Himotoki as a decision-making empowerment tool to live well with dementia

Abstract
Shared decision-making is indispensable among people with dementia, their families, and healthcare professionals to ensure that people with dementia live well. Since living with dementia involves the process of losing one’s independence and requiring support from others in all aspects of life, everyday life becomes a series of shared decision-making and collaborative efforts. Dementia care includes the process of rebuilding relationships through shared decision-making and collaboration. In particular, it is of paramount importance to make decisions on how to live well with dementia. Owing to a decline in independence, it may become difficult for people with dementia to live well or achieve happiness on their own. Hence, they are expected to cooperate with people close to them, including family members, to lead happy and fulfilling lives. While making a shared decision, conversations with a person with dementia may result in miscommunication due to a decline in their ability to communicate. If it is difficult to understand certain words or actions of the person with dementia, rather than dismissing them as incomprehensible, caregivers are recommended to analyze the factors underlying those words and actions (background factors), such as the person’s current cognitive state and functioning, human and physical environments, and relationships with other people.