Friday, July 14, 2006


I haven’t written about this before, but now I feel like sharing a little more about the job I do in the daytime. I have a lot to say about the issues in this field, especially now that I’m taking a course to pursue a better job opportunity there. Ten afternoons a month, I work as an input operator at what they call a “herupaa steeshon” which is “helper station” pronounced in Japanese way. This name probably means something different in other English speaking countries. Here in Japan, it’s supposed to mean the agency that send home-care workers who take care of the elderly.

My job basically is to input the hours the home-care workers worked, and in the beginning of the month, send the monthly data to the government to ask them to send us money. In doing so, I have to witness, whether I like it or not, the struggles that people in this field -- and this country as a whole – are going through.

The elderly care is an urgent issue here in Japan, perhaps more seriously so than in other countries. We have the longest average life expectancy with very low birth rate. The negative effect of the shrinking population on the economy is often talked about, but another threat is the days to come when the elderly have to be largely in charge of elderly care because of the shortage of young workers. So we just have to feel our way to face this problem. What we are doing right now may serve as an example of what not to do for other countries facing more or less the same problem. If we make a big mistake, I hope other countries learn from it and avoid making the same mistake. I mean it.

Seven years ago, the whole world was terrified by the Y2K problem. Now here in Japan, people are talking about the Y2015 problem. Is it the year when elder people start crashing computers throughout Japan? No. It’s the year when all(?) the baby boomers in Japan turn above 65 y.o. and the percentage of “the elderly” is expected to increase dramatically. And ten years later, the majority of them would be in need of some kind of help, which is our Y2025 problem that has nothing to do with the three-digit area codes.

When I was in the U.S. more than 15 years ago, one of the college professors once mentioned about Japan’s elder care and asked me “How are you going to afford that?” Well, Dr. D, we all wish we knew. Japan used to provide free medical care to those above 65 y.o., but not any more. And many say that the lifelong employment is already collapsing in Japan. Now we are going through the birth pain of the new elderly care insurance system, and the pain seems to last quite a while.

More and more companies are coming into this elderly care business, because though it IS a threat, it can be a good business opportunity at the same time. But many of them are facing problems, especially care goods providers. And the government is revising the system and the regulations again and again and again. This year, right now, one big change is taking place, and the computer companies had to update and upgrade the insurance claim software over and over. They had almost no days off during the Golden Week this year, I heard.

I’m not going into details too much here, but I strongly hope that those who talk about Japan’s future, both Japanese and non-Japanese, see what’s REALLY going on in this field. Care managers and home-care workers around me are struggling so hard, trying to do the best they can under the often very unrealistic regulations. It is so touching and it makes me feel that there ARE people who do care. So I really want the lawmakers and advice-givers to see the reality and make things better for such struggling caregivers – no, it is not just for them but “for us,” because we are all going to be old someday.
posted by obachan, 7/14/2006 02:59:00 PM


nice issue you raise here. i've wondered about this but never gave it as much thought (esp. w/o the 1st hand knowledge you have.) one thing that struck me reading: would this eventually force the elderly care to look at non-japanese as potential helpers/caretakers? i know most of them are considered suitable only at J-E translation, language teaching, or entertainment (ahem) sort of jobs in Japan. when the american middle class started to emerge since the 50s through more rapid consumerism, eventually more labor-intensive jobs were assumed by new immigrants from poorer countries (as well as lower class americans too.) it IS a huge problem, but i wonder why the aging issue in japan is always seen as a borders-closed, self sustenance problem.
commented by Blogger moorl, 7/14/2006 4:32 PM  
Good point. Actually about 10 years ago, some legislator already suggested an idea of hiring a good number of non-Japanese people for elderly care in Japan. It seems to be a plausible idea, to be fair, but honestly I didn’t like the way he said it (though I don’t remember any more if I saw him on TV or on a video or I read about his interview).

I don’t remember the exact words he used, but basically what he said was that not many young Japanese want to go into this field because it is a physically demanding and unpleasant work, including changing diapers of old people. But women from Southeast Asian countries have the same kind of caring temperament and sensitivity as Japanese, so they’ll get along with Japanese elder people very well. They will be happy to work for much less salary than Japanese because in their home countries it is a big money, and also they will be happy to have the work other than the “entertainment jobs” (you know what kind of entertainment I’m talking about) they are most likely forced to do in Japan. So such Southeast Asian women will make great caregivers here.

This sounds like a “rational” solution, but … there’s something I feel uncomfortable about the way he put it. Giving a dirty work you don’t want to do yourself to someone from a poorer country and making it sound like doing a favor … But worked out in a conscientious way, this idea may lead to some kind of breakthrough …
commented by Blogger obachan, 7/15/2006 11:55 AM  
wow, sounds like i would be put-off by the legislator's words too, obachan! actually, nursing is very demanding and "unpleasant" work too, but the pay (at least in US) puts you in the upper-middle bracket, with lots of benefits, and job stability that's rare today. what about making it more $$ rewarding to attact young people? (she looks wearily at the money-man, LOL!)

(on an unrelated note, my pharmacist friend once quit a job at a nursing home. did she hate the "diapers"? she couldn't take the sadness of people who never had visitors!)

oh yeah, is this a state responsibility? no private businesses?
commented by Blogger moorl, 7/16/2006 8:36 AM  
Very interesting. Thanks for giving that little window.

I work for an agency here in the U.S. and to say the work is demanding barely covers it. The hours are long, boring, and take a good deal of physical courage-- along with a stomach of iron.

To suggest foreign workers would be cheaper misses a major point. These people are old and helpless, they are ill and do not want to deal with a foreigner unable to speak clearly or understand them at the first go. It has nothing to do with how good someone's heart is. A mean, nasty, old man deserves the same respect as the sweetest grandmother you ever saw. They do not want foreign workers. They may not accept male care givers and I, as an American born Irish woman in a position of some authority, have been insulted and demeaned because of my ancestral background.

The caregiver also needs a huge amount of backup with plenty of time off. It's a world problem.

So very sad.
commented by Anonymous Anonymous, 7/16/2006 11:24 AM  
I think the legislator was obviously thinking about paying less money to non-Japanese workers even when they did the same job as Japanese workers, which I really hated.

Talking about the payment, I guess the payment to home-care workers and care managers is not really bad here, either. But when you find a job too stressful, payment alone can not keep you in the same job, right? Especially when young people know that they can make big money a lot easier with stock investment. Besides, to make this job extremely well paid one, there will have to be a good financial resource. But where can we get the money?

The elderly care insurance program is run by the local government which includes cities, towns and villages. The home-care workers are sent from private agencies. (I think we have private agencies only at this point.) As for the facilities like nursing homes, some are public and some are private, I think. (Japanese readers, correct me if I’m wrong, please.) Anyway, here in Japan, you automatically become eligible for the elderly care insurance when you turn to a certain age, but to have a home-care worker actually come and help you with the payment covered by the insurance, you have to turn in an application first and go through some assessments.

I can relate to your pharmacist friend, BTW… I felt the same way when I worked at a nursing home.

A stomach or iron! Yep! That’s exactly it. :D

About the foreign workers, I have a somewhat different view, though. My hunch is (though I have only very limited experience in this field) that some people will get along with foreign workers, some will not accept them at all for xenophobiac reasons, and some will not accept home-care workers at all regardless of their nationalities.

For example, heavily disoriented people may not be able to tell if the care providers are Japanese or non-Japanese, and be happy to be taken care of by those who are warm and caring. On the other hand, if sent to those who are relatively OK physically but in the early stage of dementia, or who always say “someone always steals things from my room,” the problem may aggravate more with non-Japanese workers.

But yes, I agree with you. Caregivers definitely need good backup and plenty of time off. Theoretically it seems possible when more hands are involved in the care-taking, but the fact is that it’s not that easy…
commented by Blogger obachan, 7/19/2006 11:21 AM  

Add a comment