Tomoyo Shinohara
Assistant Department Head
Kagawa Comprehensive Rehabilitation Corporation

Overview of Kagawa Rehabilitation Welfare Center (Type A)

Kagawa Prefecture is located in the northeastern part of Shikoku. The prefecture’s area is the smallest in Japan with a population of approximately 930,000. In terms of health and welfare for persons with disabilities, three geographical areas have been established (Eastern Area, Shodo Island, and Western Area) to promote the coordination of health, medical, and welfare services that closely affect the lives of persons with disabilities and develop a wide-area service provision system. Kagawa Comprehensive Rehabilitation Corporation, a welfare corporation, was established in 1986 in Takamatsu City in the Eastern Area for the health and welfare of persons with disabilities. It provides comprehensive rehabilitation services, such as medical, social, vocational, and community services. Among these services, we, in the Welfare Center (Type A) (hereafter referred to as “this center”) are engaged in community rehabilitation programs, and are in charge of giving support to persons with disabilities, especially by utilizing ICT (Information and Communication Technologies).

This center aims to comprehensively promote the welfare of persons with disabilities throughout the prefecture, and to contribute to the realization of local communities wherein people can live with vitality and respect each other’s personality and individuality, regardless of the type or presence of disabilities. Its roles include supporting the creation of activities for persons with disabilities, providing backup support for the community, such as providing training and consultation services for the staff of the organizations concerned. It also provides wide-area support, such as awareness-raising and human resource development for the general public, as well as creating networks to promote social participation. We have ten staff members: two certified social workers, four certified para-sports instructors, two occupational therapists, one physical therapist, and one certified psychologist. They have been subsequently assigned to this center since 2010. They are engaged in our programs by utilizing their expertise.

Delving into their daily lives – the beginning of ICT Support

In 2002, this center was entrusted by Kagawa Prefectural Government with the “IT Support Program for Persons with Orthopedic Disabilities” (hereafter referred to as “this program”). The purpose of this program is to correct the disparity in opportunities and abilities of persons with disabilities to use information and communication technology, and to further promote social participation through the use of IT. We have started the PC Volunteer Training Program, the PC Volunteer Dispatch Program, and the PC Class Program.

In particular, through the PC Volunteer Dispatch program, our support was extended to people with severe disabilities and intractable diseases such as ALS, who have limited mobility and participation in activities, through home and hospital visitations.

At the start of this program, a certified social worker was available for consultation. A woman with cerebral palsy who said, “I want to make New Year’s cards on the computer,” told us that she really wanted to be able to make cards for her family and be of help to them. A person with ALS said, “I want to send e-mails to my daughter who lives outside of the prefecture.” She wanted to fulfill her role as a mother, saying, “I want to help my daughter who will soon get married if she has any concerns.” How do they want to live their lives – when, where, with whom, and through what kind of activities and means of communication? There are various forms of social participation that are unique to each person. With the support of ICT as a means to realize their hopes and with the support of connecting with other persons with disabilities, the network has gradually expanded. However, considering that many supporters are new to working with people with ALS, etc., some issues have become clear to us.

Before PC volunteers can provide operational support, it is necessary to first assess the person’s functions, abilities, and work environment, and then help the person adapt to the equipment he needs. An issue is equipment adaptability as there are few opportunities to gather information and learn about ICT support. Another issue is information sharing, which requires continuous support in response to changes in physical conditions, living conditions, and life stages – changes arising from the transfer of persons with disabilities from the welfare system to long-term care insurance, or from hospital to home. ICT support can unfortunately be disrupted when persons providing support have a change in their living conditions. Another issue is poor coordination. Collaboration and cooperation among multiple professions and various fields are essential for these types of support, but sometimes support is delayed due to unclear assignments and responsibilities within the support team.

Our daily lives – Creating an ICT support system in the community

In response to these community issues, we discussed with Kagawa Prefectural Government the measures that should be taken to ensure that support needs do not become unexpressed in the immediate community. In FY2010, a new program to improve the ICT support system was added to this program and launched. First, the name of the program was changed from “IT Utilization Support Program for Persons with Orthopedic Disabilities” to “IT Utilization Support Program for Persons with Orthopedic Disabilities, Etc. (currently, “IT Utilization Support Program for Persons with Disabilities, Etc.”).” Below, we added “supporters” to “Targets” and to the “Contents,” “Other Support Programs” that include the improvement of ICT support systems was added (Figure 1).

Figure 1IT Utilization Support Program for Persons with Orthopedic Disabilities, Etc. from 2010

We receive consultations from consultation support specialists, care managers, public health nurses, medical social workers, visiting rehabilitation staff, etc.

• We provide supporters with:
• 1. “Consultation support,” such as clarifying the clients’ needs, forming a team for ICT support, and coordinating in the assignment of responsibilities;
• 2.“Adaptation support” to provide information on tools, equipment, and systems and their introduction to the user;
• 3. “Support for continuity” by attending meetings with persons in charge of services, monitoring, etc.; and if necessary,
• 4. A series of logistical support for ICT that leads to continued support in response to various changes.

Among the staff in charge, occupational therapists and physiotherapists are also assigned (all working concurrently). We, administration staff, are also involved as a team. We visit the home of the persons concerned and provide support in actual situations. Sometimes, we hold study sessions or training sessions. We also cooperate with the rehabilitation consultation offices in determining whether or not a person is eligible for a communication device.

To show you a comparison between FY2015, when the current statistical processing began, and FY2022 (at the end of February in both years), the total number of consultations we received increased from 174 in FY2015 to 243 in FY2022. Consulters come from a wide variety of fields and professions. The number of consultations from teachers and those involved in employment support is increasing. In terms of disabilities, the percentage of those with intractable diseases was 56% in FY2015 and 73% in FY2022 (including 80% with ALS), followed by those with physical (orthopedic) disabilities, developmental disabilities, and others. As for the details of the consultation, many were concerned about the creation of an environment conducive to communication, such as the provision of communication devices. The recent trend has broadened with the creation of environments in which people can work from home, study at school, and have leisure activities like e-sports.

About the future

This program started with dispatching PC volunteers, and through trial and error, we have shared opinions with the people concerned and worked to create an ICT support system in the community. At the ICT training session for supporters held the other day, some of them shared what they experienced, including concerns, such as “There is a person who wants to enjoy YouTube,” “He was trying to communicate something, but I don’t know how we can communicate with each other. What kind of tools are available?” Many of them still did not know where to go for consultation.

We would like to continue our efforts to expand the network by accumulating and disseminating consultation cases one by one, and by training and awareness-raising activities utilizing various opportunities in the Welfare Center (Type A) to make this program known as an ICT support consultation service for persons with disabilities while connecting them with supporters.

Editated and published by the Japanese Society for Rehabilitation of Persons with Disabilities. Published on June 25th, 2023.