On a warm afternoon in September of 2017, Keiko Sawada met a friend for lunch at a new pop-up restaurant in Tokyo's Roppongi neighborhood, where patrons desperate for a table spilled out onto the sun-drenched sidewalk. It takes something truly special to excite diners in Tokyo, which is home to more Michelin-starred restaurants than any other city on Earth—Roppongi boasts several, including the puffer fish restaurant Usuki Fugu Yamadaya, which holds one Michelin star, and, not far away, Azabu Yukimura, which was awarded three of the coveted decagons for signature dishes like steamed sea urchin with lobster broth. Sawada and her friend, both in their early 30s, pushed through the bustling Roppongi lunch crowd for a taste of a humbler menu of what might be called Japanese comfort food: Spicy ramen noodles, omelets over rice drenched in tomato sauce, and ground beef steaks covered in rich gravy.
"I'll have the spicy ramen," Sawada said to the elderly waitress. "And some Chinese-style dumplings."
Sawada's friend ordered the ground beef steak, and when the octogenarian waitress returned with their dishes 20 minutes later, both of them looked surprised, and just a little disappointed to see that the old woman had brought them exactly what they'd ordered.
"To be honest, I was sort of hoping she'd surprise us with something different," Sawada said. "But considering the name of the restaurant, getting exactly what we ordered was probably the most surprising thing that could have happened."
The name of the restaurant was 注文を間違える料理店, which means "The Restaurant of Mistaken Orders." While its chefs are young professionals, the wait staff is made up entirely of elderly people living with dementia. One of the silver-haired waitresses, who has advanced Alzheimer's disease, occasionally forgot what she was doing there.
"What do I do?" She asked one young couple.
"You're here to help us order food," the man said.
"Ah, yes," she said, then laughed gleefully while covering her mouth with one hand.
It's striking to witness such a jovial scene surrounding an issue that people tend to resist discussing openly in Japan, where 4.6 million people are living with Alzheimer's disease or some other form of dementia. The country's rapidly aging population means that, by 2025, the figure will rise to 7.3 million people, or one out of every five Japanese citizens over the age of 65.
Dementia touches so many lives in Japan that Prime Minister Shinzo Abe has said that increasing the number of nursing homes and wages for care workers is a priority. But Katsuhiko Fujimori, an associate at Japan's Mizuho Information and Research Institute, said that Abe won't be able to make a real difference without committing more government funds to welfare programs for dementia sufferers and their families—an unlikely move given the fact that Japan's public debt is already more than twice the size of its economy.
"Japan's social welfare system has always operated on the assumption that people with dementia will be taken care of by their children or other family members," Fujimori said.
Under the weight of this assumption, and the strain of a stagnant economy that has caused real household wages to drop, annual instances of elder abuse reported to authorities rose by about 30 percent over the past decade, according to Japan's Ministry of Health.
The idea to open a restaurant staffed with dementia patients came to Shiro Oguni in 2012, when he was working as a television presenter for Japan's national broadcaster, NHK.
"I was interviewing Yukio Wada, who specializes in caring for dementia patients," he said. "Mr. Wada is a pioneer who has spent 30 years running a group home where the patients are encouraged to keep living their lives by doing their own shopping and cooking and cleaning."
The goal, Wada told him, was to allow people in the group home to feel that they were still living their lives, rather than being confined. Three years later, in June of 2015, he took Wada's radical approach one step further by opening the restaurant's first pop-up location in Tokyo, hoping to raise awareness by inviting 80 special guests to dine there over the course of a few days. Before it was over, he was surprised to find the restaurant's name trending on Twitter in Japan.
In September, as Sawada prepared to leave the restaurant's latest pop-up location, a middle-aged waitress took a seat in front of a piano at the far end of the room, where she began playing a spare classical tune with her husband accompanying her on viola. When the music stopped, the diners joined the chefs and the wait staff in rousing applause, and, for a moment, no one was unsure of what they were doing or why they were there.