The Nutrition Assessment and Care for the Elderly in Japan

In Japan, a new nursing insurance system was enforced in April 2000, where premiums were paid according to the level of necessary care. Our project, Nutrition Care and Management(NCM) for the elderly was started in 1995, funded by the Ministry of Health and Welfare of Japan. The NCM project was to provide appropriate nutrition care for the elderly and to see that it effectively functions as part of the health care services. There were 4 stages to the project : the first stage was to find out the PEM status among the elderly patients in hospital and home-care settings in Japan. The 2nd stage was to develop and evaluate nutritional assessment methods, anthropometry, resting energy expenditure measuring methods using of portable indirect calorimeter, and the convenient protein energy intake assessment methods, etc. for the elderly patients with PEM risk. The 3rd stage was to examine the effectiveness of the nutrition care plan induced of protein energy supplement and team care in improving nutrition among the elderly patients. The last stage was to develop the NCM set for the elderly patient based on the past three years of scientific evidence. it is expected that the NCM system for the elderly will provide adequate nutritional care management, improve the elderly care environment and create effective resource management.