Research on the Establishment of a Long-Term Care System for the Elderly with Alzheimer’s Disease Under the Background of Long-Term Care Insurance: A Literature Review

With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and the issue of care services for these elderly has attracted widespread attention from society.However,judging from the current level of social security provided to the elderly with dementia in the country,there is a serious imbalance between supply and demand.Therefore,this problem needs to be solved urgently and is of great significance for further improving the country’s social pension security system.Routine care is limited to hospitals and mainly focuses on the patient’s condition.Patients fail to receive comprehensive care services and the effect is not ideal.Therefore,in order to improve patients’cognitive function and quality of life,and learn from international experience,a“community-institution-home”three-dimensional linkage care model based on long-term care insurance can be established.The application of this model can effectively solve and further improve the country’s elderly care and social security system.

Equity of access to long-term care among the Korean elderly

The aim of the current study is to examine the extent to which equity in the utilization of longterm care services has been achieved in the Republic of Korea (hereafter Korea), based on the Aday—Andersen Access Framework that takes into consideration a series of variables hypothesized as predictive of utilization. The current study used cross-sectional survey data collected and conducted by the Korea Labor Institute (KLI) between August 1 to December 22, 2006. The sample for this study was 5544 persons who are older than 60 years. The study was extracted from a larger nationally representative cross-sectional survey of 10,255 individuals. The stratified cluster sampling technique was used to draw the survey respondents. A self-administered questionnaire was used to collect the data from the sample. Descriptive and logistic regression analysis was performed examining the relationship between the dependent variable and the independent variables and the relative importance of factors. The results indicate that a universal health insurance system has not yielded a fully equitable distribution of services. The limitation of benefit coverage as well as disparities in consumer cost-sharing and associated patterns of utilization across plans high out-of-pocket payment can be a barrier to health care utilization, which results in inequity and differential long-term care utilization between sub-groups of older adults. Health policy reforms in Korea must continue to concentrate on expanding insurance coverage, reducing the inequities reflected in disparities in consumer cost-sharing and associated patterns of utilization across plans, and establishing a financially separate insurance system for poor older adults. The behavioral responses of physicians to the method of reimbursement, and the subsequent impact on overall rates of utilization and expenditures need to be more fully understood. In addition, further research is needed to identify the nonfinancial barriers that persist for certain demographic subgroups, i.e., those 70 and older, men, lacking social network members, those who have four or more family members, and those who have no schooling.

Analysis on Long-Term Care and Influencing Factors of Empty-Nest Differently Abled Elderly People in China —Based on the Data from the Chinese Longitudinal Healthy Longevity Survey

Purpose: This study aimed to understand the actual needs of empty-nest differently abled elderly people and analyze their long-term care status including the factors affecting choice of care mode so adequate resources can be allocated to meet their healthcare needs. Methods: An empty-nest group was compared with a non-empty-nest group based on data from the 2014 Chinese Longitudinal Healthy Longevity Survey. Individual characteristics, family characteristics, and sociological factors were considered as independent variables, and long-term care model was the dependent variable in the three binary logistic regression method. Results: Age, gender, marriage, and disability were the most important factors influencing the choice of long-term care mode, including the willingness of the differently abled elderly. Family care can no longer meet the needs of the severely disabled elderly. Long-term care for such elderly people should be undertaken by professional and specialized social institutions. Conclusion: Multi-level services should be provided according to the elderly peoples’ needs, and the skill and expertise of professional personnel of care institutions should be strengthened. The government should deploy fund-raising initiatives, actively use the power of non-governmental organizations, and strive to resolve the financial issues faced by the empty-nested elderly people with disability.

Cultivate Inter-disciplinary Elderly Care Workers in the New Era to Promote the Development of the Aging Industry

The purpose of this paper is to point out the urgency and importance of cultivating inter-disciplinary elderly care workers in the new era by analyzing the prominent problems facing the current pension industry in China.Based on data analysis,survey and summary,multi-disciplinary integration and other means,training methods for inter-disciplinary elderly care workers in the new era are put forward,including enhancing multi-disciplinary theoretical knowledge reserve,improving professional skills and psychological communication skills and improving nursing ability of elderly care workers.The coping strategies proposed in this article have certain reference value for cultivating inter-disciplinary elderly care workers in the new era.

Path Exploration for Long-term Care of Rural Disabled Elderly: A Case Study of G Town in South Shaanxi

Field survey of G Town in South Shaanxi indicates that current situations and existing problems of rural disabled elderly. According to these situations and problems,this paper analyzes difficulties in long-term care of rural disabled elderly. From the perspective of welfare pluralism,it comes up with development paths for long-term care of rural disabled elderly with joint participation of government,communities,non-profit organizations on the basis of the family endowment.

Comparison of research hotspots and trends in long-term care for the elderly between China and Australia: a bibliometric analysis

Objective:To explore the current status and development of long-term care(LTC)research in terms of publications in China and Australia,to identify the major contributing authors and institutions,and to compare the research hotspots and trends between China and Australia in order to encourage informed collaborations and work in future.Methods:We collected bibliometric data on the LTC of the elderly in China and Australia from 2009 to 2020 using Chinese National Knowledge Infrastructure(CNKI)and Web of Science(WOS).Cite Space software was used to analyze co-authorships,co-institutions,and co-keywords.Results:A total of 826 ar ticles in Chinese and 393 in English were included for analysis.The total number of publications showed an upward trend in both countries.The top 10 productive researchers and institutions in China and Australia were identified,and their collaboration network was revealed.Then,the knowledge maps of cooccurring keywords,respectively,showed the hotspots of"LTC insurance,disabled elderly,combination of medical and health care,nursing home"and"nursing home,dementia,quality of life,intervention"in China and Australia.Strong citation burst keywords illustrated the emerging trends of"combination of medical and health care,healthy aging"in China and"polypharmacy,prevention"in Australia.Conclusions:This article provided an insight into LTC of the elderly in China and Australia,and research in this field is developing rapidly and is being increasingly valued.The findings will be useful for future researchers to facilitate collaboration,identify new topics,and suppor t urgently needed research of LTC in China.

Volunteers as caregivers for elderly with chronic diseases:An assessment of demand and cause of demand

Objective:We sought to examine the demand of volunteers on long-term care of elderly patients with chronic diseases.Further,we evaluated patients'reasons to want long-term care volunteers as well as socioeconomic factors affecting these needs.Methods:Questionnaires were distributed to 516 elderly with chronic diseases from nursing homes,hospitals,and elderly living with relatives.Patient questions dealt with basic socioeconomic questions,their reasons to want care volunteers,and the nature of chronic disease,and their motivation to volunteer and which sorts of activities they perform while volunteering.Results:73.4%of the elderly patients with chronic diseases desired to have volunteers for long-term care.The most desired services were care visits,transportation,and leisure/recreation activities.The number of chronic diseases they had,their marital status,education level,and social support system were all statistically important.Conclusion:The data presented here suggest that the government should actively advocate for volunteer service for elderly with chronic diseases.Additional support is needed in terms of financial support,incentive measures,professional training for volunteers,and supervision of volunteers.Such developments are needed to improve volunteer service standards.

Healthcare Needs of the Elderly People over 85 Years Living Alone on the Island Area in Japan: A Descriptive Study

Background: Japan has the highest aging people accounting 33.8 million with the rate of 26.7% in 2015. Although, public long-term care insurance services support people age 40 years and above, most of the users are 85 years and over due to their more vulnerability for getting sick. This study describes the physical, mental and social status of the elderly people aged 85 years and over, who were living alone at home. Method: A cross-sectional study was conducted between November 2016 and March 2017 in the island of Kure city, Hiroshima, Japan. A structured questionnaire and scales were used for data collection and documentation of physical measurements. Descriptive analysis was used. Result: A total of 190 subjects were participated, and the data were analyzed. The age range of the subjects was 85 to 98 years, and 68.4% of them were 85 to 89 years old. Male and female ratio was 21.6% vs 78.4%. Subjects of 17.4% continued their occupation at the time of the study period and most of them involved in agricultural work (93.9%). A certain percentage of the subjects had abnormal physical, mental and social difficulties and need additional support from family, friends, relatives, and community. Conclusion: Early detection and intervention such as disease management, nutritional support, and human support are required. The findings suggested policy makers to predict the burden and provide necessary care for these elderly people. It is necessary to aware family, friends, relatives, community and government supporting staff to provide information on correct recognition and usages of long-term care insurance services for these elder people.

The Relationship with Previous Use of Community-Based Services and Informal Caregiver Support and Elderly and Informal Caregivers’ Views of Living Arrangement: Analysis of Official Statistics from 2004 to 2014

Background and Objectives: Views on living arrangement from elderly and informal caregivers are crucial to “ageing in place”. They might be related to the experience in the use of elderly care services, which remains inconclusive in previous literature. This study aimed to explore the association of previous experience in formal and informal long-term care services with views of both elderly and their informal caregivers on living arrangement. Research Design and Methods: This study adopted a cross-sectional design. Assessment records of Minimum Data Set-Home Care for community-dwelling elderly who were eligible for subsidized long-term care services in Hong Kong from 2004 to 2014 were made available. Multivariate logistic regression was applied to examine associations between both views on elder’s living arrangement from the elderly, caregivers and their previous informal caregiver support, and experience in formal care services. Results: 82,306 dyads of elderly and informal caregivers were included in the analysis. The elderly with previous use of home and community-based services (OR = 0.84, 95% CI 0.80 - 0.88) and informal caregivers (OR = 0.78, 95% CI 0.76 - 0.81) believed that the elderly should live away from home. Temporal trends of fewer elderly and caregivers supporting the idea of living away from home were also observed. Discussion and Implications: The results highlighted the importance of informal caregiver’s support and previous utilization of formal home and community-based services. It was concluded that resources and information of community-based care have a significant association with views on living at home also proper support services and training of care for the elderly should be made available to informal caregivers to reduce their burden.

Study on the quality of life and the factors influencing it in elderly patients

A society of advanced age is arriving with the increasing number of elderly patients. Little attention has been paid to the quality of life of elderly patients, which is decreasing gradually. This article aims to study the quality of life among elderly patients and explore the factors influencing it, in addition to exploring effective ways to improve the quality of life of elderly patients.

Fitness Age Score and the Risk of Long-Term Care Insurance Certification—The Kyoto-Kameoka Longitudinal Study

Long-Term Care Insurance System has been introduced to provide appropriate care for the elderly who needs nursing care in Japan. Physical function is one of most important function for the elderly to live independently. A previous study had established a Fitness Age Score (FAS) based on a theory for biomarker of aging. This study clarified whether the FAS could be used to predict the need for certification of long-term care (CLTC) in independent elderly people. We included 939 independent, community-dwelling-elderly (average age, 74.4 years) whose physical function was measured and for whom the CLTC was tracked for 24 months. The FAS comprised five physical fitness items: Walking time, grip strength, one-leg standing, vertical jump, and functional reach test. Based on the FAS, we calculated the odds ratio (OR) for the CLTC. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) was used for further analysis. We also used the Youden Index (YI), minimum distance method (MD), and two-graph ROC method (TG) to calculate cutoff values (CVs) for screening. We divided subjects into the low and high physical fitness group with CVs. We developed cumulative CLTC curves using the Kaplan-Meier method. Sixteen people could not be tracked for the full 24 months. The measurement of FAS was completed for 798 people, of whom 28 became CLTC. The measurement of FAS was not completed for 125 people, of whom 21 became CLTC. The CLTC OR for people with incomplete FAS was 5.553. The AUC was 0.72 (p < 0.001). The CVs for the FAS were -0.29 for YI (sensitivity, 92.9% and specificity, 40.4%), -1.23 for MD (57.1% and 73.4%), and -0.81 for TG (60.7% and 60.9%). The cumulative CLTC curves according to CVs all showed significant differences (p = 0.000 - 0.020). In conclusion, the FAS can be used to predict CLTC.

农村康养产业发展的理论阐释、多元实践与政策协同

农村康养产业作为一种新兴业态,是秉承新发展理念,在乡村舒适性资源利用、后生产主义乡村价值兴起、农村产业融合驱动、城乡地域共同体功能再造、康养政策引领与市场开发的共同作用下发展起来的。在实践中,通过对自然资源、文化资源、中医药资源和森林资源的开发,与乡村旅游、文化体验、休闲度假、景观游赏等相融合,发展出田园康养、文化康养、医疗康养和森林康养等新型形态,在一定程度上满足了老年群体多样化的养老需求,建立了互益性城乡交流渠道,推动了乡村产业振兴和社区建设。但目前其发展的体制机制尚不成熟,存在统筹规划力度不足、业态短板比较突出、专业康养人才匮乏、数字化技术融入较低等问题。文章建议从主体、资本、人才、技术的角度构建政策协同的路径,加强顶层设计、突出康养特色、创新职业培训、推进科技创新,实现农村康养产业的可持续和高质量发展。同时,围绕农村康养产业发展,还应加强对城乡互益性养老服务机制的研究,探讨建立衔接有序、功能互补的城乡养老服务网络的可能路径。

养老产业在消费信托领域的实践研究及建议——以广州市为例

国家卫健委指出,我国目前正在形成“9073”的养老格局,即90%左右的老年人居家养老,7%左右的老年人社区养老,3%左右的老年人机构养老。随着我国老龄化形势逐年加剧及我国对养老产业帮扶政策的同步扩大,我国养老产业市场规模将进一步壮大,为了优化养老金融结构,扩大第三支柱占比,同时满足广大居家养老家庭的养老消费需求,可考虑采用养老消费信托产品作为养老产业的有效补充。养老消费信托产品具有低风险、高收益、附带消费折扣等特点,可有效缓解居家养老家庭的经济压力。本文对养老消费信托产品在广州市准老年人群体中的认知水平和接受程度进行相关调查,结果显示,金融素养、投资预期及产品多元化等因素对准老年人群体对养老消费信托产品的接受程度产生正向影响,由此提出有利于养老产业在消费信托领域进一步推广的相关建议。

老龄健康产业业态和服务模式

本文调研了老龄健康产业国际国内发展现状与发展趋势,调研重要国家/地区和我国重点城市的老龄健康服务模式的现状,总结出国际与我国老龄健康服务模式的特点。在此基础上,对我国老龄健康产业发展提出建议。

产业融合背景下合作社参与农村养老供给的实践机制

在产业融合背景下,合作社参与农村养老供给不仅与其服务内容综合化、生产模式规模化、经营范围多元化、利益联结紧密化等内部因素有关,还与村庄福利供给形式化、小农生产边缘化、社会组织介入便利化、村社发展耦合化等外部因素有关。当前合作社在参与农村养老供给的实践中逐渐呈现出政府项目扶持型、集体资源开发型、社会组织介入型和村社一体发展型四种形态,但其中也存在一定的问题。对此,提出了对应的解决措施:理顺政府与合作社关系,引导合作社有序发展;开发村庄资源,实施产业融合发展;整合多方力量,推动服务可持续发展;创新利益联结机制,促进服务精细化发展;完善监督机制,加强村社一体化发展。

郊区生态休闲养老:城市养老保障新模式

本文以北京市为例,分析了随着城市老龄化的进程出现的城市养老问题,提出了郊区生态休闲养老产业是解决城市养老问题的途径之一,同时可以带动当地经济的发展,为农民带来经济收入,为生态资源良好的郊区提供一个经济、社会、生态三赢的发展模式的切入口,促进城乡和谐发展。

森林康养：内涵、作用与发展对策

森林康养以森林为根基,立足于健康、康养和恢复身心,是集林业、旅游、医药、文化于一体的新兴产业。森林康养不仅适应了人们对高品质生活追求的需要,也是一种新的经济发展形态,具有生态、产业和保健三大作用。针对我国发展森林康养存在的突出问题,应搞好顶层规划、建设森林康养基地、开发森林康养产品、强化人才支撑和增加资金投入。

日本养老产业的精细化、专业化与人性化——2018日本国际福祉机器展及日本养老设施考察记

日本步入老龄化社会较早,老龄化情况严重,因此养老事业起步较早,对于养老产品的开发及养老服务的探索等逐渐发展形成相对完善的体系。通过对于亚洲最大福祉展2018日本国际福祉机器展及日本不同等级类型养老设施的考察,对日本养老产业进行直观深入的了解,挖掘日本养老产业内涵及其精细化、专业化、人性化的养老服务及产品输出,希望对于国内起步较晚的养老产业在养老政策、养老产品开发及养老服务体系等的发展上具有一定的启发和借鉴意义。

Long-term care for aged ethnic minority people in Yunnan,China:Understanding the situation

Chinese governmental sectors have been investing lots of money in setting up new institutions for long-term care(LTC)in rural China to respond to the predicted increasing and urgent needs of the growing number of aging people.However,very few have identified that many ethnic minority groups have been enjoying their traditional home-based LTC systems,which are cost-effective and have been working really well for generations.This article reports on a study on LTC needs and provisions for the Dai,one of the ethnic minority groups in rural areas of southwest China,in Yunnan(Province).A randomized sample was drawn from 12 villages in Ruili,a county 752 km from Kunming,the capital city of Yunnan.Totally,187 elderly persons were interviewed intensively.Activities of daily living were measured as the core indicator for understanding LTC.The research revealed that there is a significant disparity between the needs of the villagers and provisions from the different levels of government.There is an urgent need to reexamine the allocation of public resources for the aged.Traditional culture and practices of caring for the elderly,and practices in LTC of different ethnic groups,must be carefully considered.

Correlations between Motor Ability with Gait Speed and Cognitive Functions in Rehabilitation Users

Purpose: To compare and examine motor and cognitive functions in people who require support, and in healthy elders. Method: The variables of age, BMI, educational background, blood pressure, grip strength, knee extension, gait speed, MMSE, and subjective health feeling for 36 rehabilitation users and 22 healthy elders were assessed. We compared and examined motor and cognitive functions in rehabilitation users who need support and healthy elders. Results: The percentage of MMSE scores with 27 points or higher and that of subjective health feeling with 3 points or higher were significantly higher in healthy elders than in rehabilitation users. Systolic and diastolic blood pressure were significantly higher in rehabilitation users than in healthy elders. Gait speed and MMSE scores were significantly higher in healthy elders than rehabilitation users. Conclusion: Gait speed could be used for physical fitness in elders. Gait speed was the best physical fitness measurement for elders. Gait speed of rehabilitation users was strongly related to MMSE scores. Gait speed could be a determinant of MMSE scores.