Renovating Homes of Urban Elderly for 'Home Care', Rural Elderly Gather for 'Together Care' [Senior House]

[19] Rural Elderly, Urban Elderly

Urban Elderly Use Both 'Facilities and Home' Approaches
Senior Welfare Housing Should Be Built on Closed School Sites in Downtown Seoul
With Home Renovation and Meal Provision, They Can Continue Living in Their Apartments

Rural Elderly Need to Live Together for Care
A 'Compact City' with Housing, Hospitals, and Welfare Centers Should Be Created

Interview with Yoo Ae-jung, Director of the Integrated Care Research Center at the Health Insurance Research Institute

On the 3rd of last month, residents were having a conversation at Spring County Xi, a senior welfare housing in Yongin City. Photo by Jin-Hyung Kang aymsdream@

In South Korea, the elderly population can be divided into 'rural elderly' and 'urban elderly.' Everything differs between rural and urban areas, including land prices, living costs, transportation, medical services, and even lifestyles. On the 10th, Yu Ae-jeong, head of the Integrated Care Research Center at the National Health Insurance Service, said, "There are housing types suitable for the elderly in cities and rural areas according to their environments."

Urban elderly are numerous. Support must be provided through a combination of small-scale elderly welfare housing and home care. Rural elderly live scattered in small villages. There should be housing and welfare facilities where they can receive care services collectively. Director Yu said, "We must first examine the demographics of urban and rural areas."

Yoo Ae-jeong, Director of the Integrated Care Research Center at the Health Insurance Research Institute. Photo by Dongju Yoon doso7@

- How do the elderly population structures differ between rural and urban areas?

▲Let's compare Seoul and Gyeongbuk, which has the highest aging rate. According to population projections released by Statistics Korea, the late elderly aged 75 and over will account for 23% of Seoul's population in 2050, totaling 1,818,000 people. Gyeongbuk's proportion is higher at 31.1%, but the population is only 703,000. Although rural aging is severe, in absolute numbers, Seoul has far more late elderly. In Japanese bookstores, there is a book titled "Tokyo Will Explode Due to Care." Tokyo's story is Seoul's story. Because the number of late elderly in cities is so large, it is impossible for all urban elderly to live in facilities.

- Then where should urban elderly live?

▲Because land prices are high, building elderly welfare housing in the city center is impossible. The solution is to build small-scale housing on the outskirts of the city to provide places for middle-class elderly to live. It is important to reduce costs by including only functions like meals and simple medical services. Tokyo also has no large-scale elderly welfare housing. It is common for 10 to 30 elderly people to live together in one villa. Due to low birth rates, elementary, middle, and high schools are closing even within Seoul. Closed schools are ideal spaces for building small-scale elderly welfare housing. Seoul should provide closed school sites to private developers building elderly welfare housing.

- There must be many urban elderly who need to live at home as well.

▲Therefore, home renovation and home-visit medical services are essential. In Tokyo, care workers, social workers, doctors, and nurses ride bicycles to visit each home and provide 24-hour care for elderly living at home. This is the basis of Japan's 'community comprehensive care.' Even among Korea's baby boomer generation, most have returned to their hometowns, but few want to go back to rural areas. As people age, they want to live closer to larger hospitals and enjoy cultural activities. For late elderly who need care to live in their own homes, home renovation is essential.

On the 28th, elderly people were strolling near Tapgol Park in Jongno-gu, Seoul. Photo by Kang Jin-hyung

- How should homes be modified?

▲We need to create 'apartments accessible by wheelchair.' There are three places that must be renovated: the bathroom, the entrance to go in and out, and the kitchen sink. In Japan, when elderly people with care grades apply for home renovation, the government covers the costs. In Korea, many elderly prefer to stay in their homes if daily life is not inconvenient. As the number of late elderly explodes, the market for home renovation will grow, and specialized interior companies will emerge. If homes are renovated and there are restaurants that provide meals, existing apartments can serve as elderly welfare housing for middle-class seniors.

- What about rural elderly?

▲Rural areas have fewer people and lack infrastructure. Therefore, gathering elderly is important. Elderly housing should be built in places with convenient transportation, along with nearby hospitals and welfare centers. The key is for rural elderly to live together in one living area and receive services. As the number of late elderly increases, care workers will become scarce. This is the most effective way to use minimal personnel. In Japan, small and medium-sized local city centers were made into 'compact cities' to gather elderly scattered in rural areas. Medical, administrative, and transportation facilities were concentrated there to provide care all at once. We should follow this method.

- Could you tell us more about the Japanese example?

▲There is a place called Toyama City, known as the 'Japanese Alps.' It became a 'compact city' by connecting surrounding areas by train. Elderly who were scattered in mountainous areas were brought here. Care workers cannot visit elderly living alone in remote mountain villages even if they want to. For rural elderly, living together in a larger group is the solution. This creates business viability and attracts private investors. Japan is not the perfect answer, but it has the most similar legal system and regional environment to Korea. By examining what Japan has considered and done over the past 20 years, we can see what preparations we need as we enter a super-aged society.