The personal cost of dementia care in Japan: A comparative analysis of residence types

Nakabe, Takayo; Sasaki, Noriko; Uematsu, Hironori; Kunisawa, Susumu; Wimo, Anders; Imanaka, Yuichi

doi:10.1002/gps.4916

Cited by 9 publications

(17 citation statements)

References 35 publications

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“…This between‐country difference is likely to be derived from country‐specific long‐term and dementia care systems. Informal care costs account for a higher share of in‐home dementia care costs in Japan (67.5%) than in the USA (31–49%) . As adult children cohabiting with their parents is common in Japan, many individuals who are using public long‐term care services also receive a degree of caregiving from relatives .…”

Section: Discussionmentioning

confidence: 99%

“…This study protocol was approved by the ethics review board of the Tokyo Metropolitan Institute of Medical Science, Japan (No. [18][19][20][21][22][23][24][25][26][27], and was carried out in accordance with the Helsinki Declaration of 1975, as revised in 2013. Their continued participation was considered indicative of their consent to the questionnaire instructions provided on the website.…”

Section: Settingmentioning

confidence: 99%

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Care preferences of healthy, middle‐aged adults in Japan and the USA if they acquired dementia: A cross‐sectional observational study

Nakanishi

Miyamoto

Nakashima

et al. 2019

Geriatrics Gerontology Int

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Aim Japan introduced dementia‐friendly initiatives into its national policies to help people with dementia remain involved in society for as long as possible. However, some people might choose to live in a nursing home to avoid care burden on family members. Understanding middle‐aged adults’ preferences for place of care and identifying factors that influence their preferences would help policy decision‐makers promote dementia‐friendly initiatives. The present study aimed to investigate the care preferences of middle‐aged adults if they acquired dementia in Japan and the USA. Methods We carried out a cross‐sectional observational study using an internet‐based questionnaire survey of Japanese residents with Japanese ethnicity, Japanese Americans, and non‐Asian Americans aged 40–70 years. A total of 301 participants, including 104 Japanese residents, 93 Japanese Americans and 104 non‐Asian Americans, completed the survey. Participants were asked to answer the items based on a hypothetical situation in which they had acquired dementia requiring regular care and supervision. Results Participants preferred nursing home care (29.9%), followed by professional home care (19.6%), family home care (17.6%) and hospital care (11.3%). Japanese residents had a significantly lower preference for professional home care than did Japanese or non‐Asian Americans (adjusted odds ratio 0.28, 95% confidence interval 0.10–0.75). Between‐ethnicity difference in care preferences was not observed. Conclusions A low preference for professional home care among the middle‐aged adults might be influenced by country‐specific long‐term and dementia care systems. Policy decision‐makers should develop professional home care services that are more available for families of people living with dementia. Geriatr Gerontol Int 2019; 19: 829–833.

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Section: Discussionmentioning

confidence: 99%

Section: Settingmentioning

confidence: 99%

Care preferences of healthy, middle‐aged adults in Japan and the USA if they acquired dementia: A cross‐sectional observational study

Nakanishi

Miyamoto

Nakashima

et al. 2019

Geriatrics Gerontology Int

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“…The Japanese government recommends policies to shift to patient-centred and home-centred care to reduce the fiscal burden of the insurance system on community-based integrated systems. While microlevel of impact of dementia care has not been insufficiently understood,7 to construct a sustainable dementia care system, we clarified the personal economic burden of dementia care for different residence types and demonstrated that the cost at home in a community setting was equal to or higher than in various institutions 8. Sustainable dementia care systems should be provided to benefit the government or insurance system and also to benefit people with dementia and their caregivers.…”

Section: Introductionmentioning

confidence: 94%

Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey

et al. 2019

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ObjectiveThe purpose of this study was to clarify the microlevel determinants of the economic burden of dementia care at home in Japanese community settings by classifying them into subgroups of factors related to people with dementia and their caregivers.DesignA cross-sectional online survey.Participants4313 panels of Japanese research company who fulfilled the following criteria: (1) aged 30 years or older, (2) non-professional caregiver of someone with dementia, (3) caring for only one person with dementia and (4) having no conflicts of interest with advertising or marketing research entities.Primary outcome measuresInformal care costs and out-of-pocket payments for long-term care (LTC) services.ResultsFrom 4313 respondents, only 1383 caregivers in community-settings were included in this analysis. We conducted a χ² automatic interaction detection analysis to identify the factors related to each cost (informal care costs and out-of-pocket payments for LTC services) divided into subcategories. In the resultant classifications, informal care cost was mainly related to caregivers’ employment status. When caregivers acquired family care leave, informal care costs were the highest. On the other hand, out-of-pocket payments for LTC were related to care-need levels and family economic status. Activities of Daily Living and Instrumental Activities of Daily Living functions such as bathing, toileting and cleaning were related to all costs.ConclusionThis study clarified the difference in dementia care costs between classified subgroups by considering the combination of the situations of both people with dementia and their caregivers. Informal care costs were related to caregivers’ employment and cohabitation status rather to the situations of people with dementia. On the other hand, out-of-pocket payments for LTC services were related to care-need levels and family economic status. These classifications will be useful in understanding which situation represents a greater economic burden and helpful in improving the sustainability of the dementia care system in Japan.

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“…Although informal care costs are suggested to be a main cost driver in dementia, social care costs account for approximately 40% of costs in high‐income countries, and it has become a priority to determine how to pay for these expenses as the incidence of dementia increases . Despite the availability of studies showing data on the overall number of LTCI‐certified people and LTCI service users based on statistics published by the Ministry of Health, Labor and Welfare, and the results of online surveys, individual service use and cost data specific to the severity of AD are limited . The present study examined the use of social services and their costs based on the severity of dementia and individual characteristics among patients with AD who were followed up in a memory clinic.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] Despite the availability of studies showing data on the overall number of LTCI-certified people and LTCI service users based on statistics published by the Ministry of Health, Labor and Welfare, and the results of online surveys, individual service use and cost data specific to the severity of AD are limited. 6,8,9 The present study examined the use of social services and their costs based on the severity of dementia and individual characteristics among patients with AD who were followed up in a memory clinic.…”

Section: Introductionmentioning

confidence: 99%

Increase in direct social care costs of Alzheimer's disease in Japan depending on dementia severity

Takechi

Kokuryu

Kuzuya

et al. 2019

Geriatrics Gerontology Int

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Aim With the aging population, costs of direct social support for patients with Alzheimer's disease have grown and will continue to increase. The purpose of the present study was to estimate the cost of direct social support for Alzheimer's disease under long‐term care insurance in Japan. Methods This cross‐sectional study included 169 patients with Alzheimer's disease or mild cognitive impairment who visited a memory clinic and were followed over time. Dementia severity, use of care services and costs were analyzed. Results The use of direct social support and costs increased significantly between patients with mild, moderate and severe dementia (P < 0.001). In particular, the use of day services and short stay services increased with the severity of dementia (P < 0.001). Similar findings were obtained when participants were stratified by long‐term care insurance care levels. Of 169 participants, 49 had not applied for long‐term care insurance, although their dementia severity was not different from support‐need level 1 and care‐need level 1. Logistic regression analysis of “did not apply” and “applied and certified” groups showed significant differences not only in dementia severity, but also in age (odds ratio 1.112, 95% confidence interval 1.037–1.193, P = 0.003) and living arrangements (odds ratio 0.257, 95% confidence interval 0.076–0.862, P = 0.028). Conclusions As the number of patients with Alzheimer's disease increases, direct social costs will increase. The findings of this study might help standardize the type of direct social support provided after diagnosis of Alzheimer's disease and contribute to the development of cost‐effective care for these patients. Geriatr Gerontol Int 2019; 19: 1023–1029.

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The personal cost of dementia care in Japan: A comparative analysis of residence types

Abstract: The inclusion of informal care costs reduced the differences in total personal costs among the residence types. The economic burden of informal care should be considered when quantifying dementia care costs.

Cited by 9 publications

References 35 publications

Care preferences of healthy, middle‐aged adults in Japan and the USA if they acquired dementia: A cross‐sectional observational study

Care preferences of healthy, middle‐aged adults in Japan and the USA if they acquired dementia: A cross‐sectional observational study

Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey

Increase in direct social care costs of Alzheimer's disease in Japan depending on dementia severity

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