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COVID-19 and long-term care policy for older people in Japan
- Authors:
- ESTEVEZ-ABE Margarita, IDE Hiroo
- Journal article citation:
- Journal of Aging and Social Policy, early cite May 2021,
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Japan’s initial response to COVID-19 was similar to that of the US. However, the number of deaths in Japan has remained very low. Japan also stands out for the relatively low incidence of viral transmission in Long-Term Care Facilities (LTCFs) compared to both European countries and the United States. This paper argues that Japan’s institutional decision to lockdown Long-Term Care facilities as early as mid-February – weeks earlier than most European countries and the US – contributed to lowering the number of deaths in LTCFs. This paper highlights a few lessons from the Japanese experience: (i) the presence of hierarchically organized government agencies whose sole missions are elderly care; (ii) the presence of effective communication channels between LTCFs and the regulatory authorities; and (iii) the well-established routine protocols of prevention and control in LTCFs. (Edited publisher abstract)
Reminiscence triggers in community-dwelling older adults in Japan
- Authors:
- HANAOKA Hideaki, et al
- Journal article citation:
- British Journal of Occupational Therapy, 79(4), 2016, pp.220-227.
- Publisher:
- Sage
Introduction: Visual and auditory cues have been highlighted as methods to trigger reminiscences; however, the basis of this practice remains unclear. Here the authors conducted a preliminary cross-sectional study to identify reminiscence cues and their scientific basis by investigating the relationship between reminiscences in elderly people and their reminiscence cues. Method: The participants were 126 older adults aged 65 years or over. They were asked about the experiences of reminiscences in response to stimuli such as photographs, music, or smells. Data on the frequency and quality of reminiscences were collected. Geriatric depression scale and simple personality test for the elderly were assessed. Results: A multiple regression analysis revealed that reminiscences tended to be more frequent in older and less sociable participants. Highly sociable participants with reminiscences in response to olfactory stimuli tended to have positive reminiscences, while participants with less sociability and past unresolved issues tended to have negative reminiscences. Conclusion: To understand the process of reminiscence in an older person, it is important to consider the person’s age, personality characteristics, and past unresolved issues. In addition, olfactory stimuli may also evoke pleasant reminiscences. (Edited publisher abstract)
Home visits by commissioned welfare volunteers and psychological distress: a population-based study of 11,312 community-dwelling older people in Japan
- Authors:
- NOGUCHI Masayuki, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 30(12), 2015, pp.1156-1163.
- Publisher:
- Wiley
Objective: Social support is a resource for the older people that effectively reduces psychological distress, with or without specialised health service provision. This cross-sectional study was conducted to determine whether home visits by commissioned welfare volunteers (organisations of community residents assigned by national or local governments) are associated with a lower risk of psychological distress among the older people. Methods: Questionnaires were sent in August 2010 to all residents aged ≥65 years in three municipalities (n = 21,232) in Okayama Prefecture in Japan; 13,929 were returned (response rate = 65.6%). The final sample size for the analysis was 11,312 participants. Home visits, psychological distress (Kessler Psychological Distress Scale: K6 > 5), and severe psychological distress (K6 > 13) were measured by the questionnaire. Odds ratios (ORs) were calculated and 95% confidence intervals (CIs) for psychological distress, adjusting for age, gender, education, marital status, and qualification for long-term care insurance. Results: The prevalence was 41.4% for psychological distress and 6.5% for severe psychological distress among all participants. Home visits were significantly associated with a lower risk of psychological distress after adjusting for the covariates. These associations were comparable for men and women. The association was clearer for severe psychological distress. Conclusions: Home visits by commissioned welfare volunteers are significantly associated with a lower risk of psychological distress among older people (Edited publisher abstract)
Relationship between depression and risk of malnutrition among community-dwelling young-old and old-old elderly people
- Authors:
- YOSHIMURA Kazuya, et al
- Journal article citation:
- Aging and Mental Health, 17(4), 2013, pp.456-460.
- Publisher:
- Taylor and Francis
A cross-sectional design was implemented to explores the association between nutritional status and depression among healthy community-dwelling young-old (aged 65–74) and old-old elderly (aged 75 and older). A total of 274 community-dwelling older individuals (142 young-old; 132 old-old) were assessed using the Geriatric Depression Scale (GDS), Mini-Nutritional Assessment Short-Form (MNA-SF) and Life-Space Assessment. Logistic regression analysis was used to determine if depression was independently associated with risk of malnutrition, stratified by age (young-old vs. old-old). In the logistic regression model for young-old, being at risk of malnutrition Was strongly associated with depression. In contrast, in the old-old group, the model was not statistically significant. This study reveals that not only the factors correlated with but also the symptoms of depression may vary among different age stratifications of the elderly. (Edited publisher abstract)
Ageing and well-being in an international context
- Author:
- CLIFTON Jonathan
- Publisher:
- Institute for Public Policy Research
- Publication year:
- 2009
- Pagination:
- 36p., bibliog.
- Place of publication:
- London
The author asks what lessons the UK can learn from several case studies from overseas about how the well-being of older people can be incorporated into a wider range of policy areas than those, traditionally, of pensions, health and social care. For example, in the UK an ageing population brings more focus onto mental health, loneliness and isolation issues, whereas life satisfaction is highest in Japan among those over 65. In addition, case studies from Ireland, the United States, Norway, Finland, New Zealand and China are presented with much variation in findings. Examples of how the well-being of older people can be addressed in the four key areas of relationships, work, learning and the built environment are discussed and put forward by the author as good practice for the future of an ageing population in the UK.
Quality of life from the viewpoint of patients with dementia in Japan: nurturing through an acceptance of dementia by patients, their families and care professionals
- Authors:
- FUKUSHIMA Tetsuhito, et al
- Journal article citation:
- Health and Social Care in the Community, 13(1), January 2005, pp.30-37.
- Publisher:
- Wiley
Quality of life (QoL) of patients with dementia was investigated from the patient's viewpoint, and the role of an acceptance of dementia in maintaining important and distinctive elements of QoL was analysed by questionnaire and interview methods. Subjects were 18 patients, 21 family members and 8 staff at a day-care facility in Japan. Patients with dementia hoped to maintain an 'ordinary' way of life. Living peacefully, living together, living healthily and helping each other were considered by them to be important elements of their QoL. Living happily in the present is important, but hopes and expectations for the maintenance of human values in future are of greater importance in their estimation of QoL. Through recognising these needs, a culture and understanding of 'living with dementia' can be nurtured. A dynamic process involving mutual acceptance of dementia in relationships between patients with dementia, their families and care professionals enabled elderly people to surmount their initial troubles and recoup and activate their former humane attitudes. Positive thinking reappeared and new forms of relationships emerged. Patients, families and care professionals came to understand each other better and gained the sense of 'living together'. The process began with 'confronting' the situation and progressed to the final stage of 'acceptance': the patient with dementia was confronted with the dementia itself, the family was confronted with the elderly person as a human being, and the care professional was confronted with her or himself. At first care professionals had felt a sense of social responsibility for delivering justice, but they had gradually noticed that they were themselves relieved of the strain resulting from these attitudes. Acceptance of dementia by the care professional was important in carrying forward this dynamic process, which helps to ensure the desired QoL for the patient with dementia.
Social policies for the elderly in the Republic of Korea and Japan: a comparative perspective
- Authors:
- PALLEY Howard A., USUI Chikako
- Journal article citation:
- Social Policy and Administration, 29(3), September 1995, pp.241-257.
- Publisher:
- Wiley
The Republic of Korea (South Korea) and Japan are highly industralised and modern nations which are both influenced by the Confucian tradition of respect for elderly and family responsibility for the care of aging parents. In both countries the proportion of the elderly population is increasing. Japan, since the end of World War II, has utilized its government bureaucracy to help develop the social welfare system and to formulate social policies and programs for the elderly. Japan's tradition of samurai Confucianism is congruent with the commitment of the Japanese government to such social development as a matter of national policy. The Republic of Korea has not assigned a comprehensive planning role to its government bureaucracy. Lacking the mix of industrial/post-industrial infrastructure of Japan and not yet faced with the immediacy of a very large elderly population, the Republic of Korea's government has developed its social policies for the elderly in a more incremental manner, usually emphasizing small scale and piecemeal initiatives. With respect to social support, it has emphasized voluntary family efforts as congruent with the Korean (and Chinese) variant of Confucianism. This paper will compare and contrast these different approaches.
Home-care nurses’ community involvement activities and preference regarding the place for end-of-life period among single older adults: a cross-sectional study in Japan
- Authors:
- INAGAKI Asa, et al
- Journal article citation:
- Health and Social Care in the Community, 29(5), 2021, pp.1584-1593.
- Publisher:
- Wiley
Older adults’ preference regarding where they want to spend their end-of-life (EOL) has been reported to be a significant predictor of the actual EOL location. Home-care nurses have often been reported to try involving single older adults’ neighbours in the support network of the older adults (community involvement activities) to allow them to stay at home. Hence, nurses’ community involvement activities may be among the significant factors of older adults’ preference to stay at home during EOL. Therefore, this study explored home-care nurses’ community involvement activities and its association with single older adults’ EOL preference. A cross-sectional questionnaire survey was conducted with older adults (aged 65 years or older) who lived alone and used home-care nursing services for more than 6 months, their home-care nurses, and managers of their home-care nursing agencies. Questions included participants’ characteristics, nurses’ community involvement activities and older adults’ preference to remain at home during EOL. We conducted multiple logistic regression analyses to explore the relationship between nurses’ community involvement activities and older adults’ preference to remain at home during EOL while controlling for their demographic variables. In total, 103 pairs of home-care nurses and single older adults from 27 home-care nursing agencies participated. Approximately 70% of older adults preferred to remain at home during EOL, and 50% of nurses implemented community involvement activities. Older adults’ preference to remain at home during EOL was associated with implementation of community involvement activities (Odds Ratio [OR]: 3.4; 95% Confidence Interval [95%CI]:1.1–9.8), home-care nurses’ higher practical clinical ability (OR: 1.4, 95%CI:1.0–1.8), and older adult's longer use of home-care nursing service (OR: 2.2, 95%CI:1.2–4.1). Community involvement activities may be essential in helping single older adults to stay at home as per their preference for EOL. (Edited publisher abstract)
Comparing socio-economic inequalities in healthy ageing in the United States of America, England, China and Japan: evidence from four longitudinal studies of ageing
- Authors:
- LU Wentian, PIKHART Hynek, SACKER Amanda
- Journal article citation:
- Ageing and Society, 41(7), 2021, pp.1495-1520.
- Publisher:
- Cambridge University Press
Healthy ageing has become a popular topic worldwide. So far, a consensus measure of healthy ageing has not been reached; and no studies have compared the magnitude of socio-economic inequality in healthy ageing outside Europe. This study aims to create a universal measure of healthy ageing and compare socio-economic inequalities in healthy ageing in the United States of America (USA), England, China and Japan. We included 10,305 American, 6,590 English, 5,930 Chinese and 1,935 Japanese participants for longitudinal analysis. A harmonised healthy ageing index (HAI) was developed to measure healthy ageing multi-dimensionally. Educational, income and wealth rank scores were derived accounting for the entire socio-economic distribution and the sample size of each category of socio-economic indicator. Associations between socio-economic rank scores and HAIs were assessed using multi-level modelling to calculate the Slope Indices of Inequality. Healthy ageing trajectories were predicted based on the full-adjusted age-cohort models. We found that education was a universally influential socio-economic predictor of healthy ageing. Moving from the highest to the lowest educational groups was associated with a 6.7 (5.2–8.2), 8.2 (6.0–10.4), 13.9 (11.4–16.3) and 6.1 per cent (3.9–8.2%) decrease in average HAI at 60 years in the USA, England, China and Japan, respectively. After 60 years, the educational inequality in healthy ageing kept increasing in the USA and China. The educational inequality in healthy ageing in China was also greater than any other socio-economic inequality in the four countries. Wealth was more influential in predicting healthy ageing inequality among American, English and Japanese participants, while income was more influential among Chinese participants. The socio-economic inequality in healthy ageing in Japan was relatively small. Chinese and American participants had worse healthy ageing profiles than Japanese and English participants. (Edited publisher abstract)
Neural basis for the relationship between frequency of going outdoors and depressive mood in older adults
- Authors:
- SAKURAI Ryota, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(6), 2017, p.589–595.
- Publisher:
- Wiley
Objective: Low frequency of going outdoors (e.g. being homebound) is associated with depressive mood; however, the underlying neural mechanism of this association is unclear. The authors therefore investigated the neural substrate involved in the relationship between frequency of going outdoors and depressive mood using positron emission tomography (PET), focusing on the frontal lobe and the limbic system. Methods: One hundred fifty-eight community-dwelling older adults aged 65–85 years underwent PET with 18F-fluorodeoxyglucose to evaluate regional cerebral metabolic rates of glucose normalised in reference to cerebellar glucose metabolic value (normalized-rCMRglc) in six regions of interest. The authors also assessed depressive mood, frequency of going outdoors, and potential covariates. Depressive mood was assessed using the Geriatric Depression Scale (GDS). Results: The proportion of participants who reported low frequency of going outdoors (LG, every 2–3 days or less) was 36.1%. The LG group showed significantly higher GDS scores than those who reported high (once a day or more) frequency of going outdoors. A multiple linear regression analysis adjusted for potential covariates showed higher GDS scores were associated with lower normalised-rCMRglc in the ventrolateral prefrontal and orbitofrontal cortices. Adjusting for frequency of going outdoors, the association between GDS score and normalized-rCMRglc in the orbitofrontal cortex was attenuated. Conclusions: The authors' results suggest that the orbitofrontal cortex may mediate the relationship between low frequency of going outdoors and depressive mood among community-dwelling older adults. These findings may help disentangle the role of going outdoors in regulating brain function to improve and/or maintain mental health among community-dwelling older adults (Edited publisher abstract)