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In Sweden, responsibility for the public care of the frail elderly rests with three authorities acting at different levels. At national level, the Riksdag and the Government realize policy goals through legislation and financial control measures. At regional level, 18 county councils and two regions are responsible for the provision of health and medical care. At local level, Sweden's 290 municipalities have a statutory duty to meet the social service and housing needs of the elderly. Sweden's municipalities and county council have a high level of autonomy by international standards. Activities in caring services are ultimately controlled by politicians appointed to policy-making assemblies in municipalities and county councils through general elections. The decentralization of responsibility for elderly care makes it possible for local and regional conditions to be taken into account when policies for the elderly are formulated. The national authorities – the National Board of Health and Welfare and the 20 county/region administrative boards – are responsible for supervision, follow-up, and evaluation of municipal and county council caring services.

Scholars have explained how people in Japan feel ashamed when elderly members of the family are cared for by formal services such as day care or government/commercial-based nursing homes due to the cultural norms of the consciousness of social appearance. However, this consciousness of social appearance plays a minimum role when it comes to elderly Japanese immigrant women's preference to utilize formal care services in the United States. They see receiving family based care as a burden on their middle-aged children (or grandchildren) and they prefer purchasing formal long-term care services when they can no longer feel confident about maintaining their independent lives. Elderly Japanese immigrant women hold rather positive views on formal care in the United States, including nursing homes. This chapter suggests that elderly Japanese immigrant women may not consider it shameful to utilize formal care as many previous scholars have suggested.

Purpose – The objective of this research is to know the correlation of stress level with the degree of depression in the elderly at a nursing home in Lhokseumawe in the year 2017.

Design/Methodology/Approach – This research is analytic using a cross-sectional approach with a total sampling method. The total number of samples was 55 respondents.

Findings – The results showed that the elderly in a Lhokseumawe nursing home at average are at mild stress level to medium degree of depression. Pearson correlation test results show that there is a correlation between stress level and degree of depression in elderly in the Lhokseumawe nursing home in 2017 with medium strong relationship (r = 0.406; p = 0.002).

Research Limitations/Implications – We expect that the elderly living in the orphanage avoid negative thinking about themselves and the future, eliminating feelings of guilt or regret about past mistakes, taking adequate rest and maintaining a diet to avoid stress so as to prevent the onset of depression.

Originality/Value – In addition the study increases the theoretical understanding of the correlation between stress level and degree of depression in elderly at nursing home.

This chapter will review the evaluations of the newly developed elderly care system in Japan, Long Term Care Insurance, and its social implications with the focus on demographic change.

By reviewing literature, this chapter will examine how demographic and social change over the years has impacted the features of caregivers. Then, how this policy change has demedicalized the aging process will be described. Finally, this chapter will evaluate whether this insurance has shifted the responsibility for elderly care from the family to society as the governmental slogan advertised.

The new insurance has offered more options in different services and established a new norm of self-reliance and determination for one’s own aging however it is doubtful if this new insurance has shifted the responsibility from family to society.

Applying the implications of policy reforms for elderly care in Japan to the United States, one can assume the traditional U.S. norms and values can facilitate effective utilization of the elderly care system. However, since each nation faces different problems with its specific condition, continuous studies and observations on the relationship between elderly care, immigration issues, and demographic changes will be necessary in order to offer more specific suggestions for each aging nation.

As Japan’s new insurance scheme for the elderly has been studied by many aging nations, recommendations for more comprehensive plans are suggested including building a community-based support system into the Long Term Care Insurance scheme to prevent social isolation and respond to emergency situations for the elderly.

In recent years a great deal of time and resources have been devoted to understanding poverty in general and elderly poverty in particular. This paper uses a panel data set spanning the years 1980–2001 to investigate the impact of certain economic and demographic factors on overall, non-elderly, and elderly poverty. We also investigate the robustness of income-only poverty measures when the threshold income level is altered.

This paper considers the effects on current pensioner incomes of reforms designed to improve the long-term sustainability of public pension systems in the European Union. We use EUROMOD to simulate a set of common illustrative reforms for four countries selected on the basis of their diverse pension systems and patterns of poverty among the elderly: Denmark, Germany, Italy and the UK. The variations in fiscal and distributive effects on the one hand suggest that different paths for reform are necessary in order to achieve common objectives across countries, and on the other provide indications of the appropriate directions for reform in each case.

A review of the literature on the Filipino elderly reveals that social and cultural expectations of filial duty and obligations are still strong in the Filipino family. Filial piety based on the concept of “utang na loob” or debt of gratitude to parents, and respect for age are important traditional Filipino values as evident in the support given by children to their parents, and in the words and practices showing deference to the older generation. Studies have shown that the most common living arrangement of the elderly is co-residence with children or to have at least one child living close by in the neighborhood. With the generally poor economic well-being of the elderly, they rely heavily on their children both in the Philippines and abroad for support. Caregiving of the elderly is family-based with the children, particularly the daughters, as major providers of care and assistance to maintain their physical well-being. Studies have also shown the importance of intergenerational solidarity for the social well-being and mental health of the elderly through constant communication and visits, with a two-way flow of economic and emotional support between parents and children. Institutionalization of the elderly appears to be a last resort to complement rather than replace the welfare function of the family.

For future research, it is recommended that government laws benefitting the elderly and their implementation be analyzed, including the most effective way to reach those in remote areas in order to disseminate information on their benefits. Studies should also be done to develop programs for caregiving training and incentives, on ways to uphold standards and monitor the quality of facilities of private retirement homes, to establish more government homes or home-care services for the indigent who needs long-term care. It is also recommended that studies on geriatric centers and facilities be done to ensure high-quality of elderly care.

Since health behaviors of elderly Asian Americans are often underreported, the study, based on the health behavioral model (Andersen’s model), was to examine if there is a reciprocal relationship between healthcare utilization and health outcomes, and how social characteristics play their role in this relationship between US-born and foreign-born elderly Asian Americans.

Using structural equation modeling, this research examined the proposed hypotheses which consisted of direct and indirect effects among health outcomes, healthcare utilization and social characteristics, as well as the disparities of the effects between US-born and foreign-born elderly Asian Americans (65 + ). A sample size of elderly Asian Americans was divided into a US-born group (N = 1,305) and a foreign-born group (N = 4,902) from the National Health Interview Survey (NHIS) 1998–2012. Health outcomes consisted of current health status and health change. Healthcare utilization included general doctor visit, ER, and mental health professional visit. Social characteristics of population included predisposing characteristics (such as age, sex, marital status, and region of residency) and enabling resources (such as education, family size, and family income).

Results from the study indicated that first, there was a reciprocal relationship between health outcomes and healthcare utilization for both groups. Second, predisposing characteristics had a direct effect on health outcomes, and enabling resources had an indirect effect on health outcomes via healthcare utilization. In addition, living in the West had both direct and indirect effects on health outcomes. Third, regarding disparities of the effects between both groups, the US-born elderly are more likely to attain health benefits from healthcare utilization and their social characteristics than the foreign-born. As a result, the interactive relationship between health outcomes, healthcare utilization, and social characteristics, as well as disparities of healthcare outcomes through health utilization and social characteristics for elderly Asian Americans is highlighted.

First, due to the design of NHIS, this research was limited to fully present the needs and more characteristics of elderly Asian Americans. This shows the great need for a large scale, representative study for health behaviors of elderly Asian Americans. Second, in the dataset, the study was limited to explore health behaviors of elderly Asian Americans into each Asian ethnic subgroup. Since the culture of Asian Americans is heterogeneous, it is recommended that future research can explore differences and commonalities of the health behaviors between Asian subgroups. Third, based on the health behavioral model and the design of the dataset, this study was limited to illustrate variations of life experiences between both groups. These differences regarding their needs and desires for healthcare services and health outcomes can become an important foundation for service providers and policy makers to provide appropriate services that improve the quality of the later lives of elderly Asian Americans.

First, the study applied the health behavioral model and proved that the effect of healthcare utilization and social characteristics on health outcomes is greater for the US-born elderly Asian Americans than for the foreign-born. Second, this study confirmed that the healthcare services in US society are still beneficial for the health outcomes of elderly Asian Americans. Third, the study found that when family is used to explain the social behaviors of elderly Asian Americans, researchers need to be more careful to identify various family factors in accordance to its dynamics, such as interpersonal relationship, material supply, and emotional support.

Care for the elderly is the most pressing problem now facing Japan. For maintaining a long and healthy life, it is important to refine the self-care of people and to create a well-balanced system of support involving health care, welfare, nursing care, and medical treatment. Mutual support within each local community is also indispensable for restructuring care-minding areas. Due attention should also be paid to the ethical aspects concerning care of the elderly. This chapter attempts to reflect on the brief history of the care for the elderly in Japan.

Based on the data from “Thousand village surveys” project of Shanghai University of Finance and Economics, we employ the ordered logistic method to do the empirical analysis on consumption, life and satisfaction (subjective well-being) of Chinese rural elderly. First, the result shows that the consumption (exclude medical expenses) has positive effect on the satisfaction of Chinese rural elderly, while the rural elderly are not preferred to compare with others. Good participation in social life and medical care condition could enhance the satisfaction of rural elderly. Second, the authors divided the sample into two groups as high-consumption group and low-consumption group. The result shows that the low-consumption group more tend to rely on their family members than high-consumption group. The authors suggest that in order to improve the rural elderly life satisfaction, the government needs to improve medical care system.