Community-based care for healthy ageing: lessons from Japan

Abstract

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.

Social Participation and Functional Decline: A Comparative Study of Rural and Urban Older People, Using Japan Gerontological Evaluation Study Longitudinal Data

“…Even in rural areas, promoting participation in groups such as sports and hobbies groups could prevent the incidence of functional decline. In Japan, the salon-type community intervention [40] has been implemented as one of the ways to promote social participation. These salons, managed by local volunteers, are held once or twice a month in communal spaces within walking distance of community members' homes, and older people can meet and interact with others through enjoyable, relaxing, and sometimes educational programs [40].…”

“…In Japan, the salon-type community intervention [40] has been implemented as one of the ways to promote social participation. These salons, managed by local volunteers, are held once or twice a month in communal spaces within walking distance of community members' homes, and older people can meet and interact with others through enjoyable, relaxing, and sometimes educational programs [40]. Moreover, participation in local community organizations was only protective against decline in rural older people in this study.…”

Sustainable health promotion for the seniors during COVID-19 outbreak: a lesson from Tokyo

“…Group exercise and social activities are common events for elderly community residents in Tokyo and cities across Japan [1]. Municipalities, stakeholders in the communities, and service providers of primary health care altogether create an opportunity for healthy lifestyle behaviors and care prevention, preserving autonomy and enriching social bonds.…”

Long-Term Care System in Japan

“…The low participation in community prevention programs resulted in limited attributable effect unless researchers committed to the prevention program. 12) The government recognized the difficulties in maintaining participants' motivation and changed its policies for population-based preventive service provisions.…”