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Caregiver’s Corner: Okinawa, Ikigai, and American Dementia Care

If last week’s Think Tank has a “founder of the feast,” it’s James Lee. He’s the CEO and Co-founder of the innovative Bella Groves dementia community in San Antonio, and he started this Think Tank in 2021 as a way of bringing together a few innovative people. What started as a group of about 15 grew to over 50 this year!

Everyone in the group was put in a small group to create and present a project. James’ group, however, embarked on a particularly special endeavor. They travelled across the globe to Okinawa—a fabled “blue zone”—to learn about longevity and dementia in one of the longest living cultures in the world.

A large part of their time was spent with Dr. Makoto Suzuki, a cardiologist who is still working 30 hours a week at 92 years of age, with no sign of stopping! His area of most passionate research is helping others achieve increased longevity and joy in aging. The key principle for him, beyond the usual fare of adjusting diet and exercise, is finding one’s ikigai (pronounced ee-kee-guy).

Like many Japanese and Okinawan philosophical concepts, ikigai is a difficult idea to define in Western terms. The diagram above does a nice job of trying to capture the spirit of it. It’s not exactly the meaning of life, your life’s purpose, or the source of your joy, although it is tied intimately to all of those things. Among the many spheres of activity that bring meaning to our lives, ikigai sits in the middle of it all as the joyous and purposeful center of things.

Ikigai is that which brings together all of the various threads of life and weaves together joy, compassion, usefulness, and service. Rather than being the meaning of life, it is that which allows each individual to lead a life of meaning.

Dr. Suzuki also distinguishes between “big” ikigai and “little” ikigai. Big ikigai is what we’ve already talked about: that which brings life to, well, life. But it comes about naturally when we start to recognize the moments of little ikigai: a morning walk, the crunch of biting into an apple, or sitting on the back porch in autumn. They are those nudges that push us toward that big and joyful ikigai that moves us forward with purpose.

What does this mean for dementia? This was a question I asked of the group who went to Okinawa. When I feel like my mom is walking away from me one step at a time, how can I help her find her personal ikigai when some days she does not remember the most fundamental details of her life?

It’s a difficult and important question. In some ways, this is the question that must drive us if we are to meet the needs of the minds, bodies, and spirits of our loved ones. Although my mom may not be able to communicate what brings her joy by using her spoken words, I can see it if I pay attention to the other ways she speaks. I can feel it in the way she grabs my hand or looks at me.

Music has always been a special place for her, and that continues. It may be a moment of “little” ikigai now as she plays for just a few minutes. However, I’ve also noticed that her music has become much more playful. As a “preacher’s wife” she used to play by the book every Sunday morning for the congregation. Now, however, she’s blending songs, moving seamlessly from one to the next, and adding flourishes and subtleties. I’m actually hearing a side of my mother’s music I’ve never heard before. To my ear, she has never played more beautifully.

Having the word “ikigai” gives me a focus point for our interactions, something to look for as I go into every encounter with her. How can I speak to that which gives her meaning in this moment? How can I find joy with her right now, right here? How can I draw on my lifetime of experience with her to make our time together matter. Sometimes it’s silence, or music, or food, or listening.

I know that flash of joy may be gone in the next instant for her, but I do believe it touches something deep. I think that when we have those moments, something in the most secret and sacred parts of her spirit responds. I see it in her eyes and I feel it in my own heart too. Finding her ikigai has become a piece of my ikigai.

📰 Some Ikigai Resources for More Information 📰

There are lots of ways to understand the subtle concept of ikigai (and lots of disagreement, too!). If you’d like to hear more, here are some different voices:

• The Complete Guide to Understanding Ikigai (My Mind Talks): a solid overview of the most common Western understanding of the concept. FAQs with actionable steps.

• Discovering Ikigai: A Pathway to a Meaningful Life (Navigating Transitions): 8 needs and 5 pillars of ikigai

• 3 Examples of Living According to Ikigai (Positive Psychology): this link takes you to a portion of a larger article that gives real examples including that of 100-year-old Jiro Ono. Jiro is widely regarded as the greatest living sushi chef, and he is still going as a centenarian! He was the subject of the fascinating 2011 documentary Jiro Dreams of Sushi. 👈️ Highly recommended!