日本经验提示中国长期护理的未来设计OA

China is confronted with the dual pressures of deepening population aging and a shrinking working-age popula-tion.In 2022,the population aged 65 and above exceeded 200 million,accounting for 14%of the total population,and the figure is projected to reach approximately 400 million by 2050.Meanwhile,the birth rate remains persistently low,the working-age population is plummeting,there is a severe shortage of care workers,and the occupancy rate of elderly care institutions stays relatively low.A continuous extension of long-term care periods will put the sustainability of the elderly care system at risk.Taking shifts in the values of Japan's post-WWII birth cohorts as a frame of reference,this paper introduces the concept of"independence-life seeker(ILS)",ai-ming to facilitate a social transformation in China that shortens caregiving durations and enables older adults to maintain self-reliant lives to the greatest extent possible.In Japan,the proportion of marriages arranged by matchmakers dropped from 70%in the 1970s to less than 10%by 2020.In terms of funerals,household funerals accounted for 55%of all funerals as of 2022.Surveys show that roughly 35%of residents have expressed intentions to formulate advance care plans,and the shortfall of care workers is expected to rise to 250,000 by fiscal year 2026.These data reflect the growing recognition among older adults of values centered on self-reliance and dignity-conserving care.Japan's experience offers reference rather than ready-made solutions,and China needs to redesign its elderly care system in light of its unique national and socio-cultural context.This paper puts forward a three-tier institutional framework,pro-poses an evaluation framework integrating evolving cultural values and medical and long-term care outcomes,and outlines short-term,medium-term and long-term implementation pathways.There fore,to achieve the sustainable operation of aging society,policymakers should center its policies on the ILS concept to foster elderly self-sufficiency and compress the length of long-term care utilization.