We published a new paper from Bulletin of the World Health Organization.
Problem
The measures for long-term care prevention that the Japanese
government had introduced in 2006 were unsuccessful because of the
failures to identify high-risk individuals and to enrol enough
participants in the community prevention programme.
Approach
The Japanese government shifted its primary strategy from a high-risk
strategy to a community-based population strategy in 2015, by
reforming the Long-term Care Insurance Act. This act is focusing on
community-based care and social determinants of health. The Act and
the government’s plans for long-term care prevention are inspired by a
social participation intervention called ikoino saron, that is
gathering salons for people older than 65 years. These salons, managed
by local volunteers, are held once or twice a month in communal spaces
within walking distance of community members’ homes and have a low
participation fee. At the gatherings, older people can meet and
interact with others through enjoyable, relaxing and sometimes
educational programmes.
Local setting
Japan has the world’s largest ageing population, with 27.7% (35.2
million/126.7 million) of people older than 65 years.
Relevant changes
Studies have shown that participation in the salons was associated
with a halved incidence in long-term care needs and about one-third
reduction in the risk of dementia onset. Evidence also suggests that
financially vulnerable older adults were more likely to participate in
such interventions. In 2017, 86.5% (1506/1741) of the Japanese
municipalities had implemented the salons.
Lessons learnt
Integrated care for long-term care prevention should consider
interventions targeting the whole community in addition to high-risk
individuals.
(2019). Community-based care for healthy ageing: lessons from Japan. Bulletin of the World Health Organization, 97 (8), 570 – 574. World Health Organization. http://dx.doi.org/10.2471/BLT.18.223057