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KMID : 1023720160710020165
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Journal of Welfare for the Aged
2016 Volume.71 No. 2 p.165 ~ p.194
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A Study on the dementia special grade and on the local government’s role for its development
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Lee Kwang-Seok
Lee Hee-Joo
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Abstract
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The erosion of the welfare state has been a much talked-about issue since the 1970s, but the role of a state in welfare is still crucial. The introduction of the dementia special grade can be its proof. It was initiated in July 2014 to prevent functional deterioration of the elderly with mild dementia who need medical care, and to alleviate their families’caregiving burden. However, if we take a close look at the details of this project, several issues arise. This paper deals with the issues. This paper classifies the issues into two categories：the one is related to facility operations and the other is the cognitive programs themselves. This paper concludes that the real problem is that the system was designed without involving local governments although they could have the capacity to participated in the system. As an example, the governor of Gyeongsangbuk-do(the head of local government) has showed an interest in the system, which leads the local government to be deeply involved in it, compared with other provinces. This paper examines whether the case of this ○○ -gun, ○○○-do is applicable to other local governments. This paper tries to find some justifiable examples from the Japanese system and recent changes made in the United Kingdom. On the basis of this perspective, this paper searches for an alternative to the government objectives by suggesting an appropriate project direction, which is a unitary comprehensive system between central government (the enforcing agency, the National Health Insurance Corporation) and local government.
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KEYWORD
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Dementia special rating, long-term care insurance, local governments` dementia Management, Japan`s regional comprehensive support centers, integration of medical and social care in the UK
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