Long-Term Care Insurance System of Japan

November 2016
Health and Welfare Bureau for the Elderly
Ministry of Health, Labour and WelfareChanges in the Percentage of the Population Over Age 65
45%
39.9%

40%

Korea, Rep.

35%

Germany% of population aged 65 & older

Japan
30%
26.7%
25%
21.5%

Sweden

20%

20.0%

UK

18.6%
18.0%

US

14.5%

15%

13.2%

France

10%
9.6%

China

5%
0%
1950

1960

1970

1980

1990

2000

2010

2020

2030

2040

2050

Sources: For Japan – Ministry of Internal Affairs and Communications, Population Census; National Institute of Population and Social Security Research –“Population Projections for Japan (January 2012 estimate): Medium-Fertility & Medium-Mortality Assumption” (Figures as of Oct. 1 of each year)
For other countries – United Nations, World Population Prospects 2010

2060
（Year）
1

Changes in Japan’s Population Pyramid (1990–2060)
 By examining changes in Japan’s demographic makeup , it can be seen that the current social structure consists of 2.6 persons
supporting each elderly person. In 2060, with the progression of the aging population and decreasing birthrate, it is estimatedthat 1.2 person will be supporting one senior citizen.
1990 (Actual figures)
Age

Total population:
123.61 million

100
90

Age

Total population:
128.06 million

100
90

Age 75 & older
597(5%)

80

Age 65–74
892( 7%)702025

2010 (Actual figures)
Age

Total population:
120.66 million

100
90

70

Age Total population:
100

Age 75 & older
2,179(18%)
Age 65–74
1,479(12%)

60

60

50

50

50

50

40
30

40
30

Age 20–64
6,559(54%)

40

Age 65–74
1,128(13%)

7060

Age 20–64
7,497(59%)

Age 75 & older
2,336(27%)

8060

Age 20–64
7,590(61%)

86.74 million

90

Age 75 & older
Baby Boom
1,407(11%)
80
Generation
Age 65–74 (Born 1947–49)
70
1,517(12%)

80

2060

Age 20–64
4,105(47%)

40

30

30

20

20

2nd Baby Boom
20

Generation(Born 1971–74)

20

Age 0–19
3,249(26%)

100

Age 0–19
2,287(18%)

10
0

0

50 100 150 200 250
10Kpeople1

Persons 65 andolder
Persons aged
20–64

5.1

Age 0–19
1,849(15%)

10
0

0

50 100 150 200 250
10Kpeople1

2.6

Age 0–19
1,104(13%)

10
0

0

50 100 150 200 250
10Kpeople11.8

050 100 150 200 250
10Kpeople1

1.2

Source: Ministry of Internal Affairs and Communications – Population Census, Population Estimate; National Institute of Population and Social Security Research – “Population Projections
for Japan (January 2012): Medium-Fertility & Medium-Mortality Assumption” (Figures as of Oct. 1 of each year)2（１）Outline of Long-Term Care Insurance System

3

Development of welfare policies for the elderly
Aging rate
(year)
1960s
Beginning of welfare policies
for the elderly

5.7%(1960)

1970s
Expansion of healthcare
expenditures for the elderly

7.1%(1970)

Major policies
1963 Enactment of the Act on Social Welfare Services for the Elderly◇ Intensive care homes for the elderly created◇ Legislation on home helpers for the elderly1973 Free healthcare for the elderly1982 Enactment of the Health and Medical Services Act for the Aged
◇ Adoption of the payment of co-payments for elderly healthcare, etc.

1980s
“Social hospitalization” and“bedridden elderly people”
as social problems

9.1%(1980)

1990s
Promotion of the Gold Plan

12.0%
(1990)

Preparation for adoption of
the Long-Term Care Insurance
System14.5%(1995)

2000s
Introduction of the Long-TermCare Insurance System

17.3%(2000)

1989 Establishment of the Gold Plan (10-year strategy for the promotion ofhealth and welfare for the elderly)◇ Promotion of the urgent preparation of facilities and in-home welfare
services
1994 Establishment of the New Gold Plan (new 10-year strategy for thepromotion of health and welfare for the elderly)◇ Improvement of in-home long-term care1997 Enactment of the Long-Term Care Insurance Act

2000 Enforcement of the Long-Term Care Insurance System

4

Problems before introducing the Long-Term Care Insurance System
Welfare system
for the elderly
Services provided:

Medical system
for the elderly
Services provided:

・Intensive Care Home for the Elderly, etc.
・Home-help service, Day service, etc.

・ Health center for the elderly,
Sanatorium medical facility, general hospital, etc.
・Home-visit nursing, day care, etc.

（Problems）○Users could not choose services :Municipal governments decided services and service
providers.
○Psychological resistance :Means test was required when applying services.

（ Problems ）○Long-term hospitalization to be cared in hospitals (“social
hospitalization”) increased:
hospitalization fee is less expensive than welfare services
for middle/upper income group, as well as basic
maintenance of the welfare service was insufficient.
→Medical cost increased:
Hospitalization fee was more expensive comparing with
Intensive Care Home for the Elderly and Health center forthe elderly.
→Facilitation of hospital was not sufficient enough forlong-term care with staff and living environment:
Hospitals are expected to provide “cure” (e.g. Limited
room area for care, dining hall or bathrooms)○Services tended to be unvarying without competition:
Services were basically provided by municipalities ororganizations entrusted.
○ Service fee could be heavy burden for the
middle/upper income group:
The principle of ability to pay according to income ofthe person/Supporter under Duty.

These systems had limitations for solving problems.

5Background of the introductionof the Long-Term Care Insurance System
 As society ages, needs for long-term care have been increasing because of more elderly
persons requiring long-term care and lengthening of care period, etc.
 Meanwhile, due to factors such as the trend towards nuclear families and the aging of
caregivers in families, environment surrounding families has been changed.

Introduction of the Long-Term Care Insurance System(a mechanism to enable society to provide long-term care to the elderly )【Basic Concepts】
 Support for independence: The idea of Long-Term Care Insurance System is to support theindependence of elderly people, rather than simply providing personal care.
 User oriented: A system in which users can receive integrated services of health, medicine,
and welfare from diverse agents based on their own choice.
 Social insurance system: Adoption of a social insurance system where the relation between
benefits and burdens is clear.

6Outline of difference between previous systems and present
Previous Systems

the Long-Term Care
Insurance System① Municipal governments decided
services, after users’ application.

Users themselves can choose services
and service providers.

② Separated applications wererequired for each service of medical andwelfare systems.

By making use plans of care service(Care Plan), integrated medical andwelfare services can be utilized.

③ Services were provided mainly bymunicipal governments and other publicorganizations (e.g. Council of Social
Welfare).

Services are provided by various
associations such as private companies
and NPOs, etc..

④ Co-payment was heavy burden forthe middle/upper income group, which
kept them from applying to services.

Regardless of income, co-payment is set
as 10% (20% for persons with income
above certain level, after August 2015) .
7

Structure of the Long-Term Care Insurance System
Municipalities (Insurer)
Municipalities

12.5%

Tax

Prefectures

State

12.5%(*)

25%(*)

50%

Premiums

50%

Pay 90% (80%) of
the costs*As for benefits for facilities, thestate bears 20% and prefecturesbear 17.5%.

22%

28%

Application

Service providers
 In-home services- Home-visit care
- Outpatient Day Long-Term Care, etc.
 Community-based services- Home-Visits at Night for Long-Term
Care- Communal Daily Long-Term Care for
Dementia Patients, etc.
 Facility Services- Welfare facilities for the elderly- Health facilities for the elderly, etc.

Determined based on
the population ratio(JFY2015-2017)

Fiscal Stability
Funds
Premiums

National pool ofmoney
Individualmunicipality

Users pay 10%(20%) of
long-term care services inprinciple, but must pay theactual costs for residence
and meals additionally.

Use of the services

National Health Insurance, Health
Insurance Society, etc.

Withheld from pensions,in principle

Certification of NeededLong-Term Care

Insured persons

Primary Insured Persons- aged 65 or overSecondary Insured Persons- aged 40-64(32.02 million people)(42.47 million people)

Note: The figure for Primary Insured Persons is from the Report on Long-Term Care Insurance Operation (provisional) (April, 2009), Ministry of Health, Labour and Welfare and that for
Secondary Insured Person is the monthly average for JFY2008, calculated from medical insurers’ reports used by the Social Insurance Medical Fee Payment Fund in order to determine theamount of long-term care expenses. Burden ratio for persons with income above certain level is 20:80, after Aug 2015.

8

The insured○ The insured under the Long-Term Care Insurance System are (1) people aged 65 or over (Category 1
insured persons) and (2) people aged 40-64 covered by a health insurance program (Category 2 insured
persons).
○ Long-term care insurance services are provided when people aged 65 or over come to require care or
support for whatever reason, and when people aged 40-64 develop aging-related diseases, such as
terminal cancer or rheumatoid arthritis, and thereby come to require care or support.
Primary insured persons

Secondary insured persons

Eligible persons

Persons aged 65 or over

Persons aged 40-64 covered by a healthinsurance program

Number

32.02 million
aged 65-74:15.74 million

42.47 million

Requirement forservice provision
Percentage andnumber of persons
who are eligible forservices
Premiums collection- Persons requiring long-term care(bedridden, dementia, etc.)- Persons requiring support (daily activities
requires support)

Limited to cases where a condition requiring
care or support results from age-relateddiseases (specified diseases), such as terminal
cancer and rheumatoid arthritis

5.69million（17.8％）
aged 65～74： 0.72million（4.4％）
aged 75～： 4.97million（32.1％）

0.15million（0.4％）

Collected by municipalities (in principle
withheld from pension benefits)

Collected together with medical care premiumsby medical care insurers
9Procedure for Use of Long-term Care Services
Municipal governments (sections in charge)

Users
Investigation for Certification

Doctor’s written opinion

Certification of Needed Support/Long-Term Care

Care levels 1-5

Those likely tocome to needlong-termcare/support in
the future

Support levels 1 & 2Care planfor the use of long-term care

Care planfor preventive long-term care

○ Facility services○ In-home services○ Preventive long-term care services

・Intensive care home forthe elderly・Long-term care healthfacility
・Sanatorium medical
facility for the elderly
requiring long-term care・Home-visit long-term care・Home-visit nursing
・Outpatient day long-term care・Short-stay admission service, etc.

・Outpatient preventive long-term care・Outpatient rehabilitation preventive
long-term care・Home-visit service for preventive longterm care, etc.

○ Community-based services
・Multifunctional long-term care in small
group homes
・Home-visit at night for long-term care・Communal daily long-term care fordementia patients (group homes), etc.

Long-term care benefits

Not certified○ Long-term careprevention projects○ Services whichcope with the actual
municipalities’ needs(services not coveredby the long-term careinsurance)○ Community-based services forpreventive long-term care・Multifunctional preventive long-termcare in small group homes
・Preventive long-term care for dementia
patients in communal living, etc.

Preventive
long-term care benefits

Community support projects

10Varieties of Long-term Care Insurance Services
Home-visit Services
Private Home

Home-visit Care, Home-visit Nursing, Home-Visit
Bathing Long-Term Care, In-Home Long-TermCare Support, etc.

Day Services
Outpatient Day Long-Term Care, Outpatient
Rehabilitation, etc.

Short-stay Services
Short-Term Admission for Daily Life Long-TermCare, etc.

Residential Services
Daily Life Long-Term Care Admitted to aSpecified Facility and People with Dementia etc.

In-facility Services
Long-term
Care Facility

Facility Covered by Public Aid Providing LongTerm Care to the Elderly, Long-Term Care HealthFacility, etc.
11

（２）Present condition and future prediction ofLong-Term Care Insurance System

12Increase in number of persons who are eligible for LTC insurance and users○While the number of insured persons aged 65 or older has increased by approximately 1.5 times over 15 years
since 2000, when the Long-term Care Insurance System was established, that of care service users has
increased by approximately 3 times over the same period. The surge in the number of in-home care users
accounts for the threefold increase of the care service users.

①Increase in number of insured persons aged 65 and older
End of April,2015

End of April,2000
Number of first insured persons

21.65 million⇒

33.08 million

1.53 times②Increase in number of persons with care needs & support needs certification
End of April,2015

End of April,2000
Number of persons with care needs &support needs certification

2.18 million⇒

6.08 million

2.79 times③Increase in number of service users
End of April,2015

End of April,2000
Number of users of in-home care

0.97 million⇒

3.82 million

3.94 times

Number of users of facility care

0.52 million⇒

0.90 million

1.73 times

Number of users of community-based care

－

Total

1.49 million

39 million⇒

5.11 million

3.43 times（Source: Report on Long –Term Care Insurance Service）

13

State of Affairs Regarding Long-Term Care Insurance in the Future
1. The no. of seniors over age 65 is predicted to reach 36.57 million by 2025 and reach a peak of 38.78 million in 2042.
Additionally, the percentage of seniors over age 75 is expected to grow, surpassing 25% by 2055.
2010

2015

2025

2055

No. of seniors 65 & older (ratio)

29.48milion (23.0%)

33.95milion (26.8%)

36.57milion (30.3%)

36.26milion (39.4%)

No. of seniors 75 & older (ratio)

14.19milion(11.1%)

16.46milion (13.0%)

21.79milion (18.1%)

24.01milion (26.1%)*Source: “Projection of the number of households for Japan (nationwide projection) “compiled in Jan. 2013, National Institute of Population and Social Security Research (1&3)

2. Among seniors over age 65, seniors with dementia will increase.

3. Individual/ couple-only households with householders over age 65 will
increase.
15,0004.62mil.
(15%)
2012

20.0

6,209

6,512

26.6

25.7

24.9

23.1
10,000Approx.
7mil.
(20%)

(%)

Changes in no. of one-person and couple-only households w/ householder
aged 65 or older(1,000 households)（parentheses indicate % of seniors overage 65）

28.0

6,453

6,328

6,254

7,622

2035年
2035

30.0

20.0

5,403
5,000

10.0
4,980

6,008

6,679

7,007

7,298

2010年
2010

2015年
2015

2020年
2020

2025年
2025

2030年
2030

0

2025

*Source: Preliminary report from Special Research of Health
Labour Sciences Research Grant by Dr. Ninomiya, Kyushu
University.

0.0
No. of couple-only households with householder aged 65 or older
世帯主が65歳以上の夫婦のみの世帯数
No. of one-person households with householder aged 65 or older
世帯主が65歳以上の単独世帯数
Percentage of above two groups together to total number of households.
世帯主が65歳以上の単独世帯と夫婦のみ世帯の世帯数全体に占める割合

4. The no. of seniors over age75 will rapidly grow in cities and gradually grow in rural areas with originally high senior population. Tailored response
according to regions is necessary as aging circumstances differ according to region.

2015< > = Ratio
2025< > = Ratio( ) = Factor
of Increase

SaitamaPref.
0.765 mil.
people<10.6%>

Chiba Pref.

Aichi Pref.

Osaka Pref.

0.717 mil.
people<11.6%>

Kanagawa
Pref.
1.016 mil.
people<11.1%>

0.817 mil.
people<10.9%>

1.070 mil.
people<12.1%>

1.177 mil.
<16.8%>(1.58)1.082 mil
<18.1%>(1.51)1.485 mil.
<16.5%>(1.46)1.166 mil.
<15.9%>(1.43)1.528 mil.
<18.2%>(1.43)--Kagoshima
Pref.

Akita Pref.

Yamagata
Pref.

Nationwide

1.473 mil.
people<11.0%>

0.267mil.
people<16.2%>

0.188mil.
people<18.4%>

0.190mil.
people<17.0%>

16.458 mil.
people<13.0%>

1.977 mil.
<15.0%>(1.34)0.295mil.
<19.4%>(1.10)0.205mil.
<23.0%>(1.09)0.207mil.
<20.6%>(1.09)21.786 mil.
<18.1%>(1.32)Tokyo--*Source: “Regional Population Projection for Japan” compiled in Mar. 2013, National Institute of Population and Social Security Research

145. Changes in the Population Over Age 75(Age group with high percentage of persons requiring care)○Since the establishment of the long-term care insurance system in 2000,
the population over age 75 has increased rapidly and such increase willcontinue for 2025.
○From around 2030, the rapid growth of the population over age 75 willlevel off but the population over age 85 will continue to increase foranother 10 years.

3,000

6. Changes in the Population Over Age 40(Age group paying for long-term care insurance system) The population over age 40, who pay for the long-term careinsurance, has increased since the establishment of the long-term
12,000insurance system in 2000 but will start to decrease after 2021.

10,000（10k people）（ 10k people ）
8,000

2,500
2,179

2,000

1,879
1,646

1,164 383

1,000

736 846

637

1,419

1,500

2,278 2,245

678

1,015
1,037

977 1,035
1,149
985

1,037

1,135

1,442
1,432
1,242

1,231
1,186

1,407
1,366
1,272
1,187

0
2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 2055 2060

Sources:

6,575
6,000

4,000

2,000

Age 75-84

224
870

Age 85 &
older

511

901 294500

2,223 2,257

2,385 2,401 2,336

6,933

2,204 2,576

7,293

7,645 7,787 7,769 7,626

2,948 3,395 3,612 3,657

7,421

3,685 3,741

7,192

3,941 3,680

Age 40-64（Category 2 insured persons）

6,664 6,387

6,060

3,868
3,856 3,768

Age 65 & older（Category 1 insured persons）

4,371 4,357 4,344 4,250 4,175 4,112

6,933

3,324 3,077 2,896

3,626

3,464

2,761 2,596

0

Age 20-39-2,0003,517 3,426 3,220

2,337 2,229 2,069
2,838 2,608 2,448

1,902 1,747 1,607 1,509-4,000Future population estimates were taken from the National Institute of Population and Social Security Research’s “Population Projections for Japan (January 2012): Medium-Fertility (Medium-6,000
Mortality) Assumption”
Actual past figures were taken from the Population Census by the Statistics Bureau of the Ministry of Internal Affairs and Communications (population with proportional corrections for those of
unknown nationality/age)15

Trends and the Future Prospects of Long-Term Care Benefits and Premiums○ The municipal governments formulate Long-term Care Insurance Service Plan which designates 3 years as one term and is reviewed in every 3 years.
○ As ageing proceeds, premiums estimated to rise to 6,771 yen in 2020 and 8,165 yen in 2025. In order to maintain sustainability of the Long-Term Care
Insurance System, it would be necessary to establish the Community-based Integrated Care System, and to make services more focused and efficient.

The sixth
phase

The fifth
phase

The
fourthphase

The third
phase

The
secondphase

The first
phase

Operation period
FY２０００
FY２００１
FY２００２
FY２００３
FY２００４
FY２００５
FY２００６
FY２００７
FY２００８
FY２００９
FY２０１０
FY２０１１
FY２０１２
FY２０１３
FY２０１４
FY２０１５
FY２０１６
FY２０１７
FY２０２０FY２０２５

Benefits（Total Cost）
3.6 trillion
4.6 trillion
5.2 trillion

Insurance premiums(national average per month)

2,911yen

5.7trillion
6.2 trillon
6.4 trillion

3,293yen

6.4 trillion
6.7 trillion
6.9 trillion

4,090yen

7.4 trillion
7.8 trillion
8.2 trillion

4,160yen

8.9 trillion
9.4 trillion
10.0 trillion

4,972yen

10.1 trillion
10.4 trillion

5,514yen
6,771yen
8,165yen16

（3）Revision of Long-term Care Insurance System17

Major Contents of Revision of Long-term Care Insurance (2014 revision)(1) Establishing the Community-based Integrated Care System(2) Making Contribution Equitable

Enriching long-term care, healthcare, support andpreventive services in order for elderly people tocontinue their lives in their accustomed areas.

Expanding reduction of premiums of people with
low-income, and reviewing co-payments of those
who have certain income or assets in order tosuppress increase of premiums.

Enriching Services
Enriching Community Support Projects towards establishing
the Community-based Integrated Care System:①Enhancing coordination between In-home Medical Careand In-home Long-term Care
②promoting measures against dementia③Enhancing Community Care Meetings④Improving the Livelihood Support Services

Expanding Reduction of Premiums of People
with Low-income
Expanding the reduction rate of premiums of people with lowincome:(An example of reduction of premiums)
For people with pension income lower than 800,000 yen peryear, the reduction rate will expanded from 50% to 70%.

Making Services More Focused and Efficient①Transferring nationally-unified Preventive benefits (Homevisit Care and Out-patient Long-tem Care) to Community
Support Projects of municipalities, and diversifying them.
②Restricting users of in-facility services of Special Long-term
Care Health Facilities to people whose care level is 3 or higher
in principle.

Review of Co-payments etc.
①Increasing co-payments of users with income more than acertain level.
② Adding assets to the check list of requirement for“Supplementary Benefits,” which provides money for foodand residence to in-facility users with low income.
18

Establishing ‘the Community-based Integrated Care System’○By 2025 when the baby boomers will become age 75 and above, a structure called ‘the Community-based Integrated Care System’ will be establishedthat comprehensively ensures the provision of health care, nursing care, prevention, housing, and livelihood support. By this, the elderly could live
the rest of their lives in their own ways in environments familiar to them, even if they become heavily in need for long-term care.
○As the number of elderly people with dementia is estimated to increase, establishment of the Community-based Integrated Care System is importantto support community life of the elderly with dementia.
○The progression status varies place to place; large cities with stable total population and rapidly growing population of over 75, and towns and villages
with decrease of total population but gradual increase of population over 75.
○It is necessary for municipalities as insurers of the Long-term Care Insurance System as well as prefectures to establish the Community-based
Integrated Care System based on regional autonomy and independence.
.

In case of illness:

Health Care

the Community-based Integrated Care System Model

Hospitals:
Acutephase,recoveryphase,chronic phase

Outpatient/in-patient
Regularhealthcare:
care
・PCP, clinics with in-patient facilities
・Regional affiliate hospitals
・Dental care, pharmacies

Visits / Moving inHome CommunityGeneral
SupportCenter Caremanager
Handlesconsultationandservice
coordination.

 One’sownresidence Seniorresidencesofferingservices,etc.

Livelihood support/ preventing long-term care
Sothatseniorscancontinue active,healthy living

When carebecomes necessary...

Nursing Care

In-homeservices:
・Home-Visit Long-TermCare,Home-Visit Nursing,OutpatientDayLong-TermCare・Multifunctional(Long-TermCarein a)Small GroupHome
・Short-TermAdmissionforDailyLifeLong-TermCare・EquipmentforLong-TermCarecoveredbyPublic Aid
・24-hourHome-Visit Service
・CombinedMultiple Service(MultifunctionalLong-Term
CareinaSmall GroupHome＋Home-Visit Nursing)■PreventiveLong-TermCareServices■Facility/Residenceservices: Nursingcarehomes
 Geriatric healthservices
facilities
 Communal-livingcare
fordementia patients
 Livingcareforpersonsat
government-designatedfacilities
etc.

* The Community-based Integrated Care System isconceived in units of every-day living areas(specifically equivalent to district divisions forjunior high-schools) in which necessary services
can be provided within approximately 30 minutes.

Senior clubs, residents’associations,volunteer groups, NPOs, etc.

19

Comprehensive Strategy to Accelerate Dementia Measures（New Orange Plan）~To Realize Age and Dementia-Friendly Community~
Basic Concept

Realization of a society where persons with dementia can live with dignity in a pleasant andfamiliar environment as how they hope to be as long as possible.

・Formulated by MHLW in collaboration with Cabinet Secretariat, Cabinet Office, NPA, FSA, CAA, MIC, MOJ, MEXT, MAFF, METI, and MLIT
・Targets at 2025 when the baby boomers turn 75 years and older
・Prioritizing the standpoint of persons with dementia and their families

Seven Pillars of New Orange Plan
RAISING AWARENESS

1

Raising awareness andpromoting understanding of
dementia

CARER SUPPORT

4

Supporting those looking after
people with dementia

INTEGRATED SERVICES

2

Providing health care and longterm care services in a timely
and appropriate manner as thestages of dementia progress

EARLY ONSET DEMENTIA

3

Strengthening the measuresfor early onset dementia

COMMUNITYRESEARCH & DEVELOPMENT

5

6

Creating age and dementiafriendly community

Promoting research anddevelopment and disseminating
the results of prevention,
diagnosis, cure, rehabilitation
model, and care model for
dementia

VIEWPOINT OF PERSONS WITH DEMENTIA

7

Prioritizing the standpoint of persons with dementia and their families

20
20New Orange Plan

“Comprehensive Strategy to
Accelerate Dementia Measures”① Early Support(Initial Phase Intensive Support Team, etc.)

Coordination of
Medical Care andLong-term Care

② Improving Ability of Care Providers(Training Programs)③ Coordination of Medical Care and Longterm Care
(Dementia Coordinator)

Research forPrevention andCure

Age and DementiaFriendly
Community④ Risk Reduction(Nationwide Prospective Dementia Cohort)⑤ Cure(Project for Psychiatric and Neurological
Disorders)⑥ “Dementia Supporters”

already 6.34 million ⇒ 8 million⑦ Safety(Cross-ministerial support:
watching system in the community, etc.)
21Initial-Phase Intensive Support Team (IPIST)
Community General Support Center

consultation

IPIST

Long-term care

①Visit（assessment）②Conference (planning）③Visit（guidance）④Visit（Intensive support）

Long-Term Care
Support Specialists＋

Medical Care andLong-term Care specialists

Team Conference

Awareness
Personsuspected to
be withdementia

Certified doctor

Seamless
Coordination

collaboration

collaboration

Medical Center for Dementia
Medical careconsultation

collaboration

Primary Care Doctors

Primary Care
Doctors

Differential Diagnosis

22

“Dementia Supporters”
Training Program

Dementia Supporters Program Voluntarily

people of every
generation, every
occupation are becoming“Dementia Supporters”

 with proper knowledge and understanding in communities and work places

Over 8 million
supporters have been
trained as of September
2016.
Community
OfficeSchoolPublic office
LTC Service Providers
23