Summary- Once a person comes to require nursing care， they need it constantly 24 hours a day， 365 days a year. But present circumstances make it increasingly difficult to provide this care in households alone. We conducted an interview survey to determine how the burden of nursing care will change in the future， estimate the population of elderly people needing nursing care in 2010 by prefecture， and ascertain the present status of nursing care.
- By 2010， half of the elderly people needing care will be concentrated in metropolitan areas such as Tokyo， Osaka， and Aichi. Ten prefectures will have elderly populations needing care in excess of 100，000: Tokyo， Osaka， Kanagawa， Aichi， Hokkaido， Saitama， Hyogo， Chiba， Fukuoka， and Shizuoka. These prefectures will account for half (49.5%) of the elderly population needing care. Thus in terms of sheer scale， the issue of elderly care can also be described as a metropolitan problem.
- When all prefectural nursing care expenses are aggregated， total spending on nursing care is predicted to reach ¥8.1 trillion by 2000， and ¥11.5 trillion by 2010. Tokyo's nursing care expenses of ¥950 billion in 2010 will be 14 times greater than in the lowest spending prefecture， Tottori， at ¥67.2 billion.
- Next we calculated nursing care expenses per person (at least age 20) by prefecture as of 2010. The national average was ¥10，580 per month， while the median was Fukushima prefecture's ¥11，038 per month. Shimane prefecture had the higshest per capita expense of ¥14，207 per month， approximately ¥4，000 above the national average. Saitama prefecture was lowest with ¥6，355， less than half of Shimane.
- As expected， the survey of the present status of nursing care revealed that families bear the brunt of the burden， particularly the women in these families. People who have provided nursing care to family members said they would prefer to receive at-home care when they come to require such care themselves. But many also do not want to impose this burden on their children or children's spouse， and would live at home if suitable services are available to lighten the burden on family members.
- Forms of nursing care vary considerably by region. In areas where the burden of nursing care is large， it will be necessary to provide support from the central government. Moreover， nursing care must not be allowed to deplete the energies of the working generations. Due consideration must be given to generations and communities， and support systems providing services must be built to conform to local characteristics.
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