Welfare Reform on the Web (Summer 2003): Care of the Elderly - Overseas

IMPACT OF LONG-TERM CARE INSURANCE ON INSTITUTIONAL DEMENTIA CARE IN JAPAN

H. Ito and Y. Miyamoto

Health Policy, Vol. 64, 2003, p.325-333

To cope with the demands of an ageing population, Japan introduced long-term care insurance in April 2000. The study used a nationally representative sample to examine the impact of the new scheme on institutional dementia care. The new insurance system was found to be effective in targeting elderly people needing high levels of nursing care. However, there are concerns that people with behavioural disturbances may be at risk of exclusion from the long term scheme.

STATE PROVISION DOWN, OFFSPRING'S UP: THE REVERSE SUBSTITUTION OF OLD-AGE CARE IN SWEDEN

L. Johnasson, G. Sundstrom and L.B. Hassing

Ageing and Society, Vol. 23, 2003, p.269-280

During the 1980s and 1990s both home help and institutional care for the elderly were cut back in Sweden. Nationally representative surveys of the provision of care for older people living in the community enable analysis of the effects of these cutbacks on the sources and patterns of care. It emerges that increased inputs from families match the decline in public services. Most of this increased, formal care has been provided by daughters, but sons have also contributed. The changes leave an increasing number of family carers without support, whereas they could formerly have expected to share their responsibilities with the state.