How Should Japan Face Elderly Care in House?
Outline
Research Question:
How should Japanese family cope with stress of taking care of elderly?
Thesis Statement:
Japan should set more effective system for elderly care-givers in house
1) Specialists should give family care-givers skills of effective care and stress coping etc.
2) Government should show more effective nursing-care insurance system.
3) Local community should make more friendly relationship.
Introduction
A. Incident from stress of caring parents―A son killed his bedridden mother
B. Aging society
C. Thesis
Ⅰ. The cause of the problem
A. Japanese cultural concepts
Filial piety
Inside and Outside
B. Social change
Decrease of children’s number ― Increase of burden
Lack of communication with relatives, neighbors or local community
Ⅱ. Possible solutions
― Importance of support system of family elderly care-givers
A. Role of specialists
B. Role of government
C. Role of local community
Conclusion
A. Repeat thesis and main points
How Should Japan Face Elderly Care in House?
On December, 2010, an incident occurred at home in Akita prefecture. A son killed his mother, who had suffered from dementia and had been taken care of by him for 10 years (“Koukoumusukoga”). The son was 66 years old and his mother was 92 years old (“Koukoumusukoga”). His stress for long nursing care made him murder his mother. According to Ministry of Health, Labour and Welfare (MHLW) in Japan, the rate of the Japanese population had become highest in the world in 2000 (Japan, MHLW). Accordingly, some serious problems about the elderly occurred more and more such as decrease of rate of working population, pension problems and dying solitary. As shown above, family care-giver’s stress for caring an elderly person is one of them. Because of aging society, the age of the family care-givers, who support the elderly who need help has also increased (Tsuno and Homa 10). In other words, taking care of the elderly can be harder things as care-givers themselves can be physically weak because of age. To reduce family care-givers stress, people around them should help them to try to decrease care-givers stress. For this problem, government, local community and specialists play important roles. This essay will argue that Japan should establish more effective systems for elderly care-givers in house with following perspectives: 1) Specialists should give family care-givers skills of effective care and stress coping, 2) Government should show more effective nursing-care insurance system, and 3) Local community should make more friendly relationship.
Ⅰ. The Cause of the Problem
The causes of stress of family care-givers in Japan seem to be related to both Japanese cultural concepts and change of society in addition to fundamental characteristics of elderly care in house.
First of all, as fundamental characteristics of elderly care in house, proximity as family and possibility of hopeless of care are different points from other stress. Taking care of family does not have a break because a caregiver has to be always with elderly in house (Nohara 12). However, it is regarded as natural for people to take care of their family (Nohara 10). In addition, taking care of elderly is sometimes hopeless because the death of elderly is waiting. This is the big difference from child care in house. Thus, elderly care in house is more stressful than other care.
Second, Japanese cultural concepts make family care-givers more nervous. In particular, in Japan, filial piety is thought much of and border of inside and outside is clear. Jeff Kingston is a professor of the Temple University in Japan and he is the expert of “the political economy and social history of modern Japan” (Temple). According to him, Japanese have the assumption that people have to take care of their elderly family because “the Confucian principle of filial piety and the respect accorded the elderly” (Kingston 291). They think it is responsibility as well as virtue to take care of their parents. In addition, in Japan, people have the view of inside and outside (McDaniel 2). People have the thinking of self-sacrifice and sustain harmony especially in outside (McDaniel 2, 5). As a result, people think it is important not to show their personal problem or stress and moreover, it is rude for outsiders to ask their private thing. As a result, people hesitate and avoid talking about domestic matters such as the specific situation of their mother or difficulties of caring of their parents, their stress of caring their elderly family in outside and pile up burdens alone because they do not have opportunities to express their feeling.
Third, Japanese society is changing in terms of decrease of children and decrease of social relationships. In the current society, children’s number is decreasing. As a result, children have more burden of taking care of their parents. For example, if there are three children in one family, they can take care of their parents, sharing the burdens. However, if there is only one child in a family, the case more common currently, he or she has to have all burdens alone. Moreover, communication with neighbors or local society is decreasing. In 2010, the Cabinet Office (CO) in Japan conducted a survey to the elderly in 5 countries, America, Sweden, Korea, Germany and Japan, by Japanese government. According to it, the rate of the elderly, who have friends or neighbors, who they can depend on is the lowest in 5 countries (Japan, CO). In addition, the rate of the elderly who have few opportunities to associate with neighbors in a week is the highest (Japan, CO). For this, the elderly tend to be limited in house unless they can get other support such as day service of nursing house and have fewer opportunities to communicate with people besides their family members. As a result, the family tends to feel more serious stress when thinking of problems alone and relationships between the elderly and care-givers are likely to become worse.
From these reasons, care-givers in families in Japan have big stress.
Ⅱ. Possible Solutions
Key solutions for reduce stress of family care-givers stress are 1) technological skill given by specialist, 2) more effective nursing-care insurance system of Japanese government and 3) more friendly relationship in local community. It is sure that the solution which care-givers want to have is different among each person. However, there are two main approaches for relief of care-givers’ stress: reducing physical burden and reducing mental burden. For example, physical stress is made by the stress of helping the elderly taking a bath or eating meals. Mental stress is, for example, anxiety about future or costs of support.
First, specialists who have technological knowledge of taking care of elderly should give stress-coping strategy for care-givers. According to Tabei, the head of Oyanoie, nursing home of nursing-care insurance of government in Musashino-shi, who I interviewed, 1) to completely leave the elderly in nursing home or 2) to leave them for a certain time as day service is one solution to reduce stress (Tabei). It is the physical approach to respite care-givers, giving time apart from their elderly. However, as actual case, according to Tabei, there are 300 hundred people who is waiting care by Oyanoie though the capacity of the elderly is only 40 people and the elderly cannot get support from Oyanoie except the elderly in worst health condition. Thus, as specific solution, especially for family whose elderly cannot get enough physical support from institutions, specialists such as NPO or local care managers have to give actual strategy of how to care for elderly well thorough training course for family care-givers. For example, inefficiency of taking bath or doing exercise can be extra physical stress for both care-givers and the elderly. However, these stresses can be reduced by learning rope of it from specialists.
Second, government should show more effective nursing-care insurance system government should set a large-scale system of support for care-givers. For example, Gold Plan, which shows “direction of health and welfare policies for the elderly over the next five years”, was made by Japanese government in 2000 (Japan, MHLW). Though theoretical system has been well-appointed, the reality that the elderly have to wait for a few years to enter nursing house in Tokyo exists (Jenike 182). To improve nursing house situation such as Oyanoie case, government should set more practical approach, making use of their large-scale as one nation. For example, more specific aim for solution such as guideline which shows proper action of the local communities should be established.
Finally, local community should make more friendly relationship. Local communities can do mental supports for care-givers which the government cannot fill because the local communities are the closest with family. Using merits of proximity, local community should do grass-roots effort to support family care-givers. For example, community centers or nursing home have some events, such as free markets or tea parties to communicate with the family and try to set an air which care-givers can talk their problem or worries.
Thus, these three parts, which have possibility of improvement of the problem, should take action more.
Conclusion
As shown above, there are some reasons elderly care in house is stressful especially in Japan. In addition to fundamental physical stress such as helping the elderly to take bath, cultural background and social change of Japan are important factors to be considered. As solutions, the roles of specialists, government and local community should be thought much of. In particular, as more effective systems for helping care-givers in house, specialists should give skills of effective care and stress coping, government should show more effective nursing-care insurance system and local community should make more friendly relationships. As the first step, it is important not to think this problem as only family problems and improve support systems of the elderly and their family members.
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