1. Let's talk about housing for Seniors What is service added housing for the elderly? October 24, 2015 (Saturday) Sapporo International Plaza ： 10 ： 00 ～ 12 ： 30 Anshin Sumai Sapporo Senior Advisor: Keiko Nishihara

2. Situation in Japan Medical and care services are relatively well provided, while their life span is the longest. Senior demography has been increasing. Life during the senior period. Kaigo Hoken (long-term nursing care insurance) covers up to 90% of the cost of long-term care services required. (One must submit an application in order to use it!)

3. Medical Care to Home Care World Trend for Seniors District Inclusive Care→Housing Care service for seniors (not relying on hospitals or other facilities) Deathbed→natural/calm death outside of hospital →no prolongation of life treatment = system in common with Western countries →change from treatment to care trend ・ Dementia care→continue daily life as usual →maintain lifestyle as much as possible →guardianship system for elders

4. District Inclusive Care System -To make our living possible in familiar surroundings even though we require constant care until the end. -Inclusive Care System offers housing, medical services, prevention, and living care support. -Target Year 2025

5. Objectives of Inclusive Care System Decreasing birthrate and aging population Total control over Social Security expenses Reform in medical services Reduction of hospital beds Care at housing w/services or at home Apply only to severe/dementi a cases Insufficient number of care givers Payment reduction of Kaigo Hoken Mutual support for low degree care

6. Types of Housing Fee-based homes for the elderly With Care 67 Residential 72 Group Home (dementia only) 240 Senior Housing with care service 165 Other than above (for seniors) 200+ Data for Sapporo, September 2015

7. Housing with Care Services Confirmation of safety Adviser for living condition Emergency handling Meal service Bathing Care covered by Kaigo Hoken Enforced October 2011

8. Living quarters for housing with care service Essentials （ standard ） toilet closet washbowl room space

9. Exterior views Small scale Large scale

10. Dining Room All dine together as a general rule. Food Menu is posted. After meals, may proceed to the parlor (large TV screen provided)

11. Individual rooms

12. Toilet

13. closet

14. Bath Public Individual

15. Washstand

16. Other facilities Haircut Laundry

17. Other entertainment Chatting corner Mahjong room

18. Understand important differences Costs （￥ 120,000 ～ 230,000 ） Facilities （ differ greatly ） Meals （ 2 ～ 3 times/day, menu, fee ） Caregiving （ Yes/No ） Services not covered by long-term insurance （ Yes/No ）

19. Selection Criteria 1 Terms: self-reliance, requiring assistance, requiring nursing care, dementia, disabled Cost: (moving in) deposit, fire insurance, additional heating charge for winter (monthly) rent, communal charge, your share of the care service expense ・ Location /Environment: Access to medical care/hospitals, banks, shopping, walking places. Noise considerations.

20. Selection Criteria 2 Room facilities: size, sun light (window direction), toilet, washbowl, alarm(where to) closet Shared facilities: dining, bathroom, chatting, entertainment, laundry (washing and drying) common kitchen Meals: Diet for the sick, 2 or 3 meals per day, skipping meals

21. Selection Criteria 3 ・ Medical and Care services: staff for day/night, relation with care service station, hospital, deathbed ・ Conditions of leaving: need more care service, deposit return ・ Communication: getting together or seasonal seasonal events ・ Operating firm: building owner and administrator, business of body organization

22. Summary Collect detailed information Visit more than 3 places Grasping the content of the contract is vital, and do it carefully. Disposal of ones possessions.