICC), an online consultation service that provides smoother support for these impaired individuals. The CICC sent a consultation application form via email every three months regarding available support for people with these cognitive impairments to approximately 150 persons who participated in our previous activities. These participants belonged to local service providers, organizations of disabled people, and their family associations. Following this, we scheduled a date and conducted the online consultation using Zoom. The CICC had six members, including professional workers in medical care and disability welfare services, as well as members of disabled people’s groups. The trial period for the CICC spanned from December 2022 to September 2023.

Consequently, three cases were referred to the CICC—two by care managers and one by a medical social worker. These three cases are of individuals aged 40 to 65, with two cases attributed to cerebrovascular disease and one to acquired brain injury. Case 1 sought information on employment support, Case 2 aimed for independent living, and Case 3 expressed a wish to transfer to an assisted living facility. Shared factors among the three cases included a lack of self-awareness due to cognitive impairments and the challenges of navigating multiple social welfare systems (medical care, aged care, disability, poverty), which were identified as barriers to achieving their goals.

As a result of the consultation, Case 1 was referred to various employment support programs and consulting services. Case 2 was encouraged to join self-help groups for people with disabilities and their families. Additionally, resources were provided to help understand disabilities, manage finances, and access domestic support services for independent living. Case 3 received information about collaborating with caseworkers on available public assistance and assisted living facilities. Through this trial of the CICC, we thought it necessary to continue to promote understanding of these cognitive impairments and to establish access links connecting to the CICC.

After my talk, the participants at the Rihakyo Café asked me questions about the lives of people in Abu Dhabi, the capital of the UAE, which is a federation of seven emirates. Abu Dhabi is the second most populous city in the UAE, with around 1.51 million residents, following Dubai. UAE nationals make up 13% of the population, while the rest consists of immigrants. In tourist-friendly areas, such as hotels and taxis, workers are often immigrants from Pakistan or Nepal. The UAE is known for attracting wealthy individuals by not imposing income or corporate taxes. By capitalizing on profits from oil and natural gas, the government provides free education and medical care to its citizens without levying any taxes. The UAE offers generous welfare benefits to its small citizen population, and both UAE citizens and foreign residents can access free basic medical care. Public and private hospitals are available. UAE citizens frequently seek medical treatment abroad, with the government covering some medical expenses and travel costs. In recent years, many advanced medical facilities funded by foreign investments have been established, including a medical district called ‘Dubai Healthcare City (DHCC),’ which features cutting-edge scientific equipment and specialized services that attract foreigners to Dubai for medical treatment.

Abu Dhabi is a city undergoing rapid development, changing beyond recognition in just five years. Zayed International Airport showcases the latest technology, allowing travelers to pass through immigration and customs without waiting in line. In September, the heat in Abu Dhabi is intense, with average high temperatures around 40.8℃ and low temperatures around 28.2℃. The high humidity makes exploring the city challenging. Furthermore, while the city is interspersed with gravel deserts, the national taxi service is readily available to take you to any destination. I felt that I broadened my horizons as I encountered many new experiences, including how people in Abu Dhabi dress, behave, and embrace their culture.

Numerous experts in the extensive rehabilitation field from around the world participated in the 2024 World Congress on Rehabilitation in Abu Dhabi. I learned about the current state of rehabilitation in each country, reflecting their economies, public health, social security systems, and social welfare initiatives. As someone involved in rehabilitation in Japan, I hope to give back to the local community what I gained from my experience at the world congress.

Edited and published by the Japanese Society for Rehabilitation of Persons with Disabilities.

Published on January 20th 2025.