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Just illustrate some of statistical data concerning how those elderly with dementia are being housed at their home, special nursing homes for the elderly, health facilities for the elderly , sanatorium type medical facilities and other facilities are presented to show the recent condition(as of the end of September, 2002);

  • Persons certified in need of care (or support) are taken as a sample number (unit: 10 thousand). Out of 314, those being housed at homes are 210, Special nursing homes for the elderly are 32, those being housed at health facilities for the elderly are 25, those who are taken care of at sanatorium type of medical facilities are 12 and other facilities are 34.
  • As to the level of independency, it is taken as a category of level II or higher and level of III or higher are listed as follow with the total number of certified person as 149 for the level II or higher and 79 for the level III or higher;

* Independency level of II: 73 (Homes), 27 (Special Nursing homes for the elderly), 20 (Health facilities for the elderly), 10 (Sanatorium type of facilities for the elderly) and 19 (Other facilities)
* Independency level of III or higher: 28 (Homes), 20 (Special nursing homes for the elderly), 13 (Health facilities for the elderly), 8 (Sanatorium type of facilities) and 11 (Other facilities).

Ms. Watanabe commented that the increase of the elderly with dementia is going to be one of critical issues in long-term care services for which Japanese Ministry of Health, Labor and Welfare must focus which will be one of the focal points in the process of the second round of the current system. She presented some of the measures to cope with this issue which is aimed at an importance of sustaining dignity. For this purpose, the Ministry has urged to implement some of effective measures which calls for (1)avoidance of a drastic environmental changes with a possible way of keeping the elderly in the environment used to the elderly,(2) Need to provide atmosphere comfortable for the elderly and (3) encourage and motivate the importance of self-dependency both physically and mentally. In order to enhance the above cited conditions in which the elderly could lead their life more normally, she cited that group homes, small-scale multi-functional services bases, development of the role that the community could establish more adhesive and collaborative networks and alliance among providers of care services and community in general.

With the historical perspective of how long-term care insurance system came into being as it is currently in place with its originally envisioned philosophy and policy as developed by the Ministry of Health, Labor and Welfare and some of emerging problems and issues since the implementation of the system, she identified three major issues which the Ministry of Health, Labor and Welfare is now placing its priority of policy in the process of reviewing the current system. It is: (1) How to improve and strengthen long-tem care prevention, (2) How to establish dementia care and (3) How to support continuity of in-home life (in cooperation with medical cares). These three points were cited as the basis for discussion points at the symposium for inviting other views, opinions, suggestions and recommendations not only from other delegates during the discussion period among the delegates but also a number of questions raised in writing as well as vocally, the some of points Mrs. Watanabe presented as her opening remarks were questioned which will be dealt at the later part of this summary of the symposium.

Interestingly enough, Dr. Igata who has been one of the ranking members of the Ministerial Commission for Japan's Long-term Care Services Insurance System made somewhat noticeable remarks, commenting on the roots out of which the enactment of the current law(s) was initiated at least from the view point of Japan's Social Policy and the on-going conditions at the time of developing philosophical and political angles. By quoting his own expression, the development and creation of long-term care service insurance system on universal basis across the nation was right in its direction due to the imperative requirement to meet the need of aging population in the recent years in Japan, but the methodology adopted for the creation of this system at the time of initial stage was based on the idea of "Try and Run" It may well be either interpreted or pointed out in terms of the pros and cons that the funding fathers of this system placed more weight on the establishment of institutional care facilities first to meet the increasing demands of the elderly without more comprehensive studies and insight into how the supporting and operating aspects of programs were to be followed later. In other words, it has been pointed out by many experts on this important system that the architect of the long-term care services insurance system failed to have a good projection of how mounting and complex problems could emerge at the later date such as a question of sustainability of this system due to regional discrepancies exist across the nation and that the prediction of growing aging population in its accelerating rate, continuing decline of birth rate and above all the fiscal picture of the nation's wealth including a prediction of growth national economy and other related important factors.


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