Integrated Long-Term Care 'Neighbourhoods' to Support Older Populations: Evolving Strategies in Japan and England.

Western countries are currently facing the public health challenge of a rapidly aging population and the associated challenge of providing long-term care services to meet its needs with a reduced working age population. As people age, they will increasingly require both health and social care services to maintain their quality of life and these will need to be integrated to provide cost-effective long-term care. The World Health Organization recommended in 2020 that all countries should have integrated long-term care strategies to better support their older populations. Japan, with the most rapidly ageing society in the world, started to address this challenge in the 1990s. In 2017, it introduced a national policy for integrated long-term health and social care services at a local geographical level for older people. England has recently embarked on its first plan aiming for the integration of services for older people. In this article, we compare these approaches to the integration of long-term care systems, including the strengths of each. The paper also considers the effects of historical, cultural and organizational factors and the emerging role of technology. Finally, we identify critical lessons that can inform strategy development in other countries, and highlight the need to provide more international comparisons.

Relationship between number of present teeth and nutritional intake in institutionalized elderly.

We conducted oral examinations and dietary surveys on a total of 141 subjects with an average age of 80 years or more-specifically, seniors (S-group) living in a health service facility for the elderly and patients with mild dementia (SD-group) living in a special nursing home for the elderly. All were assumed to have a roughly uniform diet. We investigated which factors contributed to their dietary intake, and the relationship between dietary intake and number of present teeth (PT). Factors affecting total energy of the subjects and those in the S-group were body weight and number of PT. No factors were recognized as having a relationship with total energy in the SD-group. A significant difference was found in males in the S-group in that those in the "five PT or more" group had higher levels of carbohydrates and vitamin B1) than those in the "four PT or less" group. However, significant differences were found in the SD-group in that subjects in the "five PT or more" group had higher levels of carbohydrates, calcium, iron, and vitamins A, B1, B2, and C than those in the "four PT or less" group. Significant differences were seen in both groups for female patients in the nursing home with regard to total energy, proteins, carbohydrates, iron, vitamin B1, and fiber intake. No significant differences were recognized, however, for females in the SD-group. Reductions in dietary intake should be considered from the perspective of nutritional status, which is a problem that can be resolved through dental treatment. This study found that recovery of chewing ability in seniors was essential not only to maintain nutritional status, but also to fully bring out all the functions of the foods themselves.