Chapter 5: Summary and Implications for Japan
Section 1: Systems and Trends in Each Country
Denmark% of older people(2012, OECD)

17.4 %

Netherlands

United Kingdom

16.5 %

16.6 %

Long-term careand living
support systems

Professional long-term care and some domestic services are ・Professional long-term care is provided through AWBZ (long-term Professional long-term care and some domestic services areprovided through social services (financed by municipalities throughcare insurance).
provided through social services (financed by municipalities
general revenue).
・Domestic services are provided through WMO (Social Support Act, through general revenue)
financed by municipalities through general revenue).

Certifying careneeds

・Each local municipality is responsible.
・Needs Assessment Center (CIZ) is responsible.
・Each local municipality is responsible.
・ There is no nationwide uniform tool or scale to assess an ・For home-based care, an indication defines the type and volume of ・There are 4 eligibility levels: critical, substantial, moderateapplicant’s needs for support and eligibility
care to be provided. For institutional care, there are 10 levels of and low. In many municipalities, only the critical andnursing/personal care.
substantial patients are eligible for services.

Living supportand volunteering

Care prevention

Trends inlong-term careand living
support・Volunteers provide psychological and social support which are not ・WMO services are provided directly by municipalities (can be ・Voluntary organizations provide living support not provided
provided through social services. Local municipalities provide
contracted to private organizations) and voluntary organizations. through social services. Although local municipalities provide
financial support for these activities.
Local municipalities provide grants for voluntary activities.
grants for voluntary activities, their size is becoming smaller.
・Working with municipalities for residents rather than working for ・Voluntary activities “supplement” and “fill the gap of” public ・Voluntary activities “supplement” public services.
municipalities. Voluntary activities “supplement” public services.
services (supplement < filling the gap).
【Prevention under Act on Health】
Provided by local municipalities under the National Public Health
Activities on foods, smoking, alcohol and physical exercise as well as Act.
activities targeted at chronically ill people to promote independence.
【Examples of programs】【Prevention under Act eon Social Services】
・Fall prevention program
Promoting programs for non-smoking, moderate alcohol intake and ・Prevention and detection of depression
exercise through “Prevention and maintenance strategies”
・Educational programs on healthy foods and exercise
・Social interaction, someone to talk to (secondary goal)【Care prevention and rehabilitation: Active days】【Revising the scope of services under AWBZ】
・Training which is based in plejecentres, etc.
・Transferring domestic services and non-institutional counseling to・Dividing clients into “improvement group” and “maintenanceWMO.
group” when providing care・Home-based care will be transferred to WMO, and nursing care will・Bringing out a person’s potential through “care with hands behindbe transferred to ZVW (Medical Insurance Act) (2015~ ).
the back” rather than “care to do what the person cannot do.”【Multigenerational cohesiveness and mutual support】【Temporary-stay beds】
Initiatives to promote mutual support in a community, such as village
Setting up “temporary-stay beds” at health centers where visiting projects in Amsterdam (StadsdorpZuid) and caregiving cooperative innurses provide care to prevent hospitalization.
Hoogeloon.

While there are no national or local social insurance schemeswith clear goals of “care prevention,” there are individualprograms.

【Streamlining in all aspects, welfare technology】
・Reducing frequency of home-delivered meals (delivery in bulk).
・Shopping support: from going to shops to delivering products.
・Promoting development of assistive devices at a national level toenhance older people’s independence, to improve quality of care,
to improve work environment for staff and for more effective job
allocation.

【Additional information: Re-ablement】
Social workers, care workers and occupational therapists
provide intensive support for 6 to 10 weeks after a patient isdischarged from a hospital to maintain and improve his/her
daily living skills.

【Examples of programs】
・Fall prevention program
・Social interaction, someone to talk to (secondary goal)【 Introducing a lifetime cap and an option to defer
payment】
・A cap will be introduced on the costs that people have to
pay for care. The lifetime cap is proposed to be set at￡72,000 (about 11.52 million yen).
・Moreover, a new system will allow people to keep theirhome until they die, rather than having to sell it in their
lifetime, to pay for care.

【Setting the minimum eligibility criteria in a country】
・Discussing ways to set the minimum eligibility criteria across【Privatization of home-based services】【Stricter eligibility criteria for institutional care】
the country, which currently vary from one municipality to・Dividing City of Copenhagen into 5 districts, selecting the 2 People with ZZP 1 and 2 are not eligible for institutional careanother.
cheapest organizations in each district through bid and having them (2013~ ). Also from 2014, those with ZZP 3 no longer have access to ・A proposal to set “substantial” as the national minimum
provide services.
institutional care.
criteria, as a number of municipalities already do.

73