¶ … Hawaiian elder care professionals improve patient eldercare services to Japanese nationals, taking into consideration Japanese cultural norms and expectations
Caregiving for elderly parents in Japan
Japan has witnessed a significant growth in its elder population. In the year 1950, 4.9% of the Japanese population was aged 65 years and above. This figure increased to 14.8% (1995). By 2025, it is estimated to grow to 25.8% (Yamamoto & Wallhagen, 1997). Japan's 'very old' population group (aged 85 and above) is swiftly increasing in number. It has been projected that by 2025, the nation's 'very old' population will account for 4.3% of its total population -- a five-fold rise in three decades. Furthermore, it was projected that as many as 2.62 million Japanese would be suffering from senile dementia by the year 2015; the 1990 estimate for senile dementia was about one million individuals (11WSA 1996).
Change in the percentage of Japan's aged population has also brought with it a corresponding change in Japanese social norms pertaining to family issues. Historically, elder care in Japan was regarded as the predetermined duty of the successive generation in patrilineal extended families. Owing to this tradition, even in the year 1992, as many as 33.4% of aged, bedridden Japanese who weren't sent to institutions were taken care of by their children's spouses (Yamamoto & Wallhagen, 1997). The above moral tradition was financially strengthened by means of primogeniture, wherein main family assets went to the male heir upon his father's demise. But following the Second World War, a newly-passed legislation on inheritance abolished the primogeniture tradition. Hence, despite the time-honored moral imperative continuing to strongly influence involved individuals, the actual operation of this familial duty is now changing gradually. For instance, Japanese households with three generations of the family reduced from to 12.5% (1995) from 19.2% (1970). The above modification to family configuration will likely significantly change Japanese views on family caregiving to aged persons.
Another key element relating to Japanese parental caregiving is women's role in the traditional Japanese family. Elderly and patient care was traditionally a role expected to be performed by the women in the household (Yamamoto & Wallhagen, 1997). As per the traditional Japanese cultural rule, the wife of the heir (first son) is required to care hands-on for his aged parents. This includes changing their diapers, feeding them, etc., until the aged person(s) gets hospitalized due to a medical condition. However, of late, this age-old role expectation might be a cause of conflict for Japan's growing number of working women. In the year 1975, roughly twelve million Japanese women held jobs, whereas by 1993, this figure had increased to twenty million (Yamamoto & Wallhagen, 1997).
With more widespread acknowledgement, in Japan, of the problem of a growing share of aged individuals requiring assistance with their everyday activities, a number of formal services were launched. In the year 1990, a "Gold Plan" (an exclusive ten-year plan) for improving support for aged individuals and family members was executed. This Plan entailed the launching of daycare facilities, homecare support facilities, and development of facilities for long-term patient care. The Japanese Health and Welfare ministry planned to bring about a roughly-tenfold increase in these services from 1990 to 2000 (Yamamoto & Wallhagen, 1997). However, family support for people with demented, aged parents continues to be limited. If possible, these services must be extended to demented, elderly individuals and families. In fact, behavioral issues displayed by aged individuals diagnosed with dementia usually exclude this group from services like "short-stay" and day care arrangements. Also, the services offered are far less than what is required in Japan. Consequently, aged persons and their familial caregivers who require assistance are made to wait long (Yamamoto & Wallhagen, 1997).
In spite of their success, the long-term and health care structures of Japan experience sustainability problems similar to those faced by their U.S. counterparts, including increasing demand and mounting expenditure. The government of Japan is weighing up and pursuing numerous options, like: preventive services; increasing premiums, fees, or taxes; and promoting community-based healthcare services (Belli, 2013). The year 2011 saw the implementation of reform focused on the holistic model of community care. Slightly similar to a responsible care institution, such a model would guarantee access to hospital, medical, or long-term patient care, preventive services, legal services or life support, and residential care services within elderly people's communities (Belli, 2013). Attention to service consolidation and prevention will, with any luck, reduce the use of costlier services, as it would ensure the population remains fitter.
1.2. Japanese vs. American elderly care
Professionals in the field typically look to Japan as an example of a nation that effectively handles its swiftly
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" References Cooney, C., & Mortimer, a. (1995). Elder Abuse and Dementia - a Pilot Study . International Journal of Social Psychiatry, 41, 276-283. Dong, X., Simon, M., de Leon, C.M., Fulmer, T., Beck, T., Hebert, L., et al. (2009). Elder Self-neglect and Abuse and Mortality Risk in a Community-Dwelling Population . Journal of the American Medical Association, 302(5), 517-526. Dong, X. (2005). Medical Implications of Elder Abuse and Neglect. Clinics in geriatric medicine,
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