Percentage of elderly and the use of welfare services at city welfare offices in Japan.

Japan's population is aging rapidly. As in other developed countries, the establishment of a system of care for the elderly, especially for those suffering from dementia, has become an urgent issue. As the role of welfare offices, which is to directly serve the people, has become increasingly important, the need to assess their use in terms of demographic factors has risen. With respect to demographic factors, this study analyses the use of the welfare services by the demented elderly at city welfare offices in Japan from 1987 to 1989. In December 1991, questionnaires were mailed to 670 city welfare offices nationwide, excluding those located in designated large cities and special wards in Tokyo. Four-hundred and thirty-seven (65.2%) of the offices responded. Offices located in areas with a relatively high percentage of elderly reported giving fewer counselling sessions and reported fewer people registered for or utilizing domiciliary welfare services than offices in areas with a relatively low percentage of elderly. The differences between the two areas in the total amount of counselling, counselling cases at the welfare office, and respite-care for 1989 and day-care service registration were significant. The Pearson's correlation coefficients for the percentage of elderly and these activities all showed negative values, except for home-help utilization in 1987 and 1989. Welfare offices in which the number of activities increased significantly over the 3 years examined in this study were more common in the areas where a committee for communication between medical and welfare sectors (hereinafter "liaison-committee") existed. Discriminant analysis suggests a correlation between the existence of a liaison-committee and the following variables: the percentage of the elderly living alone, the number of home-helpers per elderly, the capacity of day-care service per elderly and the number of surgeries per elderly. From the results, it is apparent that the welfare offices in areas with a high elderly percentage tended to have less activity. Today, municipalities with a high percentage of elderly in its population are particularly required to draw up plans for their health and welfare. The establishment of a network like a liaison-committee will enable the municipalities to achieve their goals.