三井住友金融集團(tuán)（SMFG）：支持高齡老人自己解決問題減輕家人負(fù)擔(dān)的信息共享策略

1Theme:InformationCollaborationMeasurestoHelpIndividualsSolveProblemsinTheirOldAgedReducetheBurdenonFamilies(1)TheNuclearFamilyandLowBirthRateareProgressinginanFordecades,JapanhasairedcartoonscalledChibiMaruko-chanonSundayeveningsat6:00andSazae-sanat6:30.Bothdepicttheeverydaylifeofafamilywhereacouple,theirchildandoneofthecouple'sparents(grandparentsforthechild)livetogether.However,inreality,theshareofthesethree-generationhouseholdsandcouple-onlyhouseholdsincreasing(Chart1).Intermsofthenumberofhouseholds,thenumberofone-personhouseholdsandtwo-personhouseholdsincreasedsignificantly,whilethenumberofhouseholdsconsistingofthreeormorepeopledecreased(Chart2).7.025.634.215.817.318.931.97.627.614.119.629.88.312.829.519.827.98.732.434.625.634.215.817.318.931.97.627.614.119.629.88.312.829.519.827.98.732.434.69.0eholdoupleonlyhouseholdstingofmarriedcouplesandchildrenngofasingleparentandchildrenuseholdsFigurePercentageofgeneralhouseholdsbyfamilytype0196019701975198019851990199520002005201020152020One.(Households)Three.(Households)Two.(Households)4people(Households)rtNumberofgeneralhouseholdsbynumberofhouseholdmembersimatedthatinwomenandinmenwillbelivingaloneby2040(Chart3).20302035Numberofsolohouseholds(women).0600054045192502423.9483223.25000459022.424.520.820302035Numberofsolohouseholds(women).0600054045192502423.9483223.25000459022.424.520.824.3419721.8400072835595300032250268029352435200020560020152020202500.0022040Numberofsinglehouseholds(males)Solituderate(men)Numberofsinglehouseholds(males)hartEstimatesofthenumberofsinglehouseholdsandtherateoflivingaloneedandoverSources:FutureestimatesofthenumberofhouseholdsinJapan(byprefecture)(201932.50人21.6%21.1%26.7%28.9%32.4%29.8%31.3%32.9%34.4%2.30人2.23人2.23人22.50人21.6%21.1%26.7%28.9%32.4%29.8%31.3%32.9%34.4%2.30人2.23人2.23人2.21人2.21人2.19人2.19人2.10人2.09人56.2%54.1%1.96人1.94人56.0%57.0%55.4%57.8%56.4%53.6%53.2%1.90人1.70人9.8%3.7%11.0%3.0%8.9%3.4%9.3%9.6%2.7%twoandthenumberofcoupleswiththreeormorechildrenisdecreasing(Chart4).100%80%60%40%20%0%15.9%6.4%1115.9%6.4%11.7%5.6%1.50人6.2%1977198219871992199720022005201020150peopleOne.Two.3ormoreNumberofcompletedbirths(rightaxis)artNumberofchildrenmarriedcoupleshavenumberofcompletedbirthsAstheabovedatashows,thekindofhomeinanimewherefamiliesofmultiplegenerationsgatheraroundthedinnertableandeveryoneisdisgustedandscoldedwhenthemaincharacter'smischievouschildmakesamistakeisnowonlyonTV,and"smallfamilies"suchasanuclearfamilyofparentsandasmallnumberofaveNoOnetoAskForHelptoreceivewhenlivingaloneincludehelpwithoutingssuchasdoctorvisitsandshopping,dailyhouseholdchores,andhelpwithsuddenillness.Itcanbeseenthatolderpeople,unlikeyoungerpeople,developanxietythattheycannotdodailyoutingsandhouseworkontheirown.4onrfooddeliveryservicesorkliketakingoutthegarbageorchanginglightbulbs orriesationpartnerllnessgaFreePlacetoGo0204037.527.919.215.622.146.837.851.1hartServicesyouwanttoreceivewhenyoulivealoneSource:AttitudeSurveyontheAgingSociety,commissionedbytheOfficeofthePolicynandPolicyPlanningOfficertheMinistryofHealthLabourandWelfareyhadnoonetoturntofordailybiasedtowardrelatives,andthatiftheycan'trelyonrelatives,itisdifficulttoaskothersforhelp.(Chart6)Infact,single-personhouseholdsaremorelikelytoaskforhelpfromsomeoneotherthantheirrelatives,becauseitisdifficulttorelyonthem.Morethanhalfofelderlysinglemalehouseholdshavenoonetoturntoforcareandnursing,andabout30%ofotherhouseholdshavenoonetoturnto.Onlyrelatives,ifanyonecanrelyonthem.AsIwilldiscusslater,eveninJapan,wherepubliclong-termcareinsurancehasbeenintroduced,wecanseethatrelativesaremainlyexpectedtohelptheelderlyonadailybasis,andthatthereisasituationinwhichpeoplecannotrelyonanyoneotherthanrelatives.5eholdoldedcouplesonlyeholdoldedcouplesonlysonlyhouseholds15.417.29.111.16.26.98.1%60%%relativesIhavesomeoneIcanturntootherthanmyrelatives.Thereisnoonetorelyon.dependonothersforthatPeopleyoucanrelyonfordailyhelpSource:NationalInstituteofPopulationandSocialSecurityResearch,SurveyonLifeandpport11Singleelderlymalehousehold.2Singleelderlymalehousehold.25.4Singleelderlyfemalehousehold36.35.7Householdsformarriedcouplesonly*60.0sonlyhouseholdsrelativesesThereisnoonetorelyon.dependonothersforthatrtPeopleyoucanrelyonforcareandnursingSource:NationalInstituteofPopulationandSocialSecurityResearch,SurveyonLifeandpportnaeemptyelderly2019Revision,whichpublishedbyUN,withtheelderlypopulationprojectedto6upofthetotalpopulationbysourceconfirmedButaccordingtorelatedinstitutionreport,itwillbe34%by2050.IthasalsobeenpointedoutthattherateofagingisfasterthanindevelopedcountriesinEuropeandtheUnitedStatesandevenfasterthaninJapan.Asindicatedbythetermunrichseniority,theproblemisthat,unlikedevelopedcountriesinEuropeandtheUnitedStates,theocietybeginswhenGDPpercapitaislowFigurePopulationagedandoverinChina(%)onProspectsTheRevisionInChina,thesocialandeconomicdevelopmentsincethe1990shasledtochangesinlifestyles,suchastheavailabilityofprivatehousingandanincreaseinthenumberofpeopleleavingruralvillagesforurbanwork.Asaresult,thenumberofmarriedchildrenseparatedfromtheirparentshasbecomemorecommonandtheaveragehouseholdsizehasdecreased(Chart9).Familiesthemselveshavealsobecomesmallerduetothebadbirthpolicy.Againstthisbackdrop,thenumberofincreasinginurbanandruralareas,andisreferredtoas"emptyelderly"or"emptyhouseholds."Thepercentageofemptynestersvarieswidely,withmorethan50%ifanonlychilddiesbeforehisorherparents,therewillbenoonetosupporttheelderlyparent(adegeneratefamily).Thelackofhelpindailylifeforthesehouseholdsandultimatelytheriskofdyingalonemayalsoincrease.7tChangesinaveragehouseholdsizevyburdenontheworkinggenerationiiAsaresultoftheonechildpolicy,onlychildrenmarryeachother,andthe"4:2:1"structure,inwhichtwomarriedcouplessupportandcareforfourparentsandonechild,nowprevails(421families).Untilthe1980s,state-ownedenterprisesprovidedlife-stagesupporttoemployeesandtheirparentsandchildrenontheassumptionoflifetimeemployment.Employeesandtheirfamiliescouldusethefacilities'servicesfreeofchargeoratlowprices,aswellasbeprovidedwithstateownedenterprisesplayedaroleinthesafetynetprovidedbythegovernment.However,duetothedeterioratingmanagementofstate-ownedenterprises,thesystemwasreformedinthemidsforcingcompaniestofocusonimprovingproductivityandmanagementcapabilities,andthelifetimeemploymentsystemwasabolished.tructureinwhichlargefamiliesandstate-ownedenterprisessupportedtheelderly,buttodaywherethesupportofelderlyparentshastobetakencareofexclusivelybyindividuals.8(4)IntroductionofLong-TermCareInsuranceandConditionsoftiesFortheFlderlyinChinaInJapan,publiclong-termcareinsurancewasintroducedin2000,andallcitizensovertheageof40areeligibleforit.Whenapersonneedsnursingcare,heorsheommunitybasedservicesandfacilityserviceswhicharecombinedandusedaccordingtothecertifiedlevelofcareneedandcondition.Thenationalgovernmentispromotingtheconstructionofa"communitycomprehensivecaresystem,"inwhichhousing,medicalcare,nursingcare,preventionandlifesupportareprovidedinanintegratedmannersothatpeoplecancontinuetolivetheirownwhichformulatesalong-termcareinsurancebusinessplaneverythreeyearswiththeaimofcreatingacommunitycomprehensivecaresystemaccordingtothecharacteristicsofthecommunity,basedontheautonomyandindependenceofthemunityTraditionallyandlegally,familymembersareresponsibleforthesupportofthelewhoareunableforunavoidablereasonsiiiMusurenjinandGoboronjinilitiesorreceivecashbenefitstoprovideaminimumleveloflivingsecurity.However,asmentionedabove,theimpactoftheonechildpolicyhasledtoarapiddeclineinthebirthrateandtheemergenceofasituationinwhichitisdifficulttosupporttheelderlyeveniftheyhaveafamily.Therefore,fromthelate1990s,theprivatesectorwasallowedtoestablishandoperatefacilitiesfortheelderly,andthenumberofresidentsexpanded.Thisledtoasharpincreaseinthenumberofnursinghomesandbeds.However,ithasbeenpointedoutthatinurbanareaswheredemandishigh,therearefewerbedsandwaitinglistsforadmission,whileinsuburbanfacilities,theadmissionrateislowsslikelytoacceptadmissionduetotheshortageofnursingstaffi.Furthermore,Huangstatesthatthelowrateofadmissiontoseniorinstitutionsisfundamentallyduetothelowlevelofsocialsecuritybenefitsandthelackoffinancialresourcesforseniorcitizenstoenterinstitutionsduetotheirunrichseniorcitizens,andthatthenumberofuserswilleniorcitizensisreducedthroughlongtermcareinsuranceandassistance.[*]iiiInChina,15pilotregionsbeganpilotingapubliclong-termcareinsurancesystemin2016.Initially,theplanwastointroducethesystemnationwidein2025,butthetargetyearfornationwidedisseminationwasrevisedto2025becauseofthetime9neededtosolvetheproblemsthatemergedthroughtrials.[*]ivChallengesincluderdscreatingemsvupportfortheElderlyinChinaAgainstthebackdropofachangingfamilyenvironment,theChinesegovernmenthasadoptedthesloganofafamilyfriendlysociety"asitswelfarepolicycoveringfamilycareandchildrearingsincethe19thNationalCongressoftheCommunistPartyofChinain7.Asmentionedabove,inthe1980s,thenumberofpeoplewhobelongedto"units"calledstate-ownedenterprisesandcouldnotreceivewelfareservices,includingtheirfamilies,increased.Thenumberofpeopleworkingoutsidestate-ownedservicesSincethe1990s,therefore,thegovernmenthaspromotedthedevelopmentof"companyzones"andtriedtoshifttoaframeworkbasedonregionsratherthancorporations.farepolicyfortheelderlyisbasedonthemodelinwhichthewardmembersareunabletocopewiththesituation,andfacilityservicesareprovidedtopeopleinsevereneedoflong-termcarewhenitisunavoidable.9073meansthatfamiliesareresponsiblefor90%,corporatewardsfor7%andinstitutionsfor3%.Itisnotsomuchsocializationofcareasstrengtheningthefunctionsoffamilycareiii.includedailylivingserviceshousekeepingserviceschaperonesforshoppingandseniorcitizens'cafeteria),medicalinsuranceservices(Home-visitmedicalcare,home-visitnursingcare,ambulatoryattendance),culturalandentertainmentservices(Seniorcolleges,culturalclasses,bookandnewspapersdayservicesandnursinghomes[*]viHowever,ithasnotyetbeenpossibletoreducetheburdenonfamilies,forhomehelperscalled"Baomu"butthisisnotcommonbecauseofthehighcost.[*]viiWiththeintroductionofthepubliclong-termcareinsurancesystem,itisexpectedthatthenumberofproviderswillincreaseandtheserviceswillbeenhancedbecausethecostburdenonuserswilldecrease,makingiteasiertouselong-termcareservices.2."Care"fortheElderlyIncludesDecisionSupportandgement(1)ChallengesinJapan,morethan20yearsaftertheintroductionlongtermcareinsurancesystemvicestolifesomeonewantsInJapan,ithadlongbeenassumedthatfamilieswouldcarefortheelderly,anddasameasurewhenthiswasdifficultHoweverafterthe1970s,theincreaseinaveragelifeexpectancyduetotheadvancementofmedicalcareandotherfactors,andthechangetoadiseasestructurecenteredonchronicdiseases,ledtolongerandmoreseverecare.Inaddition,asthepopulationwomen'ssocialadvancementandthenuclearfamilybecamemorecommon,anditbecameincreasinglydifficultforfamiliestocarefortheelderly.Asaresult,violationsofthehumanrightsoftheelderlywerecausedbysocialhospitalizationandpoorcareconditions.Therefore,sincethe1990s,thedirectionofpoliciesthatsurancesystemwasimplementedinApriluranceisthatunlikemeasuresinwhichthegovernmentdecideswhichservicesareneededandprovidesthem,theinsured(residents)selectthenecessarylong-termcareservicesthemselvesandusethembasedona"contract"withalong-termcareserviceprovider.(Whenresidentschooselong-termcareservices,long-termcaresupportspecialistsassesstheconditionofthoseinneed,setgoals,andmediatewithserviceproviders.)Serviceseincludingprivatebusinessesandnonprofitcorporationswhoandwhatserviceisusedbytheinsured,iscalleda"Junshijo"becauseitpartiallyadoptsamarketmechanism.Economically,thisisbasedontheexpectationthatdiverseserviceproviderswillcompeteandprovidequalityandefficientservices.Anotheraspectistheemphasisonrespectingthecontinuityofapersoninneedofcareintheirpreviouslivesandchoosingtherightservicesasmeanstoachievethelifetheywant.TheweightofthedemandforagencyevenwhenmentalorphysicalfunctionIntermsofchoosingservicestoachievethelifesomeonewants,theselectionoflong-termcareinsuranceservices,likenormalconsumptionbehavior,involvesthellowingstepssomeonebecomesawareofsomeproblemtobesolvedinitiatesasolutiontotheproblem,selectsapreferredandavailableoption,contractsandpaymentsaremadeandused.Inthecaseoflong-termcareinsuranceservices,theprocessofapplyingforlong-termcareinsuranceandselectinglong-termcaresupportprofessionalsisalsorequiredbeforeselectingindividualservices.Asmentionedabove,thenumberofpeoplelivingwiththeyoungergenerationhasdecreased,andnowthathouseholdsconsistmainlyofelderlysinglepersonsorelderlycouples,thepersoninneedofcaremusttaketheinitiativeincarryingoutnofchildrenlivingapartThisisaconsiderableburden,andtherearetimeswhenitcan'tbedone.Itistruethattherearemoreoptionsforlong-termcareservicesandmechanismsinplacetousethem,butwithmentalandphysicalfunctionsdeclining,itisbecomingdifficultforthoseinneedoflong-termcareandelderlyspousestousethesemechanisms.Forexample,anelderlypersonlivingalonemaynotbeabletodisposeofgarbageduetobadhealth,andtheneedforcareisrecognizedoutsideonlywhenastrangeodorissmelledfromthehouseorthepersonisfoundcollapsed,butbythenthepersonisnolongerinpositiontoapplyforuseofthelong-termcareinsurancesystemorchooseservices.Intheabsenceoffamilymembers,localresidentsuchasmunicipalemployees,welfarevolunteers,landlords,andsocialworkersatandprovidesupport,suchasarrangingcaresupportspecialists.TheyoftenrefusetousetheservicebecausetheydonotrecognizetheneedanddislikeoutsideuildandpersuadethesupportersItisalong-termcareinsurancepolicythatdoesnotassumethecareoffamilydandifthisisnotmet,itwillbeanatypicalsituationandplaceagreatburdenonthepeoplearoundthem,whichwillalsoputthepersonatadisadvantage.endorserissuehomeorwhentheyarerentinganewresidence,theyaresometimesturnedawayiftheydonothavea"guarantor"fortheyoungergeneration.It'snotjustaproblemformereasoncan'tgethelpfromtheirchildren.Sincearound2017,thisproblemhasstudieshavebeenconductedWhydoesthishappen,forexample,isthatmedicalinstitutionswantsomeonetotaketheirplacetohearwithpatientsaboutcriticalmedicalprocedures,toinformmedicalonsoftheirintentionsregardingendoflifecaretoprocureandpayforthenecessitiesoflifewhileinthehospital,topayformedicalcare,tohelpwithdischarge,and,iftheydie,tocollecttheirbodiesandarrangefunerals.Innursinginstitutioncannotfunctionasamedicalinstitutionunlessitprovidespropercare,letionoftreatmentandisdischarged,andsocananursinghome.Eveniftheyarenotnecessarilyinneedghriskofnotbeingabletodotheabovebecauseoffunctionaldeclineordeath,andtheyareaskedtohaveaguarantortoproceedontheirbehalf.Andolderpeoplewhoareaskedtohaveaguarantoroftenhavenoonetoaskforsomeone,puttingthematadisadvantagewhentheyarehospitalized,admittedormovedin.fhavingnoonetodopostmortemproceduresElderlypeople(singlehouseholdsandhouseholdswithonlyelderlycouples),whoarelesslikelytohaveaccesstosupportfromyoungerfamilymembers,aremorectfamilysupport,butalsobecauseofconcernsabouttheriskofnotbeingabletoperformthenecessaryprocedurestoaccesshealthandcareservices.Withoutthesupportofyoungerfamilies,problemsarisenotonlyinlifebutalso(realestateandotherproperty),andtherolethepersonplayed(suchascaringforfamilymembersorpets),somethingthepersonnaturallycannotdo.Ithaslongnaproblemthatlandlordsandlocalgovernmentshavenochoicebuttoexpendmoneytodisposeofvacanthousesandpetsleftbehindafterdeath,which,ifleftunattended,canhaveanegativeimpactonthesurroundingenvironment.Inrecentyears,peoplehavebeentalkingabout"unrelatedremains"thatlocalncreaseinthenumberofcaseswherelocalgovernmentscancremateadeceasedpersonbyapplyingalaw(thecemeteryandburiallaw)thatassumesthatthepersonisunknown,butthepersonisknownandhasmoneyinthebank,buttherearenorelativestoperformthefuneralandthelocationofthegraveisunknown,sothelocalgovernmentwillcetheminacollectivegraveAlthoughitisdebatableadthereareasmallnumberoflocalgovernmentsthatconsideritanissuefromtheperspectiveofdignityandengageinthebusinessofmediatingcontractswithfuneralhomeswhiletheyarealiveforthepurposeofprevention.Inthecaseofcremationbythelocalgovernment,thecostwillbebornebythelocalgovernmentandthetaxwillbeusedbytheresidents,andtherefore,itisconsideredthatitisnecessarytopreventpeoplewhoseidentitiesareknownfrombecomingunrelatedashes.sesforprovidingservicessprangupgcarelyevenafterdeath,itisnecessaryforapersonwhocanunderstandtheperson'ssituationtoarrangevariousservicesandmakearrangementsforcontractsandcareinsurancesystemonlyexternalizeddirectcare,whiletheindirect,so-calledmanagementportionwasleftasafamilyrole.Especiallyafterdeath,ithasbeentakenforgrantedthatitshouldbedonebythefamily,andithasnotbeenassumedthatthereisnoonetotakechargeofit.Withoutasupportivefamily,thispartofmanagementisdifficulttocarryout,orpeoplearedeemedunabletomanageandarenotprovidedwiththenecessaryservices,whichisthefiduciaryproblemdescribedabove.Tosolvethisproblem,aprivatebusinesshasemergedthattakesonmanagementfunctionsonbehalfoffamilymembersandiscalledthefidelityguaranteebusiness.Itisnotaserviceprovidedbythelong-termcareinsurancesystem,butratheraprivatebusinessundertakingwhatthefamilydoesfortheelderly(watchover,arrangeandpayfornecessaryservicesonbehalfofothers,post-mortemprocedures).However,duetothefactthatinthepastmajoroperatorshavegonebankruptwhilekeepingtheyandthereisnoadministrativebodytosupervisetheoperationinthefirstplace,sufficientcredibilityhasnotbeenestablishedforthisbusiness.Inaddition,thebusinesscoversawiderangeofrolespreviouslyplayedbyfamilymembers,makingitdifficulttounderstandorexpensiveasacontract.Ithasnotspreadwidelybecauseitcanonlybeusedbypeoplewhohaveacertainleveloffinancialresourcesandunderstandingofcontracts,butitshouldbenotedasanewbusinessareabecausethedemandwillincreaseinthefuture.imilarProblemsAswehaveseen,inbothJapanandChina,thetraditionalstructureinwhichlargederlythathasbecomeimpossibletocarryduetothedownsizingoffamilies.Japanhasintroducedapubliclong-termcareinsurancesystemthatincorporatesaquasi-marketmechanism,makinghomeandfacilityservicesthemselvesavailablenationwide(However,thereareregionalvariations,andtheshortageofcareworkersandimprovedtreatmentareconstantchallenges).Inotherwords,thepartthattakescareoftheelderlyonadailybasishasbeenexternalized.TheproblemnowinJapanisthatthereisanincreasingnumberofcasesinwhichthereisnochildgenerationwhoissupposedtobeingservicesandmanagementfunctionsrelatedtocontractsandpaymentsonbehalfofthosewhoarementallyandphysicallyimpairedandneednursingcare,orwhoarenotinaposition(disabled,whereelderlyparentshavebeensupportingchildrenwhoarenotoraredifficulttobeindependentformanyyears(referredtoasthe8050problem),itbecomesnecessarynotonlytoarrangecarefortheelderlybutalsotoarrangesupportmeasuresforthechildren'slivesinthelightofthefactthatiftheparentgenerationfalls,thechild'slifewillnotbepossible.rvicesareexpectedtoenhancemeasurestosupporttheelderly,butweshouldassumeinadvancewhopeopleedforhumansupportandaresometimesonthesideofhelpingothers)cometoneedit.Especiallyinareaswithmanyservicesandforthosewhocanaffordthem,thereisariskthatifmanagementfunctionsarenotperformedwell,thesituationwilldeterioratewithoutsupportfromanyone.3.InformationLinkageMechanismstoSupportDecision-makingreRequiredAnindividual'slifeisnotpossibleifheorsheisingoodphysicalandmentalingcareinevitablytendtobethefocusofattention,butinlife,housing,theenvironmentpets,andsometimestheyplayamajorroleinsomekindofbusiness(Chart10).Ifsomeoneisnolongerabletocarryouttheseactivitiesonsomeone'sown,onlythedailymanagementandmaintenanceofthemind,body,residenceandenvironmentcanbesupportedbymedicalandnursingservices.atmakeupourliveseparedbytheJapanResearchInstituteEspeciallyafterdeath,itisnotonlytheendofcremationandburial,butalsotheredistributionofthepropertyandsocialrolethatleadstothedeathoftheperson.[*]viiiRatherthanendinganengagementwithaphysicaldeathandadeathreport,follows.(2)UsingServicesandMaintainingQualityofLifeisaProblem-Asmentionedabove,ourlivesconsistofmultipledomainsandactivities.Iftheycannolongerdoitthemselves,theywillusealternativemeanstocontinuetheiractivitiesineachareaorprocesstheirtermination.Continuingorterminatingtheactivitiesofeachdomainisaproblem-solvingprocess.Dailyexamplesshowthatwhentheproblemofhungerarises,eatingriceisthesolution(Ifthereisaproblemthattherearenotenoughingredientsinthefood,youcansolveitbygoingshopping.).Theproblem-solvingprocessandthebarriersthatcanariseinitcanbeillustratedinFigure11.First,itisnecessarytorecognizesomechallenges,thenconsiderandselectasolutionandevaluatewhetherthedesiredsolutionhasbeenachieved.Ifitwasn'tthesolutionyouwanted,you'dhavetogobacktothebeginningandfixtheproblemagain.blemSolvingProcessandBarrierscePreparedbytheJapanResearchInstituteIfyoustumblesomewhereinthisprocess,youcan'tsolvetheproblem.Elderlypeoplewithoutdependablerelativestendtohavedifficultyinthisproblem-solvingprocess.difficultyinrecognizingataskForexample,ifyouliveclosetoorlivewithyourchildrenandhaveagoodwillhaveachancetotellthemthatithasbeendifficulttopreparemealslately,andtheywillhaveabetterchancetonotice.Withoutthese"peopleclosetoyou,"youoftendon'tnoticethetaskandmaynotevenbeabletogettothepointofsolvingit.andselectionofsolutionsTheemphasisintheJapaneselong-termcareinsurancesystemisonself-determination,andratherthan"measures"inwhichthegovernmentdecidesonthecontentofservices,thepremiseofthesystemisthateachindividualmakeshisorherownindependentjudgment,choosesand"contracts"necessaryservices,andusesthem.It'sjustnoteasytodo.Whenitcomestopreparingmealsalone,therearemultiplealternativessuchashavingahelperathomehelpwithcooking,usingamealdeliveryservice,orbuyingataconveniencestore.Caremanagerscanbeservicesarenottheonlygenreinwhichalternativesmustbetaken.Itisextremelytaxingtoconsiderandselectsolutionsonyourownforallareas,includingcremation,funeralandburialofyourbodyafterdeath.Implementationandevaluationofsolutions)Itisalsonecessarytomakepaymentsaftersigningacontractandreviewitifyouaredissatisfiedornolongerneedit.Again,thiscanbedifficulttodoonyourown.Notonlyaretheelderlyconcernedthattheycan'taffordtopayifaguarantorisemselvesInfact,itisnotuncommonforthedeathofsomeonewithoutafamilymembertoresultinunpaidmedicalandinstitutionalfeesjustbeforethepersondied.Inoldage,therearestumblesatvariouspointsintheproblem-solvingprocess,whichcanleadtoproblemssuchasnotbeingabletosortoutgarbageandthrowitaway,ornotgettingenoughnutritionbecausecookingisdifficult.Asaresult,itisnotuntilthegarbageoverflowsoutsideorthepersoncollapsesduetomalnutritionandistransportedthatitisdiscoveredthatthepersonisunabletodisposeofthegarbageorcook,andthelocalgovernmentintervenes.Thisisthe"onepersonyproblemmentionedearlierWewillifficultiesoflivingwithoutsomeoneclosetohelpyouinyouroldage,nottheneedorneedofa(3)SeniorsNeedInformationtoAccessServicesandMaintainQualityofLifemayworkforindividualcases,butit'snotsustainableinasocialcontextwherefam