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 The Care for the Elderly in Sweden and in Japan


 

8.  History of the Elderly Care in Both Countries 
8.1 Comparison of the Elderly Care Development 

In this chapter, I compare the history of the care for the elderly in both countries. 

Table.28  The Development of Elderly Care in Both Countries
Aging rate
(>65)
  SWEDEN   JAPAN  
10% 1946   *Criticism towards
  old age home by 
  Lo-Johansson , I     
1985  *Criticism  
  towards  
  geriatric 
  hospital and 
   " bedridden "  
11% 1955  *Old Age Home with 
  single room
1988  
*Home Help
    *Home Help    *Day-Care 
 *Nursing Home+ 
  with Single Room
12%   1960     1990   
    *Municipality  
 
Initiative   
 
Elderly Care Plan 
  *She Itered
  Housing  
13% 1966      1992  *Home Health Care  
  (Nurse Visit
  System )
14% 1971   1994   *Municipality  
 
Initiative
  Elderly Care  
  Plan  
    *Sheltered Housing     *Technical Aid  
15% 1975  *Nursing Homes    1996   
    *Home Health Care     
16%

1978



*Night-Patrol
*Day-Care 
1998 



*Night Patrol ?
17%  1983 Technical Aid  2000 *Group Living ?
       
*Modern Nursing  
  Home ?  
    *Group Living     
18% 1990 *Modern Old Age
 Home 
2003  
history of the care for the elderly in Sweden is written at ( ,,Aldreomsorgen i Sverige" by Ake Elmer in 1985 and Per Gunnar Edebalk "HEMMABOENDEIDEOLOGINS GENOMBROTT  
- aldringsvard och socialpolitik 1945-1965 - MEDDELANDEN FRAN SOCIALHOGSKOLAN 1990:4)  
+
As I wrote in chapter 5, Japanese nursing home is comparable to Swedish nursing home , but to Swedish old age home.

 

Step.1 

Aging Rate l0-11%

- The Aging becomes Social Issue -

(1940's - 1950's in Sweden, 1985 - 1990 in Japan) 

*1940 s(10% ) 1950 s(11%) in SWEDEN  

Lo- Johansson , I . wrote "ålderdom i sverige" in 1949 and criticized the Swedish old age homes. At that time the Swedish old age home had no single room and the QOL was very bad. It was the first time that the aging issue was discussed as a social problem in Sweden. Until then, aging issue was the problem in the family. The more society is industrialized, the longer elderly become to live and more difficult it becomes for the to take care of elderly at home. So more and more elderly was forced to live at the old age home.

After the criticism by Lo-Johansson,1., the Swedish elderly care developed in two points. One development was that the "Home Help Service for the Elderly" began. In 1950 the first home help service started in Uppsala by the Red Cross voluntary organization . "Home  Help Service" became more popular than the old age home, and home help service spread all over Sweden in 1950' s. Many housewives began to work as home helpers. Another development was that in 1950's the old age homes with single room started to be built. But at the same time, the housing problem of the elderly became bigger. In 1950's the aging rate was 11%.  

 

*1985(l0%) - 1989(11%) In JAPAN  


In Japan until the beginning of 1980's, it was quite common that the elderly parents and children lived together and the families took care of the elderly. And the elderly care was not discussed as a "social" problem. But since the middle of 1980's "Bedridden Elderly" has become one of the biggest social problems in Japan. Until then nursing home was looked as a "poor house" in Japan, but since the middle of 1980's it became very difficult to stay at the nursing homes, because the number of bedridden elderly has increased rapidly and more and more families gave up taking care of the elderly at home. At the same time, the low standard of the geriatric hospitals was criticized by some Japanese journalists.

In 1988 the journalist Mr.Kazuo Okuma published the book "Rupo Rojin-Byoto (The Truth of the Geriatric Hospital ) " and criticized the bad situation of the geriatric hospital very severely. In 1989 Mrs.Yukiko Okuma, who is also the famous journalist in Japan, published the book "Netakiri Rojin no Iru Kuni Inai Kuni" .

This book compared the elderly care in Denmark, in Sweden and in Japan and criticized that the poor elderly care resulted in 700,000 bedridden elderly in Japan. Through these campaign the aging issue became the "social" issue first time in the Japanese hi story .

At the middle and the end of  1980's in Japan the aging rate(>65) was "also" l0-ll%. So in both countries the aging issue became the social problem when the aging rate was 10-11%.

Around in 1990, after the criticism towards the "bedridden elderly", there were three developments in Japan. The first development is that the home help service and day-care-service started in Japan also. Because more and more elderly want to stay at home longer and longer, but the care-givers (families) were very tired. And the number of nursing homes were not enough at all. The second development was that the many voluntary organizations began to work as home-helpers. Many housewives began to work as home-helpers. The third development was that the nursing homes with single rooms started to be built. Around in 1990, the aging rate was "also" 11%.

 

Step 2 

Aging Rate 12-13% 

- "Home Service" , not "Service Home" 

(1960's in Sweden, 1990-1993 in Japan) *1960's(12-13%) in SWEDEN  

In this period, home help service spread in Sweden and the number of home helpers increased rapidly. But at the same time, many new old age homes were built at this period. 

At the beginning of 1960's, every municipality researched the situation of the elderly and made the elderly care plan for the next ten years. For Example, in Lund municipality made the first 
elderly care plan in 1962.  

In Sweden municipalities have had the responsibility of the elderly care since long time ago. But actually since 1960's, municipalities have started to have the main responsibility for the elderly care. So it may be concluded that when the aging rate is 12-13%, the demand and supply of the elderly care increase rapidly and the leadership of the elderly care moves to the municipalities from the central government.

  *1990(12%) 1993(13%) in Japan  

In Japan the same development is happening now. Since the April in 1993 the responsibility of the care for the elderly moves to the municipalities from the central government and every municipality is now researching the situation and the needs of the elderly and making the elderly care plan to 2000. This reform is called "Decentralization Reform" . 

In Japan, many new projects started recently. The government started to build sheltered housings. The district nurse system started and the facilities for the health service for the elderly (rehabilitation center) started to build.  

In 1990 Japanese Ministry of Health and Welfare made ten years plan "Gold Plan" in order to improve the care for the elderly and decrease the number of "bedridden" elderly. If this plan will be succeeded, the resources will be as follows;


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