Japan grapples with ¥14.5 trillion dementia costs

The cost of providing health and social care for the nation’s dementia sufferers totaled ¥14.5 trillion in 2014, with nearly half of the cost borne by families, a health ministry panel said Friday.

The ministry said it was the first ever detailed estimate of the cost of the condition, which affects more than 4.5 million people nationwide.

The government is encouraging a shift from institutional care to home care for elderly dementia patients as a way to curb the demand on government-run nursing care insurance, which has grown to around ¥10 trillion per year. But the study suggests that without strengthening home nursing care services covered by government insurance, the result will be that households are forced to assume even more of the cost and responsibility.

It is difficult to compare the situation with that in other countries because methods of measurement differ. However, dementia cost Britain around ¥3.9 trillion in 2013 and the United States ¥17.5 to ¥24 trillion in 2010, according to the study group at the Ministry of Health, Labor and Welfare.

The 2014 cost of ¥14.5 trillion in Japan is broken down into ¥1.9 trillion for medical services, ¥6.4 trillion for institutional nursing care and ¥6.2 trillion for care provided by family members, the study shows.

The group projects the social cost will balloon to ¥24.3 trillion in 2060 when the children of baby boomers are aged 85 or older.

“The challenge is how we can improve the quality of life of patient and family members with limited financial resources,” said Keio University assistant professor Mitsuhiro Sado, who chairs the group.

The ministry estimated that the number of people aged 65 or older with dementia in Japan will increase from 4.62 million in 2012 to 6.75 million to 7.3 million in 2025, which translates into roughly 1 in 5 elderly people.

The ministry study showed that the per-patient cost of care at an institution came to ¥3.53 million per year. At home, however, the outlays were greater, comprising ¥2.19 million paid to home nursing care providers and ¥3.82 million in an estimated value of care offered by family members.

Toshio Nakanishi, 62, who takes care of his wife Miyuki, 62, at home in Uji, Kyoto Prefecture, says that he feels the estimated bill of ¥3.82 billion for care by family members is not accurate.

“I feel like it is much higher,” he said.

Nakanishi says he has been looking after his wife, who was diagnosed with Alzheimer’s in April last year, almost around the clock. He only has respite three times a week, when she goes to day-care facilities.

Nakanishi, who is retired, asked the couple’s 32-year-old daughter to quit her job and join him earlier this year in caring for her mother.

For the study, the costs of medical and institutional care were calculated based on health insurance claims, while the home care figure was produced from a survey of 1,482 people through the referral of health care institutions and support groups.

They were asked about the time they spent and the type of care they engaged in during a week, and these figures were then given a monetary equivalent value.

Financial costs of providing nursing care were computed and added together, using average wages based on gender and age group.

The Ministry of Internal Affairs and Communications has estimated that 100,000 people are quitting their jobs each year to care for sick family members.

Atsushi Nishida, a researcher at the Tokyo Metropolitan Institute of Medical Science who is familiar with public dementia policies overseas, calls for new measures to enable workers to provide care without leaving their jobs.

“Japan is projected to lose working population as its birth rate is far lower than those of other countries,” he said. “Unless we take steps to make work and nursing care compatible, the country’s economic might will further decline.”