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2014年4月 8日 (火)

特養待機者急増 在宅支援の拡充が不可欠だ

The Yomiuri Shimbun 7:52 pm, April 07, 2014
Elderly need more at-home support as waiting lists for special facilities grow
特養待機者急増 在宅支援の拡充が不可欠だ

The figure now stands at 524,000. That is how many elderly people are on waiting lists for admission to special nursing care homes, according to a survey by the Health, Labor and Welfare Ministry. The number has increased by more than 100,000 since a similar survey was conducted four years ago.

More must be done to get people off these waiting lists.

The number of people waiting to be admitted almost matches the total number of inhabitants in special nursing care homes across Japan. Although the capacity of these homes is increasing, the truth is that it cannot keep up with the rising demand for spots at these facilities caused by the aging of Japan’s society.

Especially disconcerting is that 87,000 elderly people are waiting at home to be admitted to these special homes despite being officially recognized as requiring care level 4 or 5—the two levels with the greatest requirements for long-term care.

The government has submitted to the current Diet session a bill to amend the Nursing Care Insurance Law and restrict entry to special nursing care homes to people classified as requiring care level 3 or higher from fiscal 2015.

There is no option but to limit entry to these homes to people who have the greatest need for such care.

Many elderly people want to stay at these homes because they can receive care around the clock and the facilities are relatively cheap compared with fee-based nursing homes and other similar facilities. For low-income people in need of long-term nursing care, these special homes are generally their only choice.

However, even among the services covered by nursing care insurance, special care for the elderly is quite expensive, which places a heavy financial burden on the central government and local authorities. Massive construction costs are also sometimes required, which has hampered the establishment of some facilities.

Difficulty finding land

This is especially so in large cities, where land prices are high. The difficulty in acquiring land makes it even harder to build new special nursing care homes, which is why the Tokyo metropolitan area and other major cities are home to many elderly people on waiting lists.

We urge local governments to leave no stone unturned in the search for land and buildings suitable for these nursing homes. Perhaps, for example, they could be set up on the vacant grounds of merged or abolished schools, or on a floor of a condominium building.

Given that it will not be easy to quickly construct the sheer number of special nursing care homes currently required, it is all the more important to provide excellent at-home nursing care services to handle the needs of the elderly.

Many elderly people wish to continue living in areas where they have resided for many years. Doing so will require providing an environment in which they do not rely on care facilities and instead can continue to live at home with peace of mind.

In concrete terms, they need a system that provides integrated medical and nursing care services, even at night. The welfare ministry and local governments must upgrade and expand the provision of 24-hour home-visit nursing services and home-based medical care.

Elderly people who want to live at home also will need assistance with things like shopping and meal deliveries, and people to regularly check up on them.

To provide proper services while keeping a lid on costs, local governments should proactively utilize volunteer groups, nonprofit organizations, private-sector companies and other entities.

Finding and retaining enough care workers is also a pending concern. The wages earned by nursing care staff are low despite their heavy responsibilities and tough working conditions, so many walk away from the industry before long. Improving the treatment of these workers is an urgent task.

(From The Yomiuri Shimbun, April 7, 2014)


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