3.4
|
The Problems In Japan
|
3
4 1
|
700,000 "Bedridden Elderly" ~"Netakiri Shock!"~ |
One
of the biggest problems among the elderly care In Japan Is the
" Bedridden Elderly " ( Säng-liggande äldre )."
Bedridden Elderly" is called "Netakiri" in Japanese. This
is a very unique problem in Japan. In 1990 the number of elderly aged 65
and over is about 14,000,000 and the aging rate is 12%. The
Japanese Ministry of Health and Welfare estimates that about 700,000
bedridden elderly exist in Japan in 1990. It means that about 5% of the
elderly aged 65 and over is bed ridden in Japan nowadays. The definition
of "Bedridden Elderly" is not so exact, because different
municipalities use a little different definitions about the "Bedridden Elderly". But the general definition is that "Bedridden Elderly" means the elderly who spend the most of their daily time on the beds.
Table.6 show the location of the "Bedridden Elderly" in 1986.
Table.6
|
The Location of the Bedridden Elderly |
Location |
Estimated
Number |
Ratio |
At
Home |
220,000 |
37.1% |
Nursing
Home |
130.000 |
21.l% |
Hospital
* |
250,000 |
41.8% |
Total |
600,000 |
100.0% |
(Source:
|
Japanese Ministry of Health and Welfare 1986)
|
*Elderly patients who stays at the hospitals for over six months. |
There
were about 600,000 "Bedridden Elderly" in Japan in 1986 and
about 250,000(41.8%) stayed at the hospitals for over six months! And
about 130,000
(21.l%) stayed at the nursing home and about 220,000 (37.1%) stayed at
their own homes. There is no public sheltered housing (service house) in
Japan.
There
are some reasons why so many "Bedridden Elderly" exist in Japan.
The following four reasons are supposed to be very important .
<1>
|
Care-givers are usually their own Families
|
<2>
|
Japanese "TATAMI" Culture -Elderly Prefer to Lie on the Bed to Sit on
the Chair- |
<3>
|
Rehabilitation Function is very Weak
at the Long Term Care Facilities |
<4>
|
The Numbers of Stuffs and Nurses at the Hospitals and at
the Nursing Homes are Very Low |
Families have the responsibility to take care of the elderly in
Japan, but the family care-givers do not have knowledge how to
rehabilitate and activate the sick or handicapped elderly. As a result,
families let elderly lie on the bed every day.
And elderly themselves prefer to lie on the bed. Because
Japanese elderly are get used to sit and lie on the "TATAMI"
-special Japanese matt- not to sit on the chairs.
So
elderly prefer to lie on the floor when they feel tired. "To lie on
the bed and to take a rest is the best way to recover your health!".
This is a traditional Japanese saying. And the importance of the
rehabilitation for the elderly is not so realized in Japan. And at
Japanese hospitals and institutions rehabilitation has not been so
emphasized neither. The numbers of stuffs and nurses at the Japanese
hospitals and the nursing homes are much lower than Swedish standard(1
will explain about this point more in detail later).
3
4 2
|
One Million Senile Dementia Patients in Japan |
Another
Japanese problem is the rapid increase of the number of senile dementia
elderly. The Swedish society faces the same problem also. In 1991 about
one million elderly are suffered from dementia disease in Japan. Table.7
shows the location of the dementia elderly.
Table.7 |
Location of the Senile Dementia Elderly in Japan and Sweden
|
Location |
JAPAN |
SWEDEN |
Hospital
* * * |
60,000
(6.0%) |
-
(-) |
Nursing
Home
( Sjukhem ) |
83,000
( 8.3% ) |
|
Geriatric
Hospital (LångvårdkIinik) |
54,000
(5.4%) |
20,000*
( 25.0%
) |
Mental
Hospital |
33.000
( 3.3% ) |
|
Old
Age Home** (Ålderdomshern
och Servicehus ) |
13.000
(1.3%) |
16.000
( 20.0%
) |
Facilities
for Health**** Services for the Elderly |
12,000
(1.2%) |
-
(-) |
Group
Living |
-
(-) |
4,000
( 5.0%
) |
At
Home |
740, 000
( 74.0%
) |
40.000
( 50.0%) |
Total |
990.000
( 100% ) |
80,000
( 100% ) |
Source
:
|
The Research of the Health Science by the Japanese Ministry of
Health
and Welfare in 1991)
The rough estimation by the "demens forbundet" in Sweden in 1992(Demensforum NR2 1992 MAJ sidan 3) |
*
|
About
20.000 senile dementia patients stay at the long term institutions
(långvårdklinik
and sjukhem and mental sjukhes)
|
**
|
Old Age Home in Japan is an institution for the 'healthy and poor elderly. So there are only few senile dementia elderly Nursing home in Japan is similar
to the old
age
home ( ålderdomshem ) in Sweden. And
geriatric hospital in Japan is similar to the nursing home ( sjukhem
) in Sweden. More in detail is explained in chapter.5. |
***
|
In Sweden patients do not stay at the general hospitals for a long time. But in Japan patients can stay at the general hospital within three months easily. |
****
|
Facilities f or the e elderly
who do not need to be hospitalized for treatment, but who need functional training, nursing and care for rehabilitation. In general patients can
stay here maximum three months. But Actually patients can not
move back home so easily. |
One of the
difference in the two countries is that the support by
the home help service and the day care center. In Japan the number of home
helpers and day care centers are much less than those in Sweden.
So the burden
of Japanese families who take care of senile dementia elderly is much
heavier.
And
recently in Sweden the group living
(
gruppboende
) has become
popular for the senile dementia elderly. But there is no group living in
Japan.
The
location of the senile dementia elderly in both countries are very
different. The biggest reason is that the function of the various
facilities in the two countries are much different. Later I will explain
the difference of the facilities in both countries .
74%
of them stay at home. And they can get only the little home help service.
The statistics shows almost the same trend of that of "Bedridden
Elderly - most of the elderly are cared by the family at home without the
support of home helpers -".
Table . 8 |
The Forecast of the Number of Senile Dementia Patients in Japan |
Year |
Number |
Ratio(%)per Aged
Population ( > 6 5 ) |
1990 |
990,000 |
6.7% |
1995 |
l,230,000 |
6.8% |
2000 |
l,500,000 |
7.0% |
2005 |
l,790,000 |
7.4% |
2010 |
2,130,000 |
7.9% |
2015 |
2,470,000 |
8.l% |
2020 |
2,740,000 |
8.6% |
(Source
|
the same
source as Table.7)
|
|