Page 143 - GHES-2-1

Global Health Econ Sustain Elderly people with dementia

are not adequately accessing hospitals and facilities where of respondents who reported a lack of a certain level of
hospitalization is available, indicating insufficient support education suggest either a certain level of education among
for family caregivers of elderly patients with dementia the Japanese population or circumstances forcing them to
(Basnyat & Chang, 2021). The finding suggests that an live alone despite having dementia. Singapore exhibited
adequate social support system is not yet in place. the shortest duration since diagnosis, possibly due to
regional characteristics and facility conditions, such as the
Among the three regions, Hong Kong exhibits the
strongest sense of caregiving burden. As shown in Table 3 availability of medical facilities for the surveyed population
and efforts to improve the national health checkup uptake
regarding coping behavior, Hong Kong demonstrates the
highest values for emotion-oriented and problem-focused rate. The scale survey data revealed that functional
strategies. This finding not only indicates a high sense assessment and instrumental activities of daily living
of burden in the country but also a substantial response exhibited similar values across all three regions. However,
to it. In addition, Japan shows the highest score for Japan demonstrated the highest level of functionality,
dysfunctional coping strategies, followed by Hong Kong. suggesting that its surveyed population is not bedridden or
Despite Japan’s universal health insurance and long-term in any other serious condition requiring care at home. On
the other hand, Japan attained the highest MMSE score,
care insurance systems, families may perceive caring for indicating the most advanced cognitive status among the
a family member with significant dementia symptoms as three regions. However, it is worth noting that MMSE may
highly burdensome. However, the enhancement of these not be the most suitable tool for estimating the cognitive
systems can be viewed as an enhancement of coping
strategies for family members. state of a population, thus constituting a limitation of this
study. Despite this limitation, the survey data were obtained
Hong Kong and Singapore exhibit the highest cultural through face-to-face interactions with each research
awareness regarding support for the elderly, while Japan subject, enhancing its credibility in evaluating individual
shows the lowest. Within regions sharing religions and subjects. While this approach presents a limitation, treating
philosophies akin to Confucian countries, disparities in individual data as an aggregate is a unique aspect of this
concepts such as self-help, mutual aid, and public assistance study. Although it is a quantitative survey, the methodology
arise due to variations in national policies and systems. involves interviewing family caregivers of elderly patients
Notably, Japan ranks lowest among the three regions in with dementia individually, thus elevating the accuracy of
terms of awareness regarding mental health issues. This MMSE data by treating them as individual assessments
situation may stem from a cultural lack of emphasis on rather than group assessments. One possible influencing
caregiving for elderly parents, potentially resulting in a low factor is that hospitals and other facilities surveyed in
awareness of caregiving responsibilities and a high level of Japan may have focused more on family members caring
negative perceptions surrounding mental health. for elderly dementia patients with apparent dementia
However, more than 80% of elderly patients with symptoms due to their specialization in dementia care. In
dementia at home were in the early or middle stages addition, the data revealed that problematic behaviors were
of dementia, mainly in their 80s. Women comprised most frequent in Hong Kong, with Japanese caregivers
60 – 70% of the respondents, with the highest percentage exhibiting the highest stress response to these behaviors.
of those living alone found in Japan, at approximately These findings suggest that Japanese family caregivers
20%. One contributing factor may have been the targeting experience heightened stress responses to problematic
of dementia hospitals with dementia specialists during behaviors. In dementia care, when cognitive symptoms
the setting up of the survey request. The prevalence of progress while physical functions remain intact, caregivers
diabetes among elderly patients with dementia, a lifestyle- feel burdened by verbal aggression and wandering behavior,
related disease, was high in all three regions, ranging from which can lead to mental and physical exhaustion. It can be
30 to 40%. The percentages of patients with psychiatric said that attention must be paid to the individual nature
disorders in their families were 12.2% and 5.6% in Hong of caregiving. Although these data were from just before
Kong and Singapore, respectively, whereas it was 0% in the COVID-19 pandemic, some reports indicate that the
Japan. Significant differences were observed in the number pandemic increased the sense of burden for caregivers and
of years since the diagnosis of dementia, ranging from 1 was not dependent on the severity of dementia (Cohen
to 5 years, between Hong Kong and Japan, Hong Kong et al., 2020).
and Singapore, and Japan and Singapore. These results The percentage trends of the attributes of caregivers
indicate few differences in the age and gender of elderly and elderly patients with dementia across all three
patients with dementia between regions. However, the regions were remarkably similar, suggesting that these
high percentage of those living alone and the absence three regions share comparable levels of economic

Volume 2 Issue 1 (2024) 14 https://doi.org/10.36922/ghes.1954