NIRA Research Report No. 20000003
A Resident-Focused Study on Nursing Care Insurance and the Formation of Housing Complex-type Welfare Communities
Starting in April of 2000, the new nursing care insurance system (NCIS) will be implemented. This system, broadly significant in that it approaches the nursing care problem as a national issue, aims at a shift "from family-centered nursing care to socially supported nursing care."
The present study, in step with the implementation of the NCIS, examines the Otokoyama Housing Complex in Yawata City, Kyoto Prefecture, as an example of a large-scale rental housing complex managed by the Housing Corporation. While investigating the issues and present state of the housing complex community, this study aims to propose appropriate measures for combating the worsening of the nursing care and aging-society problems.
Upon examining the Otokoyama Complex, it is apparent that residents who moved in upon completion of construction will all enter their golden years at roughly the same time, and the gravity of the nursing care problem to come can thus be predicted. At the same time, it has become clear that as a result of the tightness of living space, the rate of tenant movement is high, creating a barrier to human relations and greatly impeding the formation of a close-knit community.
However, on a brighter note, it has also become clear that the neighborhood association, formed directly after the construction of the complex, has played an important role in improving living conditions and promoting community spirit. Moreover, with the recent formation of a school district welfare committee, the future prospects for development of local welfare activity are good.
In the present study, with these tendencies in mind, we propose the concept of a "housing complex-type welfare community." This is an extension of the goal of the NCIS to "build welfare communities that anybody can continue living in indefinitely."
Furthermore, in order for the NCIS to take hold in society and become effective in future, we consider the following three items to be important issues: 1) establishment of global and comprehensive regulatory laws to prevent excessive commercialization of nursing care; 2) formation of regional nursing care systems; and 3) provision of living conditions which facilitate home-based care. In addition, in the case of housing complexes, a fourth item we consider to be essential is the resolution of the living-space crunch and improvement of incentives to settle permanently in one community. In relation to the NCIS, this fourth issue is unique to housing complex communities.
We point out that in particular, in housing complex communities, because they are a sub-rank of the overall municipal nursing care system, it is important to develop regional health welfare in terms of communal care among citizens, and that this activation is an important issue for the entire municipal nursing care system.
We recommend, as a strategy for reforming the living conditions in housing complexes, moving toward realization of living conditions which enable movement of residence at the family level within the community and an environment friendly to home-based care for elderly citizens requiring nursing care. Further, as we propose an overall plan for the housing complex-type nursing care system, we will clarify the concrete direction of regional health welfare activities befitting housing complexes.
Finally, we have estimated the grace period before the Otokoyama Complex reaches the level of "ultra-aged" society to be about 10 years. During this important period, the prospect for "housing complex-type welfare communities" can be realized by a process of cooperation between Housing Corporation housing complexes and their residents, the reform of living conditions and implementation of local health welfare activity.
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