【世界の介護事情】介護先進国はどーこだ?!
新型コロナウィルスの流行により、世界の医療事情がニュースで紹介されることも増えました。さて、介護についての世界事情はどのようになっているのでしょうか。この記事では、世界の高齢化率と、各国の介護事情について日本と比較しながら、読み解いていきます。
目次
日本と世界の高齢化率について考えてみよう
介護を必要とする年代は、圧倒的に高齢者です。
まずは、日本と世界の高齢者の割合について考えていきましょう。
ここでは、欧州とアジアをご紹介しますが、いずれも総人口に占める高齢者の割合（高齢化率）は右肩上がりです。
今後も、高齢化率について、その衰えは見られず、ますます増加していくことが予想されています。
世界と日本を比較してみると、欧州でも、アジアでも日本は高齢化率が1位2位を争う順位にいます。次の（図1-1-6）世界の高齢化率の推移のグラフで確認することができます。
また、高齢化率がどの程度の期間で推移していったかも確認しておく必要があります。
高齢化率が7％から14％への移り変わりをどのくらいの期間でみせているのかという結果より、英国が46年、アメリカが72年といった期間を経て高齢化率が挙がっているのに対し、日本はわずか24年という期間で高齢化率が14％に達したことと、なっています。
中でも日本は、その割合が高いことがグラフよりわかります。主な要因として考えられることは、次のような点にあります。
- 日本の医療技術が高度である
- 皆保険制度により、病院にかかりやすい
- これまでの日本人の伝統的な食生活は、脂肪分が少ない
- 健康に対する意識が高い人が多い
その結果、日本は平均寿命が長くなり高齢化率があがっているといえるのかもしれません。
覗いてみよう！海外の介護事情について
ドイツ
少子高齢化が進むドイツでは、高齢化率が2割を超えています。日本と同じような人口動態がみられるようで、厳しい状況下にあります。
世界で初めて社会保険の仕組みを作り、介護保険を導入したのがドイツという国でもあります。
1994年からと、日本よりも早い段階で導入しています。ドイツにおける介護は、「在宅介護」を優先する方針となっており、日本で導入している、「地域包括ケアシステム」のモデルであるとも言われています。
スウェーデン
福祉大国で有名な、スウェーデン。
「ゆりかごから墓場まで」と言う言葉は、イギリスの福祉を例えていますが、スウェーデンはその充実度合より、「胎内から天国まで」と言われる程、行き届いた福祉サービスを、国が提供しています。
例えば、医療であれば、医療費が一切かかることなく、国民が一定の年齢を超えれば、老後生活するのに充分な年金が、国より支払われると言われています。この高齢者福祉の制度は、1970年と早期から実践されてきたと言われています。
イギリス
公的年金の支給額が低いと言われているイギリス。
そのため、年金の繰下げ制度も設けられています。
高齢になっても、ひとりひとりが元気に働くことを国は支援しており、老後のための経済的な基盤づくりをサポートしています。日本と似ている点もありそうですね。
国民保健サービスは無償にて、介護を受けることが可能です。
また、重度の介護者に限定されてしまいますが、国からの介護給付を受けることができます。
イギリスでは、在宅ケアをサポートするためのサービスの充実を図っています。
その一方で、施設等の介護ケアについては、ほとんど注目されていないと言われています。イギリスでも在宅ケアについての対策が進んでいると言われています。
デンマーク
デンマークと言えば、「高齢者福祉の三原則」が世界的に有名です。
高齢者福祉の三原則とは、「これまでの暮らしを継続させながら」、「できることに注目し、残存能力を活用」「高齢者の自己決定権を尊重させ、周りもそれに合わせサポートする」社会作りを行うことを目標としたものです。高齢者福祉の三原則は1982年に高齢者問題委員会と呼ばれる、行政の党を超えた集まりが提案したものです。
デンマークでは、寝たきりの高齢者はいないと言われている程、高齢者介護の分野では、発達している国です。
なかでも、特別養護老人ホームに似たような、『プライエム』と呼ばれる施設が多数存在していました。
しかし、高齢化率が15％を超えてきている現在では、プライエムの新規建設を禁止して、在宅での介護を重視するようになっています。
デンマークの訪問介護のスタッフは、必要なとき、何度でも無料で訪問することができます。また、市や病院が責任を持って、適切な住居・治療を提供する義務も課されています。
アメリカ
アメリカでは、高齢者になり、介護が必要になった際に、利用できる補助的なサービスは存在しません。
一方民間の保険が充実しており、元気なときにこの保険に入っていなければ、医療や介護について、充分なサービスを受けられない場合があります。このように、行政からのサポートが充分でないため、身体が不自由になった多くの高齢者は、自宅で介護を家族に受けることになります。アメリカの民間の保険は値段的にも高いといわれており、経済的な余裕のない方は、十分な介護をうけることが困難であると言わざるを得ません。
低年収の人を対象とした、介護ケアや食事や家事サービスを受けることができる「サポート付き住居」があります。
日本のサポート付き高齢者住宅に似たようなものです。
とは言っても、多くの方が自宅で継続した生活を望むことが多いため、高齢者も暮らしやすい住宅を整備するように行政も動いているようです。
まとめ
高齢化が進んでいるのは、日本だけでなく、主要国も同様であると言われています。中でも日本は、高齢化が進んだ期間が短い経緯があり、高齢社会では介護者も高齢となるため、さまざまな問題が生じている現状があります。しかし、中国やシンガポールなど今後日本よりも短い期間で高齢化が予想されている国も存在しています。各国では、公的サービスと民間サービスがそれぞれ充実している国があり、日本の介護福祉サービスの手本となっているところもあります。
「今後の生活環境が変わる事への不安」や「介護を使って生活をどうデザインをしていったら良いか」など介護は協力体制で成り立っております。 ちょっとでも解決できる、ストレス軽減できる記事を目指し、一つの相談場所のメディアを目指しております。
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