Changing attitudes to care of disabled older people within a changing health care system in Japan

)4 The implementation of a more flexible system of care for disabled older people in Japan is in some respects being hindered by the outdated perceptions of the gen­ eral public and professional carers of the needs and desires of older people. This multifaceted study sought to quantify the disparity in order to provide guidance on a way forward. Two sets of data were collected to provide a full picture: the levels of functional independence of a sample of disabled older people; and responses to a question­ naire about perceptions of older people and their care by a sample of 'average' people. The results show that while functional independence in disabled older people does decrease with age, it can in many cases be improved by being cared for at home. The wider public is aware of this, but increasingly do not wish to participate in caring for their older relatives at home and are happy for relatives to be cared for in nursing homes. Younger people also have unrealistic views of older people's preferences and level in independence. In order to encourage effective care for the disabled older population, care should be focused on understanding their needs and circumstances in order to facilitate improvement in their functional independence.