1 in 3 will be older adults by 2025 in Japan

In June Dr Mayumi Hayashi described Japan's vision of 'total care' for its older population in HSJ. The article that prompts this post follows another with lessons for England.

Referring to a "2025 vision" this forward thinking has its roots in established systems of healthcare set up in 1961 and social care established in 2000 (p.25).

Care integration is not new as a fundamental issue in health and social care. It is for me a career legacy issue. As a student nurse it was discussed and debated, closely allied with multidisciplinary and holistic (joined up physical and mental health) care. Even now 37 years later it will drive many arguments and policy deliberations in the run up to the next election here.

Many nations are faced with stark demographics. As the population ages and works its way through wooden blocks, Rubik cubes, it is the population pyramid that takes on increasing significance.


Dr Hayashi lists the need for inclusion, integration and continuation of four components that are essential to the realisation of this vision:

• maximising the integration of healthcare and social care;
• promoting policies for prevention and outreach together with safeguarding;
• embedding supported living programmes and dementia friendly community initiatives; and
• addressing “late life specific” housing needs.

I have mapped these to Hodges' model below:

individual
INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

embedding supported living programmes and dementia friendly community initiatives	integration of health and social care
"late life specific" housing needs (integration of health and social care)	promoting policies for prevention and outreach, together with safeguarding

It becomes clear to see in Japan, China and other nations how telecare and smart homes have a role to play. Getting the basics of integrated care resolved firstly is the prerequisite whatever the culture.

Where achieved the integration of health and social care can act as a diagonal brace as it straddles two care domains. Perhaps the model also reflects the ongoing challenges of parity in esteem in mental health care and physical care; and the funding ambiguity for people living with dementia as opposed to other medical conditions?

In January 2014 the FT Weekend magazine also featured an article on ageing in Japan.

Hayashi, M. (2014) Japan's vision of a 'total care' future looks bright, Health Service Journal, 124, 6404, 25-27. 

FT magazine cover image:
https://www.facebook.com/financialtimes/photos/a.10150157857040750.297340.8860325749/10152119294570750/?type=1