2017 Volume 18 Issue 1 Pages 8-12
In this study, we estimated the monetary value of family's burden (unpaid care on everyday life done in-home and in-community by the family, etc.) and nursing care service for dementia covered by the long-term care insurance (LTC) in Japan based on Japanese governmental statistics. From 2001 to 2013, the number of persons supported in-home and in-community with certification of needs of LTC mainly due to dementia, increased 3.22 times from 251,000 to 810,000. During the same period, the average score of such certification decreased from 3.0 to 2.3 (scores higher by severity), the average time of nursing care decreased from 7.0 to 5.4 hours a day, and the average care unit price (opportunity cost method) decreased from 1,155 to 1,042 JPY an hour. As a result, although the cost of LTC became 1.88 times from 0.93 to 1.76 trillion JPY, family's burden increased 2.24 times from 0.66 to 1.49 trillion JPY. The proportion of family's burden also rose from 41.6% to 45.8%.“Deinstitutionalization policy” encourages demented people to receive nursing care by their elderly family at lower opportunity cost, and this may contribute to the increase in family's burden. To obtain care for the elderly whose opportunity cost is low is becoming difficult, resulting in the increase of people who are forced to resign from work to provide nursing care for their aging family members. It would be an important political issue how to balance the family's burden and LCT expenditure at a cost tolerable for a family and other unpaid caregivers.
