Summary of the Research Report

International Comparative Study on Care Management and Controlled
Service to Support Independent for Older People
1. Incorporating potential for recovery in eligibility decisions and simplifying
outcome categories
It was particularly informative to learn that in the countries we studied (theNetherlands, the U.K. and Germany), potential for recovery (i.e., whether aperson can recover his/her functions or not) is part of the eligibility factors forlong-term care insurance programs and social services. Incorporating theperspective of potential for recovery in eligibility decisions can serve as afoundation for prevention and promotion of independence through rehabilitation.
Moreover, simple categorization based on quality of needs, with a certain level ofdirections, can make it possible to conduct assessment to also look at the person’s
overall life, strengths and relationships in the community that can b e seen only
from a close distance. This will make it easier to develop a plan that contributes tothe person’s well-being and independence.
2. Controlling quality and efficiency in long-term care insurance systems
The countries we studied have been robustly reforming their systems with a senseof crisis, aiming to make them sustainable. The key point in these efforts is“sticking to quality and efficiency” even though their budgets are insufficient.
These countries have effective systems to manage benefits. For example, in theNetherlands, insurance companies conduct rigorous audits on quality andefficiency within the budgets. In the U.K., means tests serve as powerfulgatekeepers. In Germany, the insurance only covers partially.
3. Developing local resources and revitalizing communities
In order to make systems sustainable, the countries we studied are calling on
communities to provide solutions. The informal sector is once again attracting
attention due to several factors, including further population aging, a lack ofhuman resources and insufficient budgets. This global trend is called“informalization.” Comprehensive support projects ( Sogo Jigyo ) are examples of
informalization in Japan and should be considered opportunities for communityrevitalization.
4. Aiming to build cohesive communities
In the countries we studied, long-term care insurance and social service systems
cover not only older people but also people of all generations. In particular,
neighborhood social support teams (sociale wijkteams or SWTs) in the Netherlands
have the universal nature beyond age and disability categories, where services cover
all the citizens who have difficulties in daily living due to illness, disabilities and oldage.
5. Independence of individuals/communities/municipalities and productive aging

In the countries we studied, medical professionals guide people to local resources
through “social prescription.” Voluntary organizations are also actively engaged
in sales and marketing activities. As roles of local communities expand, theconcept of productive aging will also become more and more significant. As
members of communities, older people will increasingly participate in andcontribute to society along with people of other generations. Sometimes they will
provide support, and other times they will be supported; this is how theirwell-being will be promoted.