Financing elderly people's long-term care needs: Evidence from China.

Confronted by accelerated population aging, China is establishing a long-term care (LTC) system. This study discusses challenges and recommendations for financing China's LTC system. On the basis of the data on elderly people's self-care ability from the Chinese Longitudinal Healthy Longevity Survey, we calculate the size of the elderly population that need LTC for the period from 2015 to 2030 and analyse the increasing tendency of LTC expenses by considering the impact of price increase. We also analyse the local governments' financial capacity for LTC support by comparing the expense level to the fiscal revenue. The study found that aging will double the LTC expenses by 2030. Therefore, this study suggests the establishment of an LTC insurance system that allocates LTC expenses, which are currently borne by individuals and families, more fairly among the government, individuals, and families. Moreover, with the current LTC reforms, implemented primarily by local governments in China, we believe that the central government should bear some of the fiscal responsibility by conducting fiscal transfers to partially support undeveloped regions that are establishing an LTC system.

Experiences of Japanese aged care: the pursuit of optimal health and cultural engagement.

Japan is a super-ageing society that faces pressures on its aged care system from a growing population of older adults. Naturalistic observations were undertaken at eight aged care facilities in central and northern Japan to explore how aged care is configured. Four aspects of contemporary provision were identified that offer potential gains in quality of life and health. The Japanese government mandates that aged care facilities must employ a qualified nutritionist to oversee meal preparation, fostering optimal dietary intake. A concept of life rehabilitation seeks to maximise physical and cognitive performance, with possible longevity gains. Low staff to resident ratios are also mandated by the Japanese government to afford residents high levels of interpersonal care. Finally, Japanese facilities prioritise experiences of seasonality and culture, connecting frail older people to the world beyond their walls.

Japanese-language Dementia Knowledge Assessment Scale: Psychometric performance, and health student and professional understanding.

AIM: Dementia prevalence is accelerating internationally commensurate with population aging. Super-aging countries, including Japan, will experience growing prevalence of this life-limiting condition in the coming decades as a result of falling fertility and mortality. The authors developed and verified a Japanese translation of the Dementia Knowledge Assessment Scale (DKAS-J) to address the paucity of reliable and valid Japanese-language measures, and to elucidate current understanding. METHODS: The present study was designed as exploratory research across five universities in Japan. The Dementia Knowledge Assessment Scale was translated into Japanese by a native speaker and bilingual physician with back-translation carried out to ensure consistency of meaning. Between January and April 2016, the DKAS-J was administered to 185 health students, academics and health professionals from the disciplines of nursing, medicine and allied health in the regions of Kyushu, Kansai and Tohoku. RESULTS: The DKAS-J showed face and content validity, acceptable internal consistency (α = 0.79) and adequate sensitivity (discrimination between health professionals and health students). A principal components analysis confirmed that an 18-item iteration of the DKAS-J performed optimally as a unidimensional scale. The results of DKAS-J administration showed low levels of dementia knowledge among participants, with particularly poor understanding related to the clinical course of the syndrome, symptomatology and the efficacy of pharmaceutical intervention for behavioral symptoms. CONCLUSION: The DKAS-J provides a useful tool for conceptualizing baseline knowledge, changes in understanding and knowledge deficits. Such a measure will prove valuable for the design and development of educational interventions as dementia increases in Japan and worldwide. Geriatr Gerontol Int 2017; 17: 1746-1751.