As India and the United States are aging, Japanese elderly care should be used as a model for specialists.
The issue of how to deal with an aging society is drawing attention not only in Japan, where the aging rate is relatively high, but also worldwide. Nature, a scientific journal, discusses the problems of an aging society with reference to Japan and India, which have a high aging rate.
Tackling the crisis of care for older people: lessons from India and Japan
How to budget and provide support in a rapidly aging society is a politically difficult issue. For example, a British analyst said, 'The social care called'dementia tax'proposed by former Prime Minister Theresa May' was explained as to why the British ruling and Conservative parties led by former Prime Minister Theresa May fell below the majority. In addition to analyzing that it is due to reforms, the policy of raising the national insurance tax rate announced by its successor, Prime Minister Boris Johnson, in September 2021 has also been criticized.
In addition, the increasing deaths of older people from the new coronavirus infection (COVID-19) in long-term care facilities around the world have highlighted one flaw in the social care system, Nature said. By 2050, one-quarter of the population will be 65 or older in the United Kingdom, and in the United States, the population aged 65 or older will increase 1.8 times in the next 40 years. In Japan, it is predicted that one-third of the population will be 65 years old or older in less than 20 years, and how to respond to the aging society is discussed as follows.
It has been customary for the elderly to be supported not only by the government but also by families. 'Support for the elderly in India is family-based, and elderly housing with care is still very rare,' said Kuriath James, an Indian demographer and director of the International Institute for Population Sciences (IIPS). increase. Extended families in India usually live close to each other, often sharing the same space or living on different floors, making it easier to care for the elderly at home.
However, in India, the world's largest source of immigrants, the number of traditional family care providers is rapidly declining. According to the Pew Research Center in the United States, the number of Indians seeking work abroad has more than doubled since the early 1990s, reaching 15.6 million in 2015. In addition, movement within India is also increasing, and the 2001 census recorded that 30% of the population did not live in the place where they were born, which increased to 37% in 2011. The migrants are usually younger and choose to leave their parents at home.
A report on the elderly in India, produced by IIPS and others in 2020, suggests that the issue of youth migration is emerging. According to this report, about 26% of India over the age of 60 live alone or with their spouse only. However, as of 2022, family life is still relatively common in India, with 41% of children over the age of 60 living with both spouse and adult children, and 28% of children adult without spouse. He said he lives with us.
India has been shown to have a lot of home care, but it is also true that home care is costly. 'The caregivers are mostly women, women can't work outside the home, and there are serious problems in India regarding women's work,' says James. In late 2020, gender employment in urban areas of India was 57% for men and only 16% for women.
Nature points out that much of the country's workforce is engaged in caring for the elderly at home, 'a serious stumbling block to the economy.' 'We don't have data on home care satisfaction, but I think home care is much more appreciated than care facilities because it's what society expects,' said Nature. 'It also leads to issues of gender equality,' he said, saying that the current situation in which women provide home care at the expense of their career pursuit is not successful. Nature then concluded that the mechanism by which women stay at home and provide long-term care is forced to change due to an increase in the number of migrant workers and the chronic effects of COVID-19.
Nature also mentions Japan, which has the highest proportion of the population over the age of 65 in the world.
Japan has a lower domestic migration rate than India, and at most 20% of people do not continue to live in the prefecture where they were born. In the past, as in India, there was a problem that there were relatively few women working in regular employment, but in 2000, 67% of Japanese women between the ages of 25 and 54 were in regular employment. There is also.
In Japan, the long-term care insurance system started in 2000. Long-term care insurance provides support to anyone over the age of 65 who needs long-term care for some reason. The qualifications are first determined by a survey, followed by a decision from the doctor and the committee / examination committee, followed by day and long-term care services in line with the content. 'The goodness of the design is commendable,' Curry said of the system, which supports people over the age of 65 who need some help throughout society.
Many of the problems that Japan tried to offset with the introduction of the long-term care insurance system still remain, but Nature points out that they have decreased since the system was introduced. Japan's working-age population declined by more than 11 million between 2000 and 2018, but the increase in the working-age female population has increased the workforce by 600,000. 'Probably because the long-term care insurance system has reduced concerns about family care and leveled the competition. As the working population declines, the government is binding many women to home care. I noticed. '
However, the aging rate is still high, and the predicament of the Japanese labor market is not over. Despite securing a workforce by hiring more women, the national workforce is projected to be 53 million by 2040, down 20% from 2017. As a result, Nature points out new challenges such as who will bear the cost of long-term care insurance and how.
In the United States, the mortality rate in long-term care facilities increased to 17% in 2020 compared to the previous year. It is believed that this was largely influenced by COVID-19, and people were reminded that it would be better to spend time together at home rather than leaving it in a long-term care facility. Laval University's French Legale pointed out. Although there is no clear model of which is better after the COVID-19 epidemic, it is said that we should move on to a hybrid model such as long-term care insurance.
'Of course, one solution is not the only solution,' said Legale. 'We need to provide personalized care, whether at home or in a facility.'
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