scholarly journals Geriatrics Perspectives From Japan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 385-385
Author(s):  
Satoru Mochizuki ◽  
Masahiro Akishita
Keyword(s):  
Community Care ◽  
Geriatric Medicine ◽  
Term Care ◽  
Care Services ◽  
Medical Facilities ◽  
Significant Burden ◽  
Emerging Issues ◽  
The Government ◽  
Care System

Abstract In 2025, Japan’s baby boomers will cross the threshold of 75 years of age; a phenomenon that has been referred to as “the 2025 crisis”, resulting in a significant burden on the healthcare system. To address this issue, the Japanese government is establishing the Integrated Community Care System, to provide comprehensive medical and long-term care services in each community. In cooperation with government and affiliated organizations, the Japan Geriatrics Society (JGS) has been working to develop the Integrated Community Care System. As a result of this effort, geriatric medicine is being integrated into the health care system through incentives for practitioners. For instance, medical facilities can be reimbursed if they perform comprehensive geriatric assessments (CGA) and CGA-based management/care. Additionally, home care medicine and polypharmacy are emerging issues of interest to the government. In this symposium, I will discuss how JGS has been trying to achieve “Aging in Place” in Japan.

scholarly journals Rural-urban disparities in unmet long-term care needs and the demand for community care services among elderly people in China

2020 ◽  
Author(s):  
Yanbing Zeng ◽  
Chenxi Lin ◽  
Lixia Wang ◽  
Liangwen Zhang ◽  
Ya Fang
Keyword(s):  
Elderly People ◽  
Unmet Needs ◽  
Community Care ◽  
Economic Status ◽  
Healthcare Education ◽  
Term Care ◽  
Care Services ◽  
Rural And Urban ◽  
Adl Disability

Abstract Objective This study aimed to examine the urban-rural differences in unmet needs and the demand for community long-term care (LTC) services among community-dwelling elderly people in China.Methods The data come from the 2014 Chinese Longitudinal Health Longevity Survey (CLHLS). A total of 1587 community residents aged 65+ with disabilities in the activities of daily living (ADLs) were included in this study. Based on the Andersen theoretical model, binary logistic regression was used to estimate the correlates of unmet needs in LTC. A chi-square test was used to examine the differences in expected needs for community-based LTC services between urban and rural areas.Results Over half (55.07%) of the participants reported their needs were unmet. For both rural and urban residents, poor economic status and reluctant caregivers seriously affected unmet needs. In addition, among urban older adults, those who were male and lonely reported more unmet needs. Among rural elderly people, those with severe ADL disability and poor self-rated health reported more unmet needs. In addition, access to medication and home visit services were negatively associated with unmet needs. Living with children (69.12%) was viewed as the most desirable living arrangement among older people, while living in a LTC facility seemed to be more accepted for rural residents with unmet needs than for other elderly respondents. Residents showed a high demand for community LTC care services, with 82.55% of them expecting to need home visits and 74.29% to healthcare education. Specifically, rural residents had greater expected needs for every community care service than their urban counterparts. However, only 4.66% to 36.42% of the respondents reported that all eight types of services were available, which was far below the demand for these services.Conclusion The risk of having unmet needs associated with ADL disability in LTC is largely determined by elderly people’s economic status and caregivers’ willingness to provide care for both rural and urban elderly residents. More attention should be paid to psychological consulting services in urban areas, as well as personal care, home visits, psychological consulting and healthcare education services in rural areas.

scholarly journals Projecting future demand for informal care among older people in China: the road towards a sustainable long-term care system

2018 ◽  
Vol 14 (1) ◽  
pp. 61-81 ◽  
Author(s):  
Bo Hu
Keyword(s):  
Older People ◽  
Informal Care ◽  
Long Term Care ◽  
Term Care ◽  
Monte Carlo Simulation Technique ◽  
Modelling Framework ◽  
Nationally Representative ◽  
The Government ◽  
Care System

AbstractThe long-term care system in China relies heavily on informal care provided by family members. This study makes projections on the demand for informal care among Chinese older people between 2015 and 2035 and quantifies the level of long-term care resources needed to meet their needs. The data come from longitudinal information in a nationally representative sample, China Health and Retirement Longitudinal Survey 2011 and 2013. The macrosimulation approach (PSSRU model) and the Markov approach are integrated into one Bayesian modelling framework. The Monte Carlo simulation technique is used to capture parameter uncertainty. We project that the demand for informal care will increase from 41.3 million people (95% CI: 39.9–42.7) in 2015 to 82.6 million people (95% CI: 78.3–86.9) in 2035. The long-term care system faces unbalanced pressure of demand for informal care from different groups of older people. The projected demand is sensitive to changes in older people’s disability trajectory and the availability of formal care provided by the government, but less sensitive to an increase in singleton households in the future. We discuss possible policy measures to alleviate the mounting pressure on the demand for informal care.

scholarly journals Long-term care system for dependent people – Austrian experiences

2019 ◽  
pp. 81-98
Author(s):  
Marta Luty-Michalak ◽  
Aleksandra Syryt
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Social Model ◽  
Term Care ◽  
Ageing Society ◽  
Federal States ◽  
Care Services ◽  
The One ◽  
Care System

Austrian society is an ageing society. Old age does not always mean dependence. However, the risk of disability and dependence increases with age. In addition, older people often experience multi-disease. High-quality long-term care services can help frail and dependent elderly on maintaining greater autonomy and participation in society, regardless of their condition. The aim of the article is to analyze legal, institutional and practical solutions in the field of long-term care system functioning in Austria. It should be emphasized that Austria is striving to develop services based on a social model and an independent life paradigm. Analysis of legal solutions indicates that the long-term care system in Austria is very complex. Institutional solutions are divided between the federal level and nine federal states. On the one hand, this results in decentralization and more effective help for the elderly, but on the other hand, it causes the diffusion and heterogeneity of standards.

A SHARP Response: Developing COVID-19 Research Aims in Partnership with the Seniors Helping as Research Partners (SHARP) Group

2021 ◽  
pp. 1-8
Author(s):  
Jacobi Elliott ◽  
Alexandra Whate ◽  
Heather McNeil ◽  
Alison Kernoghan ◽  
Paul Stolee ◽  
...  
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Community Care ◽  
Future Research ◽  
Policy Planning ◽  
Term Care ◽  
Care Services ◽  
Home And Community Care ◽  
Research And Policy

Abstract COVID-19 has disproportionally impacted older adults, and has highlighted many issues, including extreme deficiencies in Canadian long-term care homes and gaps in home and community care services for older adults. In recent years, there has been a push towards better patient and family engagement in health system research, and with the onset of the pandemic, engaging older adults in research and policy planning is more important than ever. In this article, we describe the Seniors Helping as Research Partners (SHARP) approach to engagement with older adults as an example of how partnerships that engage older adults in the development of research aims and processes can help to ensure that future research meets the needs of older adults. SHARP members highlighted a number of areas for future COVID-19 research such as improvements to long-term care, enhancing access to home and community care, and a focus on aging and social isolation.

scholarly journals Why Did the Policy to Convert Hospitals Into Facilities Not Work in Japan?

2019 ◽  
Vol 11 (10) ◽  
pp. 89
Author(s):  
Yuka Mine ◽  
Masayuki Yokoi ◽  
Takao Tashiro
Keyword(s):  
Health Services ◽  
Long Term Care ◽  
Care Hospital ◽  
Term Care ◽  
Medical Facilities ◽  
Hospital Beds ◽  
Long Term Care Insurance ◽  
The Government ◽  
Geriatric Health Services

The government of Japan formulated measures to significantly reduce the number of hospital beds for long-term care in 2006. In particular, long-term care hospital beds covered by long-term care insurance (sanatorium medical facilities) were to be abolished in 2012, and existing sanatorium medical facilities were to be converted into long-term care insurance services such as geriatric health services facilities. However, the conversion did not progress in spite of various support measures, and the deadline for abolishment was extended. In order to clarify the reason for this, we selected 28 hospitals with 402 or more long-term care beds and 28 health services facilities with 158 or more beds and examined their management philosophies and analyzed the keywords included. The most popular keyword was “community” in both hospitals and facilities. Hospitals had a significantly higher rate of 60.7% (P< 0.05) of including “trust” or “feeling of relief” in their management philosophies. Facilities had higher rates of including any of the terms “return” or “independence” or “home” (32.1%, P= 0.051), and also of including either “service” or “care” (46.1%, P< 0.05). In conclusion, it is suggested that hospitals with long-term care beds differentiate themselves from neighboring facilities in that they are able to simply accept the situation and be responsible for terminal care whenever inpatients may have difficulty returning home. In addition, it seemed difficult for hospitals to convert into health service facilities, the aim of which is to enable residents to return home.

scholarly journals COMPARATIVE LAW REVIEW OF LONG-TERM CARE SYSTEMS IN SOME EUROPEAN COUNTRIES

2021 ◽  
pp. 185
Author(s):  
Marija Dragićević
Keyword(s):  
Long Term Care ◽  
European Countries ◽  
Term Care ◽  
Advantages And Disadvantages ◽  
Care Services ◽  
National Differences ◽  
Custodial Care ◽  
Care Systems ◽  
Care System

The organisation and funding of a long-term care system have been one of the most commonly debated issues in the social policies of developed European countries since the 1920s. The key issue in the debate on the long-term care system is to what extent the population should finance their own needs for custodial care and assistance, and to what extent it should be done by the state. Another important issue is whether the funds for long-term care should only be beneficial for those who cannot pay from their own assets (residual model), or whether long-term care services should be a universal right. The existence of such huge national differences has contributed to the intensity of this debate, both regarding how the system is organised (according to the type of benefits) and how the resources are generated. Bearing in mind the foregoing, in this paper, the author analyses the long-term care systems for people dependant on custodial care and assistance in several most developed European countries. The paper examines their organisation and funding, and highlights their major advantages and disadvantages, which may eventually serve as an indication for improving the domestic system.

scholarly journals Rural-urban disparities in unmet long-term care needs and the demand for community care services among elderly people in China

2019 ◽  
Author(s):  
Yanbing Zeng ◽  
Lixia Wang ◽  
Liangwen Zhang ◽  
Ya Fang
Keyword(s):  
Rural Areas ◽  
Long Term Care ◽  
Unmet Needs ◽  
Community Care ◽  
Care Service ◽  
Economic Status ◽  
Healthcare Education ◽  
Term Care ◽  
Care Services

Abstract Background: Estimates of unmet needs, as an indicator of future needs for long-term care (LTC) services, have become increasingly crucial policy concerns. This study aimed to examine the urban-rural differences in unmet needs and the demand for community care service among community-dwelling elderly people in China. Methods: The data come from the 2014 Chinese Longitudinal Health Longevity Survey (CLHLS). A total of 1587 community residents aged 65+ with disabilities in the activities of daily living (ADLs) were included in this study. Based on the Andersen theoretical model, binary logistic regression was used to estimate the correlates of unmet needs in LTC. A chi-square test was used to examine the differences in expected needs for community-based LTC services between urban and rural areas. Results: Over half (55.07%) of the participants reported their needs were unmet. Poor economic status and reluctant caregivers seriously affected elderly unmet needs. Among urban older adults, those who were male and lonely reported more unmet needs. Among rural ones, those with severe ADL disability and poor self-rated health reported more unmet needs. In addition, access to medication and home visit services were negatively associated with unmet needs. Living with children (69.12%) was viewed as the most desirable living arrangement among older adults, while living in a LTC facility seemed to be more accepted for rural residents with unmet needs than for other elderly respondents. Residents showed a high demand for community LTC care services, with 82.55% of them expecting to need home visits and 74.29% to healthcare education. Specifically, rural residents had greater expected needs for every community care service than their urban counterparts. However, only 4.66% to 36.42% of the respondents reported that all eight types of services were available, which was far below the demand for these services. Conclusion: The risk of having unmet LTC needs is largely determined by elderly people’s economic status and caregivers’ willingness to provide care for both rural and urban elderly residents. More attention should be paid to psychological consulting services in urban areas, as well as personal care, home visits, psychological consulting and healthcare education services in rural areas.

scholarly journals Changes in home care clients’ characteristics and home care in five European countries from 2001 to 2014: comparison based on InterRAI - Home Care data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
I. V. Kristinsdottir ◽  
P. V. Jonsson ◽  
I. Hjaltadottir ◽  
K. Bjornsdottir
Keyword(s):  
Home Care ◽  
Older People ◽  
Community Care ◽  
Assessment Tool ◽  
European Countries ◽  
Cognitive Performance Scale ◽  
Term Care ◽  
Care Assessment ◽  
The Government

Abstract Background Policymakers advocate extended residence in private homes as people age, rather than relocation to long-term care facilities. Consequently, it is expected that older people living in their own homes will be frailer and have more complex health problems over time. Therefore, community care for aging people is becoming increasingly important to facilitate prevention of decline in physical and cognitive abilities and unnecessary hospital admission and transfer to a nursing home. The aim of this study was to examine changes in the characteristic of home care clients and home care provided in five European countries between 2001 and 2014 and to explore whether home care clients who are most in need of care receive the care required. Methods This descriptive study used data from two European research projects, Aged in Home Care (AdHOC; 2001–2002) and Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care (IBenC; 2014–2016). In both projects, the InterRAI-Home Care assessment tool was used to assess a random sample of home care clients 65 years and older in five European countries. These data facilitate a comparison of physical and cognitive health and the provided home care between countries and study periods. Results In most participating countries, both cognitive (measured on the Cognitive Performance Scale) and functional ability (measured on the Activities of Daily Living Hierarchy scale) of home care clients deteriorated over a 10-year period. Home care provided increased between the studies. Home care clients who scored high on the physical and cognitive scales also received home care for a significantly higher duration than those who scored low. Conclusion Older people in several European countries remain living in their own homes despite deteriorating physical and cognitive skills. Home care services to this group have increased. This indicates that the government policy of long-term residence at own home among older people, even in increased frailty, has been realised.

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