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Wine Around the World 2017: Japan’s lessons from an elder-care approach gone wrong

This series of blog posts by author Patti Digh will focus on aging in the countries whose wines we will taste at our Wine Around the World event on Thursday, October 12, 2017. Purchase tickets here! Wine Around the World 2017.

Lessons from an elder-care approach gone wrong 

Japan is a country that combines the oldest population in the world with levels of public debt to match Zimbabwe. Their experience illustrates the consequences of retracting state support for eldercare too far and relying on individual and familial support.

Until 2000, publicly-funded social care was nonexistent in Japan; caring for the elderly was a family responsibility. There were two main consequences of this approach. First, there were many reports of neglect and abuse towards older people being looked after by family members. In a survey conducted by the Japanese government, a third of carers reported feeling “hatred” towards the person they looked after. Caring also restricted the employment options of a growing number of Japanese women.

A second issue was the development of a phenomenon known as “social hospitalisation.” Older people were being admitted to hospital for long periods–not for any medical reason, but simply because they could not be looked after anywhere else.

The response from the Japanese government was radical. They introduced long-term care insurance, offering social care to those aged 65+ on the basis of needs alone. The system is part-funded by compulsory premiums for all those over the age of 40, and part-funded by national and local taxation. Users are also expected to contribute a 10% co-payment towards the cost of the service. The costs are seen as affordable and the scheme is extremely popular.

The result is that older people in Japan can access a wide range of institutional and community-based services.

However, it would be a mistake to see this as a problem solved. The uptake of services has far outstripped expectations and the Japanese government is faced with spiralling costs. Their response has been to introduce higher co-payments for wealthier adults, but the challenges continue. Other countries would be well-served to study the long-term impact of Japan’s decisions in order to course correct.

Aging Around the World: Japan

by Patti Digh, Council on Aging for Henderson County Board Member

This series of blog posts will focus on issues of aging in the countries whose wines we will taste at our Wine Around the World event on October 22, 2015. There are tickets left, but they’re going fast. Tickets can be purchased at our office or online here: coa.eventbrite.com

As you will learn, aging has different cultural meaning and expressions around the world:

  • Different cultures imbue aging with different meanings and values
  • Cultures treat their elderly differently and place different values on old age
  • Eastern cultures tend to highly value age and wisdom, while Western cultures tend to highly value youth
  • In Western societies, people take pains to appear younger than their biological age, for example

So, aging isn’t just a biological process; it is also a cultural one. Frequently the average life expectancy bears on what age counts as “old.” For example, in the United States, where the average life expectancy is over 78 years, people are not considered “old” until they are in their sixties or seventies. However, in Chad the average life expectancy is less than 49 years. People in their thirties or forties are therefore already middle­ aged or “old.”

Over the next 8 days leading up to our Wine Around the World event at The Cedars, let’s grab our passports and go on this amazing journey into aging in many cultures.


WAW-Japan-blogpostAs an Eastern culture, and a rapidly aging one, Japan reveres its elderly, bowing to the wisdom that comes with age. Many other Eastern societies also associate old age with wisdom, so they value old age much more than their Western counterparts.

Japan faces the unique problem of tending to an increasingly elderly population. 7.2 percent of the Japanese population will be 80 or older in 2020 (compared to 4.1 percent in the U.S.), which will likely lead to a host of new problems for the country. Adult diapers are already outselling baby diapers, and the pension system is on course to dry up.

In Japan, adult children are expected to care for their aging parents in ways different than in the United States. Sixty five percent of Japanese elders live with their children and very few live in nursing homes. Japanese cultural norms suggest that caring for one’s parents by putting them in an assisted living home is tantamount to neglect. This is in line with the Council on Aging for Henderson County’s emphasis on self­ determination and our mission to support independent living as long as possible before institutional care is necessary.

The Great East Japan Earthquake, tsunami, and nuclear power plant disaster of March 2011 has highlighted current and emerging issues of a “super­aging” society, especially the need for community ­based support systems. (Such as what the Council on Aging provides to our local elderly populations.) This earthquake revealed positive aspects of the Japanese society: older adults’ wisdom and resilience for survival and coping, active social and labor participation at old ages, and strengths of social relationships. The disaster also highlighted challenges that Japan is facing, especially rebuilding disaster area communities and addressing population aging in urban communities where Japanese traditional qualities are fading.

What does the Council on Aging for Henderson County do that reflects the values of Japan around aging? We also see the wisdom inherent in old age, and advocate for the independence and personal dignity of each of our clients.