History of assistive devices and home modification services under long-term care insurance system in Japan across 20 years: A narrative review

In this aging society, support services for older adults through the social welfare system have been introduced in many countries; in Japan, the long-term care insurance (LTCI) system was introduced in 2000. This review examined research of the past 20 years to investigate the history of assistive devices and home modification services and discussed future directions for health professionals through a narrative review. We selected 86 Japanese papers and six English papers: a total of 92 papers were analyzed by three researchers. This review revealed that assistive devices and home modification services contributed to helping users and decreased caregiver burden. Many studies have shown the importance of appropriate and sufficient cooperation among professionals. However, some issues related to LTCI were identified such as the regulation of subsidies and little flexibility considering local area conditions. The effectiveness and issues of assistive devices and home modification services were shown, and adjustments were suggested for the system and professional education according to the changes in a social situation. In addition, systematic research seems to be a small number; hence, studies with reliable research methods and analyses are needed to show the effectiveness of services and examine intervention by professionals.