E. Long-term Care
In principle, long-term care is to be provided by two kinds of institutions the Nursing Homes for the Elderly and the Health Care Facilities for the Elderly (HCF). Due to the serious shortage of beds in these long-term care institutions, a special type of hospital or hospital ward also provides long-term care for the elderly.
a) Nursing Homes for the Elderly
The Nursing Home for the Elderly ("Tokubetsu Yogo Rojin Hoh-mu" in Japanese, literally translated, "Special Nursing Home for the Elderly") is a long-term care institution which belongs to the category of welfare institutions. Those who want to use this institution should apply to the Welfare Bureau of the Local Government. The Welfare Bureau assesses the physical and mental conditions of the applicant and decides whether or not the application should be accepted. However, because of the serious shortage of Nursing Homes, especially in the large metropolitan areas, Tokyo, Yokohama, Nagoya, Osaka, and the like, even if the application for admission is accepted, the applicants have to wait for a long time before being actually admitted.
In principle, the running costs of this type of institution are born jointly by the State (1/2) and City Government (1/2). When the placement for admission is done by the Township or Village, the running costs are born jointly by the State (1/2) and Prefectural Government (1/2). The costs for the construction of Nursing Homes for the Elderly are jointly born by the State (1/2), Prefectural Government (1/4), and the establisher (1/4).
The client as well as the relative who is legally responsible to support and care for the client are charged in accordance with the Law for the Welfare of the Elderly. The administrative definition of the responsible relative is, however, very lenient. The charge is actually imposed only on the spouse or child who was living together in the same household, when the decision of placement is done by the Local Government. The amount of charge is decided according to income. Savings are not taken into consideration, though the interest from savings is regarded as income. The calculation method of the amount of charge is very complicated. It can safely be said that, generally speaking, the amount of charge imposed on the responsible relative is significantly less than the amount of money he/she has to bear when he/she supports and care the client at his/her own home. At present (October 1, 1996) there are approximately 236,000 Nursing Home beds throughout Japan.
