Changing systems in health and social care for older people in Japan: observations and implications for...

The impact of a rapidly ageing population on the development of insurance policies and health and social care services of older people is a major concern in Japan. The discussion in this paper draws on information gained from recent visits to leaders of these services in Japan. The paper briefly reviews the policy and demographic background to recent legislative changes in the long-term care insurance system, models of care management and assessment and outstanding challenges for health and social care professionals. Some key issues have emerged with implications for interprofessional working, such as the lack of integrated care systems, contradictions within the scope and responsibilities of care management, and the absence of quality and ethical frameworks to safeguard the interests of the service user and carer.