JAPAN: The new face of home care givers

. TOKYO, Japan / The Japan Times / Life in Japan / July 30, 2009 Awful dilemma: Keep working or look after elderly parents By Akiko Kashiwagi, Special to The Japan Times Kazuo Yamazaki was in the prime of his career as an engineer at a Japanese music company doing business across borders. His decades-long profession came to an abrupt end six years ago, however, when at age 55 he became his mother's primary caregiver. He tried to look for a different job that would allow him to still take care of her but gave up after a year. "You just couldn't work (as a regular employee) and take care of your parent at home at the same time," he says. Today a growing number of companies are beginning to lose valuable employees like Yamazaki — a severe situation emerging from the world's most rapidly aging country. Defying traditional roles, a remarkable number of men are becoming the main caregiver of aging families. They accounted for nearly 30 percent in 2007, up from 20 percent a decade ago, according to government data. And like Yamazaki, a small but increasing number of men in their 40s and 50s are quitting or changing jobs because they are unable to cope with the unpredictable demands of senior care. In the past, the elderly counted on their daughters-in-law for home care. And any difficulties, including financial, that came with that responsibility was somehow handled by the household as a private matter. That is growing rare because the tradition of several generations living under the same roof is being replaced by nuclear families with fewer children, women in the workforce and more single-person households. "Elder care has become an issue for everyone. We are in an era where few people can avoid (the responsibility)," says Masatoshi Tsudome, a sociology professor at Ritsumeikan University in Kyoto. The implications are huge for society and the economy. The percentage of people over age 75 is projected to reach 13 percent of the population by 2015 and 18 percent by 2025. Recent government data show nearly 30 percent of this age group requires care. The sheer numbers highlight the daunting challenge of caring for seniors — both visible and invisible — that the country must face. "Taking care of an elderly person affects the family on so many levels," says Tsudome, who has coauthored books on male caregivers. It affects caretakers' careers and thus affects them financially, not to mention the impact on family members, he says. Without addressing the multilayered issue comprehensively, experts warn, many more working people in their prime will find it hard to keep their jobs, leading to acute financial difficulties. Companies in turn could see their competitiveness eroded by a sudden loss of veteran employees. All of this could combine to shake up the very foundation of society. Not that the nation hasn't seen it coming. In 2000, the government introduced a new nursing care insurance program to ease the burden on family caregivers. There is little doubt the system has proven beneficial to quite a few people. The trouble, critics say, is that the assumption that there is someone in the household available to use the program is increasingly out of sync with reality. In addition, the government's recent attempt to curb growth in social welfare spending is now beginning to hurt caregivers. As if to highlight the dilemma, one in five men quit working or changed jobs to one with different hours when faced with the need to care for a family member, according to a 2006 survey by the Japan Institute for Labor Policy and Training. Tsudome estimates that more than 300,000 men, or one-third of male home caregivers, are currently under the age of 60 and thus potentially could quit their current job. "(Behind the data) are numerous workers who are clinging to their job, walking a tightrope shouldering the additional duties of elder care," says Yoshie Komuro, CEO of Work Life Balance, a consultancy. "They may have managed to get by so far by counting on outside help but don't know how long they can go on like that." The recent creation of a nationwide network of male caregivers, the first of its kind, underscores the gravity of the quietly spreading social strain. The group's members want their voices heard by the public in general and policymakers in particular to come up with measures that make a real difference for struggling home caregivers. At a recent gathering in Tokyo, a man described the impossible choice he has to make between living with his aging parents in rural Japan with little prospect of getting a decent job or staying at his current job in Tokyo, leaving his parents without a helping hand. "We have to worry about many things as the caregiver, but ultimately, our worry boils down to how to get by financially," says Fujio Arakawa, the representative of the network and a longtime caregiver. "The most difficult, almost impossible question for us is how to take care of our family while keeping a job. Our task is to try to make that work out." Employees aren't the only ones faced with the problem. Increasingly, companies are at risk of losing valuable employees with little warning. Adding to that risk is the growing number of single men in their 40s and 50s, who already account for nearly 20 percent of the age group. They might be immediately affected if a parent becomes infirm. According to Komuro, one in six of its employees will face the need to take care of aging relatives in 15 years. She says that proportion will only get worse because senior care continues indefinitely. However, there are signs of positive change. The government is reinforcing the law requiring companies to offer ways to accommodate the needs of caregivers. And some labor unions, including those of the country's key manufacturers, are starting to call on companies to offer a variety of benefits similar to those given to parents with small children. Toyota Motor Corp., for example, introduced programs this year that include flexible work hours and senior care leave to make it easier for workers to stay with the company. It appears, however, that coming up with new programs is one thing but it is quite another to change the culture so employees take advantage of them in an increasingly demanding workplace, especially amid the recession. Expanding public services or corporate support alone won't be sufficient to meet the complex needs of family caregivers. What is at issue, experts argue, is beyond providing specific "support measures." It is about the future vision of the broader society — the burden-sharing, how to reallocate limited public resources, and changing corporate culture and even one's way of life. And now is the time for Japan to begin serious debate on these fundamental questions, they say. Komuro says what companies can do above everything else is abolish their deep-rooted practice of long working hours. This alone would be a big relief for family caregivers with a job and users of public senior care services, who would otherwise be hesitant to use "benefits," she says. Regardless of its readiness, pressure on society is intensifying. The number of seniors who need care nearly doubled to 4.5 million in the seven years to 2007 and is set to reach 6 million to 6.4 million by 2014, according to the government. "It's mind-boggling," says Yoko Yamaguchi, assistant general secretary of the Japanese Trade Union Confederation (Rengo). Yamaguchi, who goes around the country to talk about both domestic and professional caregivers, says she encounters elderly people heartbroken to see their son or daughter sacrificing for them, quitting their jobs to take care of them only to live a tough life. "This is a reality of Japan. Is that the way our aging society has to be?" The life expectancy for women in 2008 increased to 86.05 years, up some 22 days, and 79.29 years for men, both posting record figures for the third straight year, the health ministry said in early July. Reflecting the growing stress felt by home caregivers across the country, incidents of domestic violence, suicides and even murders inside families have made headlines in recent years. These sad realities only add to the urgency with which Japan must cope with the mounting demographic challenge. "(At stake) is the sustainability of Japanese society in and of itself and the sustainability of the family," says Yoshio Higuchi, a professor of labor economics at Keio University in Tokyo. He says the need for senior care, and thus for support for caregivers, will increase sharply in the next 15 to 20 years, reflecting baby boom demographics. Given the government's mushrooming debt, the public can't sit back and hope it will provide them with more services and build more nursing homes. "Our society's ability to respond (to the crisis) is being tested," Yamaguchi says. [rc] (C) The Japan Times