The majority of the public’s and media’s attention is focused on the government’s make-or-break pension reform legislation, which aims to avert a budgetary crisis by reducing social security expenditure, yet what steps is the government taking to prepare the nation for the looming aging crisis? The numbers make for worrying reading.
A study published on Monday by the Ministry of Health and Welfare forecast a sharp rise in the number of dementia patients. The ministry estimated that by 2031, the number of people with dementia would have nearly doubled from an estimated 270,000 people last year to 460,000, or 2 percent of the population. By 2061 this number is projected to rise to 850,000, or 5 percent of the population.
To make matters worse, Taiwan has one of the fastest-aging populations in Asia due to its declining birthrate. According to National Development Council data, Taiwan will this year become an aged society — meaning that 14 percent of the population is aged over 65 years old — and a super-aged society in 2026, when the percentage of people 65 or older is expected to reach 20 percent.
By 2060, Taiwan’s population is forecast to shrink by 4.9 million people, creating an inverted population pyramid. The zero-to-14 age bracket would decrease by 1.4 million and the number of 15 to 64-year-olds would shrink by 7.6 million. The population of people aged 65 or over would increase by 4.1 million.
This begs the question: Who will look after Taiwan’s elderly?
In 2016, the government introduced a 10-year long-term care plan, dubbed the Long-term Care Services Program 2.0, which expanded subsidized care for the elderly and disabled.
However, although the government aims to supplement funding for the program through increased inheritance taxes and additional levies on tobacco, the program is still expected to face serious funding shortfalls as well as staffing shortages due to the declining working-age population.
An additional complication is a general aversion to the use of care homes. Due to the influence of Confucian values on Taiwanese culture, a majority of the public prefer to care for elderly family members in their homes. Providing long-term care for the majority of households — not just in cities, but also rural areas — would be problematic. There either needs to be a cultural shift or new methods of care provision should be found.
The good news is that an innovative solution is being developed by Chunghwa Post, which last year launched home care services for elderly people. The company, which has 1,300 offices nationwide, is well-placed to provide home care services. As of October last year, 12,000 delivery personnel had volunteered to provide services to elderly people who live alone.
Fortunately for Taiwan, Japan, which is already a super-aging society, has been grappling with the problem for many years and its model is worth exploring. The Japanese government has adopted a two-pronged approach: relaxing controls on immigration and funding the development of robot carers.
As of March, Japan has spent ¥5.2 billion (US$47.4 million) on introducing robots at 5,000 facilities nationwide. Robots are designed to complement, not replace, human carers by saving time and labor, providing mobility assistance, performing heavy lifting and carrying out monitoring.
The latest study on dementia shows that the Taiwanese government cannot afford to rest on its laurels. More time and resources must be spent now to develop solutions for long-term care and defuse the ticking demographic time bomb before it is too late.
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