The Ministry of Health and Welfare has conducted a review of the Long-term Care Services Program 2.0, which it implemented nearly a year ago. Judging from the issues listed in the review, it is clear that the plan has fallen short.
The biggest problem with the plan is that it actually exacerbates the problem. I work in the field of dementia care and I often visit older people.
A while ago I visited an old lady with dementia who spent her days alone at home. I found a small table covered with discarded lunchboxes, fruit and garbage. When I opened a lunchbox, I could smell rotting food. There was a note with “be sure to take medicine” written on it; the medicine next to it was left untouched. When I asked if she had taken the medicine, she scratched her head and said that she had no idea, and then grabbed the pills and swallowed them.
It is people like this woman, with dementia and living on their own, who are most in need of home care services. However, a few weeks ago her family’s application for home care was rejected, because she was assessed as being mobile and sufficiently able to interact with others. Such a decision would not have happened under the previous long-term care plan.
She was unable to receive the home care service her family applied for because, first, the program uses the Care Management Assessment Scale (照顧管理評估量表) to assess home care needs, which does not cover cognitive impairments due to dementia. Second, a care management center is responsible for providing home care if needed. Third, the program is out of touch with doctors, who are often not consulted, and when they are, their advice might go unheeded or even be contradicted. Fourth, each care manager is responsible for several hundred cases; they are overloaded with work. Finally, the program does little to address a serious shortage of caretakers.
The program seems to be missing a vital point: While it is good for older people to get out of the house, it ignores that those who need long-term care the most are those who are unable or unwilling to go out.
The program’s three-tier structure unnecessarily complicates the situation. Many seem confused about the changes, and few seem to have a clear idea of the nature of the service they are supposed to be providing. As for slow payment of departments in charge, this is a common problem inherent to the tax system. The program promises to address this, but in this it is doomed to failure from the start.
The ministry has begun setting up dementia care platforms nationwide. Dementia care is, and always has been, the most important aspect of long-term care and should be addressed as such in the program. However, with management centers unable to cope, separate arrangements have had to be made.
In the beginning, the program’s slogan was “transparent and useful.” A year on, it looks as if that slogan should perhaps have been “fathomless and useless.” The families that need long-term care have had to resort to gathering money from relatives to pay for foreign caretakers or foregoing their studies and careers to devote themselves to caring for their aging parents.
Clearly, the Long-term Care Service Program 2.0 is inadequate to meet the needs of an aging society. The government needs to act.
Shen Cheng-nan is a practitioner of geriatric psychiatry.
Translated by Lin Lee-kai
Recently, China launched another diplomatic offensive against Taiwan, improperly linking its “one China principle” with UN General Assembly Resolution 2758 to constrain Taiwan’s diplomatic space. After Taiwan’s presidential election on Jan. 13, China persuaded Nauru to sever diplomatic ties with Taiwan. Nauru cited Resolution 2758 in its declaration of the diplomatic break. Subsequently, during the WHO Executive Board meeting that month, Beijing rallied countries including Venezuela, Zimbabwe, Belarus, Egypt, Nicaragua, Sri Lanka, Laos, Russia, Syria and Pakistan to reiterate the “one China principle” in their statements, and assert that “Resolution 2758 has settled the status of Taiwan” to hinder Taiwan’s
Singaporean Prime Minister Lee Hsien Loong’s (李顯龍) decision to step down after 19 years and hand power to his deputy, Lawrence Wong (黃循財), on May 15 was expected — though, perhaps, not so soon. Most political analysts had been eyeing an end-of-year handover, to ensure more time for Wong to study and shadow the role, ahead of general elections that must be called by November next year. Wong — who is currently both deputy prime minister and minister of finance — would need a combination of fresh ideas, wisdom and experience as he writes the nation’s next chapter. The world that
Can US dialogue and cooperation with the communist dictatorship in Beijing help avert a Taiwan Strait crisis? Or is US President Joe Biden playing into Chinese President Xi Jinping’s (習近平) hands? With America preoccupied with the wars in Europe and the Middle East, Biden is seeking better relations with Xi’s regime. The goal is to responsibly manage US-China competition and prevent unintended conflict, thereby hoping to create greater space for the two countries to work together in areas where their interests align. The existing wars have already stretched US military resources thin, and the last thing Biden wants is yet another war.
Since the Russian invasion of Ukraine in February 2022, people have been asking if Taiwan is the next Ukraine. At a G7 meeting of national leaders in January, Japanese Prime Minister Fumio Kishida warned that Taiwan “could be the next Ukraine” if Chinese aggression is not checked. NATO Secretary-General Jens Stoltenberg has said that if Russia is not defeated, then “today, it’s Ukraine, tomorrow it can be Taiwan.” China does not like this rhetoric. Its diplomats ask people to stop saying “Ukraine today, Taiwan tomorrow.” However, the rhetoric and stated ambition of Chinese President Xi Jinping (習近平) on Taiwan shows strong parallels with