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Long-term care preference among Japanese older adults: differences by age, period and cohort

Published online by Cambridge University Press:  09 January 2019

Hidehiro Sugisawa Open the ORCID record for Hidehiro Sugisawa [Opens in a new window] ,
Yoko Sugihara  and
Yomei Nakatani
Hidehiro Sugisawa*
Affiliation:
Graduate School of Gerontology, J.F. Oberlin University, Tokyo, Japan
Yoko Sugihara
Affiliation:
Faculty of Urban Environmental Sciences, Tokyo Metropolitan University, Tokyo, Japan
Yomei Nakatani
Affiliation:
Faculty of Humanities, Matsuyama University, Ehime, Japan
*
*Corresponding author. Email: [email protected]
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Abstract

This study examined the differences in the preference for long-term care (LTC) by age, period and cohort (A-P-C) in Japanese older adults through repeated cross-sectional surveys from 1998 – before the establishment of LTC insurance – to 2016, in a suburban city of metropolitan Tokyo. We analysed the direct effects of A-P-C on the preference for LTC, as well as the interaction effects of A-P-C on preference by gender, family structure and activities of daily living. Data were obtained at six time-points using repeated cross-sectional surveys for people aged 65 and older; surveys were conducted in 1998, 2002, 2004, 2010, 2013 and 2016. The preference for LTC was composed of three categories: informal care, community LTC services (CLTCS) and institutional LTC services (ILTCS). The cross-classified random-effect model was used to specify A-P-C effects. Informal care, CLITCS, ILTCS and other/no answer composed 35, 23, 33 and 9 per cent of preferences, respectively. In terms of the period effect, while there was an increase in levels of preference for CLTC between 1998 and 2010 as compared to informal care, the levels of preference were almost identical after 2010. In terms of the age effect, younger participants were more likely to prefer CLTCS and ILTCS over informal care. Moreover, the age influence was stronger in females and respondents who lived alone. We did not observe a cohort effect for preference. This study suggests that there are gaps by period and age between the preference for LTC services and the actual LTC use in Japanese older adults, and as a result, the use of actual LTC services cannot fully reflect the intentions and preference for LTC in them.

Keywords

informal careinstitutional long-term carecommunity carewelfare stateJapan
Type
Article
Information
Ageing & Society , Volume 40 , Issue 6 , June 2020 , pp. 1309 - 1333
Copyright
Copyright © Cambridge University Press 2019

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References

Anderson, GF and Hussey, PS (2000) Population aging: a comparison among industrialized countries. Health Affairs 19, 191–203.CrossRefGoogle ScholarPubMed
Asahara, K, Momose, Y and Murashima, S (2003) Long-term care insurance in Japan: its frameworks, issues and roles. Disease Management and Health Outcomes 11, 769–777.CrossRefGoogle Scholar
Burstein, P (2003) The impact of public opinion on public policy: a review and agenda. Political Research Quarterly 56, 29–40.CrossRefGoogle Scholar
Cabinet Office, Government of Japan (2002) Public Opinion Poll on Care for Older Adults, 1995. Available at https://survey.gov-online.go.jp/h07/H07-09-07-07.html.Google Scholar
Cabinet Office, Government of Japan (2003) Public Opinion Poll on Care for Older Adults, 2003. Available at https://survey.gov-online.go.jp/h15/h15-kourei/index.html.Google Scholar
Cabinet Office, Government of Japan (2010) Public Opinion Poll on the Long-term care Insurance, 2010. Available at https://survey.gov-online.go.jp/h22/h22-kaigohoken/index.html.Google Scholar
Campbell, JC and Ikegami, N (2000) Long-term care insurance comes to Japan. Health Affairs 19, 26–39.CrossRefGoogle ScholarPubMed
Campbell, JC, Ikegami, N and Gibson, MJ (2010) Lessons from public long-term care insurance in Germany and Japan. Health Affairs 29, 87–95.CrossRefGoogle ScholarPubMed
Carstensen, LL, Isaacowitz, DM and Charles, ST (1999) Taking time seriously: a theory of socioemotional selectivity. American Psychologist 54, 165–181.CrossRefGoogle ScholarPubMed
Chattopadhyay, A and Marsh, R (1999) Changes in living arrangements and familial support for the elderly in Taiwan: 1963–1991. Journal of Comparative Family Studies 30, 523–537.CrossRefGoogle Scholar
Chung, MH, Hsu, N, Wang, YC, Lin, HC, Huang, YL, Amidon, RL and Kao, S (2008) Factors affecting the long-term care preferences of the elderly in Taiwan. Geriatric Nursing 29, 293–301.CrossRefGoogle ScholarPubMed
Costa-Font, J, Elvira, D and Miró, OM (2009) Ageing in place? Exploring elderly people's housing preferences in Spain. Urban Studies 46, 295–316.CrossRefGoogle Scholar
Coward, RT, Cutler, SJ and Mullens, RA (1990) Residential differences in the composition of the helping networks of impaired elders. Family Relations 39, 44–50.CrossRefGoogle Scholar
Croll, EJ (2006) The intergenerational contract in the changing Asian family. Oxford Development Studies 34, 473–491.CrossRefGoogle Scholar
Daatland, SO (1990) ‘What are families for?’ On family solidarity and preference for help. Ageing & Society 10, 1–13.CrossRefGoogle Scholar
Daatland, SO and Lowenstein, A (2005) Intergenerational solidarity and the family–welfare state balance. European Journal of Ageing 2, 174–182.CrossRefGoogle ScholarPubMed
Division of the Support for the Elderly, General Affairs Division, Ministry of Health, Labour and Welfare (2014) Situations of Applicants for Entrance of Nursing Homes for the Elderly. Available at http://www.mhlw.go.jp/file/04-Houdouhappyou-12304250-Roukenkyoku-Koureishashienka/0000041929.pdf.Google Scholar
Eckert, JK, Morgan, LA and Swamy, N (2004) Preference for receipt of care among community-dwelling adults. Journal of Aging and Social Policy 16, 49–65.CrossRefGoogle ScholarPubMed
Elliott, KS and Campbell, R (1993) Changing ideas about family care for the elderly in Japan. Journal of Cross-cultural Gerontology 8, 119–135.CrossRefGoogle ScholarPubMed
Enders, CK and Tofighi, D (2007) Centering predictor variables in cross-sectional multilevel models: a new look at an old issue. Psychological Methods 12, 121–138.CrossRefGoogle Scholar
Esping-Andersen, G (1990) The Three Worlds of Welfare Capitalism. London: Polity.Google Scholar
Esping-Andersen, G (1997) ‘Hybrid or unique?’ The Japanese welfare state between Europe and America. Journal of European Social Policy 7, 179–189.CrossRefGoogle Scholar
Fernández-Carro, C (2016) Ageing at home, co-residence or institutionalization? Preferred care and residential arrangements of older adults in Spain. Ageing & Society 36, 586–612.CrossRefGoogle Scholar
Ferragina, E and Seeleib-Kaiser, M (2011) Welfare regime debate: past, present, future. Policy & Politics 39, 583–611.CrossRefGoogle Scholar
Gans, D and Silverstein, M (2006) Norms of filial responsibility for aging parents across time and generations. Journal of Marriage and Family 68, 961–976.CrossRefGoogle Scholar
Hajek, A, Lehnert, T, Wegener, A, Riedel-Heller, SG and König, HH (2017) Factors associated with preferences for long-term care settings in old age: evidence from a population-based survey in Germany. BMC Health Services Research 17, 156.CrossRefGoogle ScholarPubMed
Hanaoka, C and Norton, EC (2008) Informal and formal care for elderly persons: how adult children's characteristics affect the use of formal care in Japan. Social Science and Medicine 67, 1002–1008.CrossRefGoogle ScholarPubMed
Hirosima, K (1987) Recent change in prevalence of parent–child co-residence in Japan. Journal of Population Studies (Jinkogaku Kenkyu) 10, 33–41.Google Scholar
Hsu, HC, Lew-Ting, CY and Wu, SC (2001) Age, period, and cohort effects on the attitude toward supporting parents in Taiwan. The Gerontologist 41, 742–750.CrossRefGoogle ScholarPubMed
Ikegami, N, Yamauch, K and Yamada, Y (2003) The long term care insurance law in Japan: impact on institutional care facilities. International Journal of Geriatric Psychiatry 18, 217–221.CrossRefGoogle Scholar
Ito, P (2003) Pushing for social care expansion: demography, gender, and the new politics of the welfare state in Japan. American Asian Review 21, 25–55.Google Scholar
Izuhara, M (2000) Changing family tradition: housing choices and constraints for older people in Japan. Housing Studies 15, 89–110.CrossRefGoogle Scholar
Kane, RL and Kane, RA (2001) What older people want from long-term care, and how they can get it. Health Affairs 20, 114–127.CrossRefGoogle Scholar
Kim, EY and Kim, CY (2004) Who wants to enter a long-term care facility in a rapidly aging non-western society? Attitudes of older Koreans toward long-term care facilities. Journal of the American Geriatric Society 52, 2114–2119.CrossRefGoogle Scholar
Lee, YJ and Ku, YW (2007) East Asian welfare regimes: testing the hypothesis of the developmental welfare state. Social Policy and Administration 41, 197–212.CrossRefGoogle Scholar
Mair, CA, Quinones, AR and Pasha, MA (2016) Care preferences among middle-aged and older adults with chronic disease in Europe: individual health care needs and national health care infrastructure. The Gerontologist 56, 687–701.CrossRefGoogle ScholarPubMed
Matsunari, M (1991) Changes in family ideology in post-war Japan: based on the results of nation-wide public-opinion polls. Japanese Journal of Family Sociology (Kazoku Shakaigaku Kenkyu) 3, 85–97.CrossRefGoogle Scholar
McAuley, WJ and Blieszner, R (1985) Selection of long-term care arrangements by older community residents. The Gerontologist 25, 188–193.CrossRefGoogle ScholarPubMed
McCormick, WC, Ohata, CY, Uomoto, J, Young, HM, Graves, AB, Kukull, W, Teri, L, Vitaliano, P, Mortimer, JA, McCurry, SM, Bowen, J and Larson, EB (2002) Similarities and differences in attitudes toward long-term care between Japanese Americans and Caucasian Americans. Journal of the American Geriatric Society 50, 1149–1155.CrossRefGoogle ScholarPubMed
Min, JW (2005) Preference for long-term care arrangement and its correlates for older Korean Americans. Journal of Aging and Health 17, 363–395.CrossRefGoogle ScholarPubMed
Ministry of Health, Labour and Welfare (2017 a) 2016 Comprehensive Survey of Living Conditions: Health, Vol. 4. Available at https://www.e-stat.go.jp/stat-search/files?page=1&layout=datalist&lid=000001184848.Google Scholar
Ministry of Health, Labour and Welfare (2017 b) Summary of Comprehensive Survey of Living Conditions in 2016. Available at https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa16/index.html.Google Scholar
Ministry of Health, Labour and Welfare (nd-a) Report on Long-term Care Insurance Service from 200 0 to 201 6. Available at https://www.e-stat.go.jp/stat-search/files?page=1&toukei=00450351&tstat=000001031648.Google Scholar
Ministry of Health, Labour and Welfare (nd-b) Outlines of Comprehensive Survey of Living Conditions in 2004, 2007, 2010, 2013, 2016. Available at http://www.mhlw.go.jp/toukei/list/20-21kekka.html.Google Scholar
Ministry of Health, Labour and Welfare (nd-c) Outline of Results of Comprehensive Survey of Living Conditions in 2015. Available at http://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa14/index.html.Google Scholar
Ministry of Health, Labour and Welfare (nd-d) Survey on Long-term Care Insurance Payments from 2001 to 2016. Available at https://www.mhlw.go.jp/toukei/list/45-1.html.Google Scholar
Ogawa, N and Retherford, RD (1993) Care of the elderly in Japan: changing norms and expectation. Journal of Marriage and Family 55, 585–597.CrossRefGoogle Scholar
Peek, CW, Coward, RT, Lee, GR and Zsembik, BA (1997) The influence of community context on the preferences of older adults for entering a nursing home. The Gerontologist 37, 533–542.CrossRefGoogle ScholarPubMed
Pinquart, M and Sörensen, S (2002) Older adults’ preferences for informal, formal, and mixed support for future care needs: a comparison of Germany and the United States. International Journal of Aging and Human Development 54, 291–314.CrossRefGoogle ScholarPubMed
Roberto, KA, Allen, KR and Blieszner, R (2001) Older adults’ preferences for future care: formal plans and familial support. Applied Developmental Science 5, 112–120.CrossRefGoogle Scholar
Social Statistics Office, Director-General for Statistics and Information Policy, Ministry of Health, Labour and Welfare (2016) Monthly Report of Survey of Long-term Care Benefit Expenditures (October). Available at http://www.mhlw.go.jp/toukei/saikin/hw/kaigo/kyufu/2016/10.html.Google Scholar
Social Statistics Office, Director-General for Statistics and Information Policy, Ministry of Health, Labour and Welfare (nd) 2016 Year Report of Survey of Institutions and Establishments for Long-term Care. Available at http://www.mhlw.go.jp/toukei/saikin/hw/kaigo/service16 /.Google Scholar
Statistics Bureau, Ministry of Internal Affairs and Communications (2012) Chapter 15 Education: Historical Statistics of Japan. Available at http://www.stat.go.jp/english/data/chouki/25.htm.Google Scholar
Statistical Bureau, Ministry of Internal Affairs and Communications (nd) Labour Force Survey. Historical Data. Available at http://www.stat.go.jp/data/roudou/longtime/03roudou.htm.Google Scholar
Takagi, E, Silverstein, M and Crimmins, E (2007) Intergenerational co-residence of older adults in Japan: conditions for cultural plasticity. Journals of Gerontology: Psychological Science and Social Sciences 62B, S330–S339.CrossRefGoogle Scholar
Tamiya, N, Noguchi, H, Nishi, A, Reich, MR, Ikegami, N, Hashimoto, H, Shibuya, K, Kawachi, I and Campbell, JC (2011) Population ageing and well-being: lessons from Japan's long-term care insurance policy. Lancet 378, 1183–1192.CrossRefGoogle ScholarPubMed
Tsutsui, T (2010) The current state and future development of the long-term care insurance system in Japan. Journal of the National Institute of Public Health 59, 372–379.Google Scholar
Tsutsui, T and Muramatsu, N (2007) Japan's universal long-term care system reform of 2005: containing costs and realizing a vision. Journal of the American Geriatric Society 55, 1458–1463.CrossRefGoogle ScholarPubMed
Tsutsui, T and Muramatsu, N (2014) Changes in perceived filial obligation norms among coresident family caregivers in Japan. The Gerontologist 54, 787–797.CrossRefGoogle ScholarPubMed
Tsuya, NO and Martin, LG (1992) Living arrangement of elderly Japanese and attitudes toward inheritance. Journal of Gerontology 47, S45–S54.CrossRefGoogle ScholarPubMed
Wang, YC, Chung, MH, Lai, KL, Chou, CC and Kao, S (2004) Preferences of the elderly and their primary family caregivers in the arrangement of long-term care. Journal of the Formos an Med ical Association 103, 533–539.Google ScholarPubMed
Wielink, G and Huijsman, R (1999) Elderly community residents’ evaluative criteria and preferences for formal and informal in-home services. International Journal of Aging and Human Development 48, 17–33.CrossRefGoogle ScholarPubMed
Wielink, G, Huijsman, R and McDonnell, J (1997) Preferences for care: a study of the elders living independently in the Netherlands. Research on Aging 19, 174–198.CrossRefGoogle Scholar
Yang, Y and Land, KC (2013) Age–Period–Cohort Analysis: New Models, Methods, and Empirical Applications. Boca Raton, FL: CRC Press.CrossRefGoogle Scholar
Yong, V and Saito, Y (2012) National long-term care insurance policy in Japan a decade after implementation: some lessons for aging countries. Ageing International 37, 271–284.CrossRefGoogle Scholar