With the aging of the US population, not to mention a long, slow economic recovery, there's reason for concern over how American society will care for a rapidly growing cohort of 80, 90 and 100-year-olds. What can be learned from other nations?
For instance, in Japan, robots are being used to help lift elderly patients in and out of bed. Speech-enabled robots even provide companionship.
In China, the concept of community-based care gave rise to a simple, elegant idea: the "Age Bank" whereby people help one another, keep track of the hours they've spent, and then "withdraw" hours when their own elderly family members need assistance.
Denmark even abandoned the entire notion of government investment in nursing homes, instead relying on a carefully nurtured network of health and community-based services, enabling seniors and frail elderly citizens to remain in their own homes for much longer.
Economics of Long-Term Care Could Improve with More Community Care
Surprisingly, Denmark's long-term care system might be more cost effective than the American pastiche network of nursing homes, assisted living facilities and unpaid family caregivers. Plus, it seems to produce better attitudinal (and possibly health) outcomes for senior citizens and the elderly.
A 2001 analysis in the journal Gerontologist, entitled "Home-and Community-Based Long-Term Care: Lessons From Denmark," by Mary Stuart, professor at the University of Maryland and Michael Weinrich, MD of the National Institute of Health in Bethesda, compared the status of elderly Danish citizens who live in nursing homes with those who remained in their homes. The authors report that that the elderly who weren’t institutionalized “appeared more satisfied with their health and are more confident of their abilities” than did elderly citizens who were living in nursing homes.
They also compared the Danish and American systems in terms of cost, how accessible the services are, and quality of services for the older population. They conclude that the Danish system offers better quality, easier access and lower cost than the American system of care.
Their findings may hold promise for an aging, graying America. After over a decade of experimentation with this new system of integrated, home-and community-based services across a wide cross-section of the nation (fully 275 municipalities), they found that “… growth in Danish long-term care expenditures has leveled off; expenditures appear to be decreasing for the over-80 population and have dropped as a percentage of the gross domestic product. Access to and quality of long-term care services appear to remain generally satisfactory."
During that same period of time, US expenditures on similar services increased while access and quality of care problems continued to plague the system.
American boomers can only dream of being able to say, as one Danish woman reported about her parents, that they receive personal services and whatever medical attention they need. She said, "You just call the municipality and you say ‘I am ill,’ and an assessor determines what services you need. Then you can choose among providers, get home care medical care and home house cleaning, and other services.”
Medicare is hugely popular, but it's not the only good idea for health care for US seniors and older citizens. It would be smart for Americans to consider innovative ideas from abroad, from Asia to Sweden. These models of innovative long-term care innovations may not be "made in America" but they're smart, promising and adaptable.
