Population ageing in Asia and the challenges of developing long-term care systems

Abstract

Population ageing is becoming a global issue. The proportion of older persons is increasing worldwide. Especially in emerging economies, the pace of ageing is rapid. Also, the number of older persons will increase significantly. Population ageing countermeasures have to be devised in a multidisciplinary manner, including social participation, employment, lifelong education, income security, health promotion, and environmental improvement. Laws and national plans for older persons are being formulated in many countries.

With increased life expectancy, the number of people with chronic diseases and disabilities will also increase, necessitating a robust framework for long-term care. A few countries have already established public long-term care systems. However, most of the emerging ageing countries in Asia continue to struggle to develop such systems. Improving the functions of families is one option to respond to increasing long-term care needs. Nevertheless, the effectiveness and sustainability of such options remain uncertain. Countries such as Japan are shifting the caregiver's role from family to social service. However, the lack of long-term care professionals is a significant challenge. Traditionally, elderly parents are looked after by family members at home. There is a cultural aversion to placing them in institutions. However, the proportion of older persons living in long-term care facilities in Hong Kong, Japan, and South Korea is already high by global standards. Securing a place of living for older persons and maintaining the quality of care is, therefore, a pressing need.

Owing to the COVID-19 pandemic, mortality in Asia initially decreased for the first year in 2020 but after that, especially since 2022, the mortality remained high. In addition to the direct impact of the pandemic, many issues have to be considered. These include changes in medical and long-term care practices because of infection control and the effects of activity restrictions.

In addition to ageing, low fertility is another serious issue emerging in Asia. Just as Japan, South Korea and China have become societies with declining populations, and it is estimated that the population of Asia as a whole will begin to decline by 2055. Active, healthy, and longer lives contribute to mitigating population decline. Therefore, a quality long-term care system is indispensable.