There is much that the western world has to learn about the care of the elderly. The aging population means that action is needed to ensure that people are cared for in the right way. What then can we learn from the experts in Japan?
The Rising Age Population of Japan
Japan has the highest proportion of people 65+ in the world, and that population is growing. Therefore the country is the leading light in the development of ways and means to care for its aging population.
Where the country led with electronics and motor manufacturing, it is also leading with how to deal with and care for people. Not though simply shoving them away in high backed chairs and waiting for worst as they hunker in care homes. The Japanese are being proactive and seeking out the solutions which deliver for the young and old alike.
This has not been an easy journey, the innovations in care homes and residential care for the elderly has not just suddenly become excellent – it has taken a long time to get where they are today.
Indeed, around 20 years ago, the long-term care approach in Japan looked much like the current system in most western nations. There was little innovation, the problem seemed to be one without a solution. Then around the turn of the Millennium they decided the issue wasn’t going away, and so did something about it.
Rising Stresses of Care
In Japan there was a strong sense that the young would respectfully care for the old in multi-generational households. That was how it was, and how it had been for centuries. It was a system of sorts, but not really with any formal boundaries or expectations.
Around 2000 it became apparent that such a piecemeal and optimistic approach wasn’t likely to be able to deliver on the nations’ needed. This was particularly impacted by the crash in the Asian economies – suddenly and shockingly the traditional family-focused approach foundered.
The demographic and economic changes wrought havoc. Daughters and daughters-in-law, traditionally the primary caregivers in Japan were growing overwhelmed by the task. Throw in these expectations with the fact that Japan had experienced a drop in birth rates and a demand for more women to join the workforce, then suddenly the wheels were coming off the care wagon.
Policymakers realised that change was needed, and that you cannot have it all. You cannot drop the birth rate and have enough children to care for the elderly. You cannot have women at work and then also expect them to care at home. There was a logical leap needed. Not least because there was growing resentment for the elderly. This was ripping up families and the fabric of the nation.
What Happened Next?
With the emotional and financial stress of taking care of frail older people in homes taking a heavy toll, pressure propelled reform and Japan came up with a public, mandatory long-term care insurance system in 2000.
The universal elder program is funded half by general tax revenues and half by a combination of payroll taxes and additional insurance premiums paid by everyone 40+. The family remains the key source of caregiving, but the system supports the adult children with subsidised services whose fees and co-pays are relatively moderate. Among the most popular services: adult day care, home help, respite care and visiting nurses.
The emphasis is on home and community-based services. Families choose the services and providers they want, introducing a measure of competition into the market. Major Japanese employers are also starting to help families manage caregiving duties and ease their burden.
In the west there is perhaps not that groundswell of pressure yet – but it is likely to come, and nations need to plan for better care for all. They need to keep people engaged and connected, happy and well even into old age.
What do you think? Do you believe the Japanese model is overdue in the US or UK? We look forward to hearing from you with your thoughts.