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The Care for the Elderly |
5.Facilities for the Elderly |
The reasons why they live here is as follows.
The
number of very poor elderly is decreasing recently in Japan, so the need
of the old age homes is also decreasing. On the other hand, the need of
the nursing homes (1 will explain next) is increasing rapidly. The
Ministry of Health and Welfare has the plan to rebuild the old age homes
to the sheltered housings in the future.
Overall responsibility for the care of the elderly in Japan rests with the state. Government and Parliament legislate and formulate guidelines for how the elderly shall be cared for and who shall bear responsibility for the various services. Japan ' s smalIest units of local government , the 3 , 600 municipalities - "Shi", "Tyo", "Son" in Japanese - administer the social services. Responsibility for the running and shaping of health and medical care rests mainly with the regional units of local government, the 46 county councils - "To","Dou","Hu","Ken" in Japanese-". The work of both the municipalities
and the county councils isregulated by legislation. In 1992 more than 700,000 "Bedridden Elderly" and more than one million dementia elderly exist in Japan. But the number of the nursing home's beds is 162,000. This number is only 1.08¥-¥. of the population aged 65 and over in Japan. So it is quite common that here exist a very long waiting list and the elderly must wait one or two years until they succeed to stay at the nursing homes. Japanese Ministry of Health and Welfare has the plan to build 80.000 more nursing homes (total 24.000 beds) until 2000. The population over 65 is 24 million in 2000, so it means that l% of the elderly over 65 can stay at the nursing homes. The definition of the nursing home for the aged -Those
elderly who have the severe mental or physical handicap, for example
"Bedridden Elderly" , and those who always need care <1>History of Nursing Home in Japan The
first nursing home f or the aged was built in 1963 .
"Social Reason" usually means the conflict with the family. This statistic tells the difficulty of the care by the families Actually 47.4% of the elderly move to the at home in Japan. nursing homes for the aged from their own homes and 38.5% moved from the hospitals. Recently the elderly who live at the nursing homes for the aged have become older and older and their staying period has become longer and longer. And more and more dementia elderly live there. As a result, the care needs have increased rapidly and the lack of the number of the stuffs at the nursing homes are serious problem to keep the care quality. And another problem is that longer and longer staying period require the quality of life at the nursing homes for the aged and the single room is needed recently. In the past most of all the rooms at the nursing homes for the aged were 4-8 beds in one rooms. Recently some of the new built nursing homes for the aged have l0% single rooms, but most of the time these single rooms are for the severe senile dementia elderly. One
of the difference between the Swedish institutions and the Japanese
nursing homes for the aged is that most of all the Japanese nursing homes
for the aged are "Private" in Swedish classification . The
special non-profit-making organization so called "Welfare
Foundation" build and run the nursing homes for the aged. When they
build the nursing home, the government pays one fourth of the construction
costs and the municipality pays one fourth also. And the "Welfare
Organization" themselves pay the half of the construction cost.
Moreover running cost is subsidized by the government. So in Japan the
nursing homes run by the "Welfare Foundation" are called
"Public", not "Private", because in Japan
"Private" means the business catering nursing home s o r t he
nursing homes which have got no subsidy f rom government . If they get
subsidy of the running cost from the government, they are classified
"public" institutions in Japan. The monthly fees charged by the nursing homes in Japan are income-related and maximum 250,000 YEN (16,700 SEK) . The rest of the care cost is subsidized by the municipality and the central government . And t he central government have t he responsibility of the care at the nursing homes. Most of all the stuffs at the nursing homes work for the "Welfare Foundation", not for the municipality. The
average nursing home accommodate about 100 elderly and the number of
stuffs is as follows. (Average age of the elderly is about 80 years old )
So the rat i o between the ca re stuffs and the eldely is
l:0.22. In
Swedish old age home (ålderdomshem),
this ratio is about 1:0.52.
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