On Tuesday last week, a fire broke out at an unlicensed long-term care facility in Taipei’s Neihu District (內湖), leading to the death of three residents. This tragic incident has sparked calls for more thorough inspections to detect unregistered facilities, but also for the establishment of more dormitory-type care homes for older people.
Taiwan will likely become a super-aged society in 2025 and encounter more problems related to elderly care.
Considering the huge amount of money that the government would need to invest in long-term care facilities, is dormitory-type accomodation really the best solution for older people without families?
For those who cannot get accustomed to living in such facilities, should they not be allowed to live their final years in their own homes?
The best solution is to establish coliving communities.
The Japanese government encourages older people to spend their final years in their own neighborhoods.
However, people who are nearing the end of their lives need greater medical care provision. Family members’ ability to provide such care is limited, especially when two older people care for each other.
Shigeru Tanaka, a management professor at Keio University, proposed the concept of a community-based integrated care system.
The Japanese Ministry of Health, Labor and Welfare in 2014 adopted Tanaka’s concept, obliging administrations at the municipality, town and village levels to implement and promote the system.
The community-based integrated care system is based on a culture of public assistance, self-help and mutual aid.
Its most important element is the establishment of coliving communities — in other words, to build a social environment in which all kinds of people can live together.
Conventional hospital healthcare, modern home-based healthcare and the services provided by long-term care providers have their place in the community-based integrated care system. They are the means for putting the idea of coliving communities into practice.
All over Japan, there are non-governmental care services where older people who have no family relationship can live together under the same roof.
In such places, they receive the care they need, including end-of-life care.
For example, Miho Ichihara, who has visited Taiwan on the invitation of the Taiwan Society of Home Health Care, established a hospice called Mother’s House in Miyazaki, Japan, in 2006.
This project is borne from a collaboration with doctors of the Miyazaki Gunishikai Clinics’ palliative care unit and home-based care providers, and has established a place where older people can remain in a familiar environment.
Another example is the White Rainbow House in Yokusuka, Japan, a community care space established by Jun Chiba and his wife, who is a nutritionist.
Taiwan, too, has many examples of community coliving.
The government should stop restricting the growth of care resources due to the focus on institutional care facilities.
Instead, it should encourage and foster coliving communities that make their residents truly feel at home.
This model of care can enable residents and caregivers to develop relationships similar to those of family members, and older people can walk the last mile of their lives in familiar communities.
Lo Pin-shan is the deputy secretary-general of the Taiwan Society of Home Health Care.
Translated by Julian Clegg
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