From August 8th to 12th, 2025,Support for sustainable decision-making and arrangements that preserve dignity for everyone during and after life" project, I visited Seoul, Korea to investigate decision-making support for the elderly. The outline of the investigation is as follows:HerePlease see the article.
On August 9th, we visited the Seodaemun District Council in Seoul. We spoke with Seodaemun District Council members and Mapo District Council members, as well as social entrepreneurs active mainly in Ulsan in southeastern South Korea, and held a discussion on supporting the elderly. Researcher Ryu Seokdo reports.
Integrated Care Support Act and Pilot Projects
In South Korea, the Act on Integrated Support for Medical Care and Nursing (Integrated Care Support Act), which was enacted in 2024, is scheduled to come into effect in 2026. The Integrated Care Support Act was enacted against the backdrop of an increasing elderly population, as a way to support people so that they can live healthy and dignified lives in the places where they live, even as they get older. It was created based on Japan's community-based integrated care system. While Japan's community-based integrated care system is primarily designed with the elderly in mind, South Korea's Integrated Care Support Act targets not only the elderly, but also people who have difficulties in daily life due to disabilities, illnesses, accidents, etc., with the aim of improving quality of life and providing resident-centered care.
Seodaemun-gu Initiatives
Prior to the implementation of the Comprehensive Care Support Act, Seodaemun-gu is running a pilot project using Seoul Metropolitan Government budgets. Specifically, an Integrated Care Support Center has been established at the ward office as core infrastructure for providing care to those in need. The center not only provides one-stop service for inquiries from residents, but also builds a collaborative system between the local government and welfare facilities and hospitals. Other initiatives include establishing a system for the use of private ambulances so that elderly people can return home safely after being discharged from hospital.
Currently, in order to provide services efficiently, support is provided by having elderly people visit the base. In the future, they would like to implement a system to provide care where they live. They also feel that it is necessary to collaborate not only with local government partner organizations such as foundations, welfare facilities, and social welfare councils, but also with private companies.
Mapo District Initiatives
Like Seodaemun-gu, Mapo-gu is also conducting a pilot project. Its distinctive feature is its collaboration with private companies. Mapo-gu is holding public-private meetings to discuss the implementation of the Integrated Care Framework Act. The district is also working to create spaces in senior housing that encourage interaction between seniors and local residents, and to provide free meals to keep an eye on the elderly. These efforts are made possible through the support of a social welfare foundation backed by private companies.
Mapo-gu also has a private network centered around cooperatives, and by collaborating with private companies, residents can receive the services they need in a variety of situations, from daily life and nursing care to long-term care. This initiative is aimed at all residents, not just the elderly, and apparently also provides projects for those in financial difficulty and health management support for middle-aged people living alone.
Social cooperatives addressing the health of older people
The hearing was also attended by the founder of the Message Factory Cooperative. This cooperative is active in Ulsan, working to resolve local social issues. Many of its activities are targeted at the elderly, such as events that allow people to experience the funeral of their choice before they die, and programs that offer day trips around the local area for dementia patients and their families. The cooperative has also developed a game in which each person draws a health management activity card and carries out the instructions written on the card, creating a mechanism to help people develop healthy habits. The cooperative is considering various projects that will enable residents to enjoy communicating with each other while viewing people's innate aspirations and abilities as messages.
What is support for resignation through public-private partnerships?
We discussed key points for supporting elderly people in their decision-making and personal decisions in the community. In South Korea, government-led preparations are underway for the implementation of the Integrated Care Support Act. A Seodaemun district council member noted that discussions on decision-making support have only just begun in South Korea, and that there has been little progress in home aging and end-of-life care, and that policy does not reflect the needs of those affected. On the other hand, there are also examples such as Mapo district, which is promoting collaboration with the private sector, and Ulsan cooperatives, which are promoting community communication. This forum provided a glimpse into the potential for future public-private collaboration and resident-centered care in South Korea.
A word from the principal investigator (Kaname Sawamura)
South Korea's aging rate will be around 20% in 2024, still lower than Japan's, but is expected to progress rapidly in the future. Local communities have begun to develop the infrastructure to enable elderly people to continue living in their communities in their own ways. They are exploring ways to provide care in everyday life, such as making use of the custom of making kimchi together and setting up spaces for the elderly. I hope that the successful aspects of Japan's community-based integrated care, as well as the areas that are becoming more difficult in the long term, will be useful as references.
