a presentation of takeo ogawa ver2 - aabc2009 2050 the ratio of 60+ from 2009-2050 by 2050, 1 in 3...
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An Agenda on Population Aging and Caring for Older Persons
in Asia Pacific
Takeo OgawaPresident
Asian Aging Business Center
10 August, 2014. Nishitetsu Inn FukuokaForum on a Conception of Harmonization of Long-Term Care Certificate
between Japan and Indonesia: Beyond a Framework of Bilateral Economic Partnership Agreement
Background of Aging in Asia Pacific
• Looking for a economical wealthy country,• Engaging high productive work• Child-bearing fewer and rearing with care• Living longer• This strategy introduces the economic
development in Asian Pacific countries, although it caused population aging too.
• Not only Japan, but also Indonesia and others.
Economical Growth and Aging in 1970-1995 in Asia Pacific
0
5,000
10,000
15,000
20,000
25,000
30,000
0 2 4 6 8 10 12 14 16 18
Japan
USA
Canada, Australia
China
Thailand
Korea
SingaporeHong Kong
Malaysia
Vietnam
New Zealand
Philippines
US$/Capita
% of 65+
Bubble= PopulationIndonesia
Economical Growth and Aging in 1995-2010 in Asia Pacific1995-2010
0
10,000
20,000
30,000
40,000
50,000
60,000
0 5 10 15 20 25
Japan
Australia
CanadaSingapore
Korea
Hong KongNew Zealand
Philippines
MalaysiaChina
ThailandIndonesia
Vietnam
US$/Capita
USA
Bubble= Population
% of 65+
Economical Growth and Aging in 2010-2030 in Asia Pacific2010-2030
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
0 5 10 15 20 25 30 35 40
Korea
USA
Australia
Hong Kong
Singapore
Japan
China
US$/Capita
Bubble= Population
% of 65+
Canada
0 10 20 30 40 50
World
US
Europe
Malaysia
Indonesia
Australia
China
Singapore
Korea
Japan
20092050
The Ratio of 60+ from 2009-2050
By 2050, 1 in 3 people in
Asia-Pacific will be age 60+
%
Japanese Challenges toward Aging
• 1970s: Universal Social Security System• 1990s: Infra-structure Improvement for the Care-
needed Elderly• 2000s: Public Long-term Care Insurance System• 2010s: Comprehensive Reform of Tax and Social
Security• In the future, 2025~2040, Japanese government will
reconstruct of a resilient country (Sustaining one hundred million population).
• Convey Japanese challenges for developing countries.
Changed and Estimated Population in Japan
83208928
93429828
10372
1119411706
12105 12361 12557 12693 12777 12806 12660 1241012066
1166211212
1072810221
9708
0
2000
4000
6000
8000
10000
12000
14000
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050
Transition of the Ratio of 65+ and History of Social Security
4.9 5.3 5.7 6.3 7.1 7.99.1
10.312.1
14.6
17.4
20.2
23
26.8
29.130.3
31.633.4
36.137.7
38.8
0
5
10
15
20
25
30
35
40
45
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050
目標年次
介護保険
国民年金
国民健康保険
老人福祉法
老人医療無料
老人保健法
ゴ|ルドプラン
高齢社会対策基本法
後期高齢者医療
社会保障税一体改革
EPA
看護介護Aging Society
Aged Society Super Aged Society
Applicability of Japanese Aging Strategies for Future Indonesia
4 3.8 3.6 3.4 3.3 3.5 3.6 3.6 3.84.2
4.7 4.9 55.4
6.3
7.7
9.2
10.9
12.7
14.2
15.8
0
2
4
6
8
10
12
14
16
18
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050
Japanese in 1990sLong-term Care for the Elderly?
Aging Society
Japanese in 1960sSocial Security?
Perspectives on the Comprehensive Reform of Tax and Social Security
(Ten Thousand)• Medical Doctor 29• Nurses 141• LTC staffs 140
• Clients of LTC 426Within In-home 304
In-Assisted 31In-Institution92
• MD32~34• Nurses 195~205• LTC staffs 232~244
• Clients of LTC 641Within In-home 449In-Assisted Living 61
In-Institution 232~244
2011 2025
Nursing and LTC for Aging • Increasing the Support-needed Elderly on Longevity (I
ADL)• Increasing the LTC needed Elderly in Senility, lifestyle-
related disease, Fall, Dementia, Disability con valescence (ADL)
• Division of Labor and Job Development between Nursing and LTC
• Qualification for Securing the Quality of LTC Competency
• Training Programs for Certificating LTC Competency• Trials and Errors for Mitigating the Imbalance of LTC
Workforce Internationally
Recognized Ratio of LTC needed by Age
Japanese Concept of Long-term Care
Social WorkNursing CareLong-term Care
KAIGO
Basic Requirement
Professional
Household Work
Acceptance of Nurses and Certified Care Workers on EPA
Social WorkNursing Care Long-term CareKAIGO
Basic Requirement
Professional
Household Work
Nurse Certified Care Worker
Origins of Nurses and Certified Care Workers of EPA
Philippines
Vietnum
Indonesia
As candidatesAfter National Exam.
Successful ones can engage in Institutional Care
Nurses and Certified Care Workers under the Bilateral Economic Partnership Agreement
Nurse Certified Care WorkerTraining SchoolOn the Job Training
Entry
6-months Language Training
Work & Studyat Hospital
Work & Studyat Nursing Home
2-years Study
Challenge to National Exam.
Challenge to National Exam.
Graduate=Certified
Special VisaFor 3 Years
Special VisaFor 4 Years
Special VisaFor Graduation
Results of Accepting Nurses and Certified Care Workers at March, 2014
AccumulatedImmigrants
AccumulatedExaminees of National Exam.
AccumulatedSuccessful Candidaters
Nurses2008-2012
440(100%)
1740(395.5%)About 4 times/capita
125(19.9%)
Certified Care Workers2008-2013
608(100%)
519(85.4%)
241(39.6%)
December, 2002: Those who immigrated until 2002 on EPA are working in Japanese hospitals and Facilities after successful National Exam; Nurses 60/629 and Certified Care Workers 22/933.
Deregulation on the Basic Policies for Economic and Fiscal Management and Structural Reform
• Expanding Acceptances of Foreign Companies • Expanding Acceptances of Foreign Workers • Prolonging the Length of Stay for the Technical
Intern and Expanding to Care Workers• Lifting of a ban for Employing Foreign Domiciliary
Workers
• How coordinate a framework of EPA and new deregulation policies.
• Harmonization on the Life-long Education System.
Basic Policies for Structural Reform
Social WorkNursing Care Long-term CareKAIGO
Basic Requirement
Professional
Household Work
Technical Intern
Maid
LTC Workforce in Neighborhood Communities: A New Agenda
• Establishing Professional Partnership• Enhancing the Self Management with
Developing Techno-aide• Supporting Family Carers and Constructing
Comprehensive Service Stations• Improvement the Literacy of LTC for regional
volunteers and Establishing Coordination Center
• Community Business Incubation
Japanese Integrated Community Care System
Long-Term Care Network in the Community in Yogyakarta
VOLUNTEER
Sub village
Older person Family
Community Volunteer
Small shops
Population and FP Field
staff
Community
LeaderHealth Center
Village-Subdistr
ict
Red cross
Hospital
Institutional Care
The Bed Bath is Common with Each Other Country
The Relaxation is Differ with Each Other Country
The Common Point of LTC Training
• In order to realize “Aging in Place”, the LTC will be provided in neighborhood communities.
• It needs not only for professionals but also family carers, community volunteers, non-skilled workers and all generations to be trained of the LTC literacy.
• The “Train the Trainers” program should be installed for the professional education internationally.
Certified Nurse in
Nurse
Nurse Aid
U
Unqualified Care Givers
Japanese Qualification System of Nurses and Certified Care Workers
Home Helper 3
Home Helper 2
Home Helper 1
Certified Care Worker
Certified Care Worker in
Geriatrics & Gerontology
Geriatric Nursing
Care Manager
Aborition
Capacity Building forFamily Carers・Volunteers・All Generations
Dementia Care?
海外から
Preparing Career Grading System of LTC
Certified Care Worker
Technical Intern
Certified Nurse in
Nurse
Nurse Aid
Unqualified Care Givers
Unqualified Care Givers
Ideas of Harmonization
Certified Care Worker
Certified Care Worker
in
Unqualified Care Givers
Unqualified Care Givers
Kadar
NurseDiplomaⅠ
NurseDiplomaⅡ
Nurse DiplomaⅢ
Japan Indonesia
Level 1
Level2
Level 3
Level 4
Level 5
Level6
Level 7
Level 8
PramuruktiCapacity Building of LTC
TRAIN the TRAINER
Toward Global KAIGO from Japan
• Environmental Improvement for Hygiene and LTCThe Support Center for LTC Intern, Sanitary ware, & Coordinator for Assisted Living.
• Culinary Arts for LTC and Oral HygieneCutting, Thickening, Presenting, Chewing Power-up, & Teeth Brushing
• Changing Position based on Body MechanismAncient Japanese Martial Arts, Slow Fitness Exercise, & Brain Training
Study of Foreign LTC Methods
• Jamu in Indonesia• Massage in Thailand• Laughter Yoga in India• Inclusive Networking for Promoting LTC in
Neighborhood Communitiesex. Kadel/Posiandu, Pramrukti, Nurse/Puskesmas
Next Step
• Let’s start collaboration of exchange program for training the trainers.
• Let’s declare a proposition for establishing a training center for harmonization of long-term care and aging studies in Fukuoka-city and Jakarta and Yogyakarta.
A Proposal of the Training Center on Asia Pacific Aging
• With/beyond EPA, an acceptance framework of foreign LTC workforce should be considered.
• The technical intern program should be improved on its criticism.• A common field of LTC for the Elderly should be neighborhood communities
(patches) in Asia Pacific.• LTC institutions and hospitals should take responsibilities not only acute and
terminal care but also for research and development and teaching LTC knowledge and skills for preventive and rehabilitation care.
• The competency of the geriatric nursing and the LTC should be integrated in the lifelong education system and its accumulated career should be evaluated with each other.
• The LTC job should be redesigned for clarify its needed knowledge and skills.• The trainer of trainers who teach LTC should be exchanged on bilateral exchange
program. • In order to Harmonize LTC certificate, a training center should be established both
in Japan and in Indonesia.