Sano Junko, Hirazawa Yuzuki, Komamura Kohei, Okamoto Shohei
Research Center for Financial Gerontology, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, Japan.
Faculty of Economics, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, Tokyo, Japan.
Arch Public Health. 2023 May 4;81(1):81. doi: 10.1186/s13690-023-01076-5.
As longevity occurs, people encounter various risks associated with ageing, including economic uncertainty and health issues. Therefore, in addition to extending healthy life expectancy, it is crucial to create an environment where older people can live better even when their intrinsic capacity declines. Additionally, integrated and comprehensive care for older adults is needed to maintain their functional ability and well-being at higher levels. This review provides an overview of the systems and initiatives in Japan, a forerunner of population ageing that supports the quality of life of older people and summarises their remaining challenges. In Japan, with support for access to necessary care available from social welfare councils and community comprehensive support centres, various health and welfare services are provided to respond to the needs of people with different levels of intrinsic capacity, including medical care, preventive care, long-term care, adult guardianship systems, pensions, and social assistance. Nevertheless, there are challenges for the systems, including the gap between life and healthy life expectancy, moderate accumulation and decumulation of retirement assets, lack of human and financial resources for care, and user-unfriendliness and non-covered needs of the current system. Therefore, integrated and comprehensive care beyond health and long-term care is needed to maintain the well-being of older adults, even with their intrinsic capacity declining.
随着人们寿命的延长,会面临与衰老相关的各种风险,包括经济不确定性和健康问题。因此,除了延长健康预期寿命外,营造一个即使老年人内在能力下降也能生活得更好的环境至关重要。此外,还需要为老年人提供综合全面的护理,以将他们的功能能力和幸福感维持在更高水平。本综述概述了日本在支持老年人生活质量方面的体系和举措,日本是人口老龄化的先驱,并总结了其尚存的挑战。在日本,社会福利委员会和社区综合支持中心提供了获得必要护理的支持,针对不同内在能力水平的人群需求,提供了各种健康和福利服务,包括医疗、预防保健、长期护理、成人监护制度、养老金和社会援助。然而,这些体系仍存在挑战,包括预期寿命与健康预期寿命之间的差距、退休资产的适度积累和消耗、护理人力和财力资源的缺乏,以及当前体系对用户不友好和存在未覆盖的需求。因此,即使老年人内在能力下降,也需要超越健康和长期护理的综合全面护理,以维持他们的幸福感。