In the Land of the Rising Sun, the equivalents of our CHSLDs do everything to ensure that their patients stay or return home, even if it means welcoming them during the day to give them a bath and administer care. One of the oldest societies in the world also demonstrates great flexibility in making life easier for caregivers.
In a large wooden house with a pointed roof, characteristic of the Japanese countryside, a thin sliding door gives access to the living room, where a hospital bed is installed near the window. Mitsuyo Imura, 96, emaciated, is bedridden there. Suffering from dementia, she hardly speaks anymore.
“I’m sure my mother is very happy to be at home,” says her daughter, Kaoru Imura, through an interpreter. Even for me, being able to take care of my mother until the end of her life is a rather happy prospect. It is my personal satisfaction. »
Kaoru Imura is 75 years old herself. Two years ago, however, she did not hesitate for a second to take her mother home after a prolonged hospitalization for pneumonia. The business was not free of challenges.
“The first year, she sometimes woke me up at night screaming. I had to sleep next to her, on the living room floor,” recalls the retired municipal official from Okamura, an island village in Ehime Prefecture, in Japan’s Inland Sea.
On the day of our visit, an occupational therapist had the nonagenarian do flexibility exercises. In addition to this weekly visit, a specialized transporter also picks up Mitsuyo Imura two days a week to take her to a care center, where she is washed and fed. If her daughter has to be away for a trip, for example, this center can also temporarily accommodate the mother.
Not just the CHSLD
The aging of the population is very visible in Japan, which has no less than 36 million people aged 65 or over. In the street, in public transport and even among the many security guards, the elderly are well represented in the public space. When they lose their autonomy, their long-term care system is designed to keep them at home.
The Santa Fe care center, in the district of Ota, south of Tokyo, makes it a mission. Erected on the quays of the industrial port, the ten-storey building, built fifteen years ago, is immaculately clean. Tall green plants greet visitors in a large, very modern entrance hall. A powerful air purification system removes all odors.
The ground floor is reserved for day services to accommodate elderly or disabled people from the neighborhood who return home in the evening, while the top floor is devoted to the rehabilitation of residents with a view to returning home.
“Our goal is to return people to their homes. It has to be a favorable family situation,” explains Maekawa Ryo, deputy director of the centre.
The establishment ensures, for example, that the client has access to suitable accommodation, equipped with a suitable bathtub, for example. A plan is then developed for care at home or at the day centre. Owned by a major non-profit long-term care association, the center also has a research mission.
Sachiko Fujita, an energetic and cheerful 57-year-old nurse, was not forced to give up her career by returning to live with her 91-year-old mother, who suffers from a mild form of Alzheimer’s disease. Five days a week, she prepares her mother before going to work.
Paratransit then takes the eldest to the Santa Fe centre. There she receives a bath, does gymnastics with other elderly people, and then organized leisure activities, such as making small objects. She can chat with her friends. Not only is she fed on the spot, but she is driven home with a meal if her daughter has to stay late at work. According to Mme Fujita, these services improve the condition of his mother.
“So far, I have never felt that I had sacrificed my personal life”, confides his daughter to the Duty, through an interpreter. She agrees that many older people are reluctant to ask their children for help for fear of upsetting them. “But if I place my mother in an institution, my neighbors will talk. This pressure exists,” she admits.
A declining tradition
In Japanese society, which still today has great respect for old age, it is traditionally the daughter or daughter-in-law who is responsible for caring for elderly parents. “We see it less and less,” said Yuki Yasuhiro, professor of social work at Shukutoku University in Tokyo.
Currently in Japan, most elderly people live alone or with their partners, and many are self-sufficient. About one in five elderly people live with their children, and one in ten is placed in a care center, explains the specialist.
I’m sure my mother is very happy to be at home. Even for me, being able to take care of my mother until the end of her life is a rather happy prospect. It is my personal satisfaction.
Japan’s Big Book of Statistics reports that Japanese women remain independent longer than anywhere else in the world: up to 75.4 years on average, and 72.7 years for men. Their government wants to keep them at home as long as possible, under a reform in the year 2000 which charges the patient only one-tenth of the bill for long-term care provided by the private sector. An efficient system, but compromised by the expected shortage of the number of workers in the coming years.
“It’s not expensive to pay [la cotisation demandée]. If it weren’t for all these services, I wouldn’t have the courage to take care of my mother,” says Kaoru Imura. However, this amount can weigh more heavily on the wallets of retired fishermen or other less fortunate inhabitants of her village, she adds.
After sitting her mother in her bed with the help of the occupational therapist, in the middle of her living room on Okamura Island, she sings her a song. The 75-year-old explains that sometimes her almost 100-year-old mother still remembers the lyrics.
This report was made possible with the financial and logistical support of the Foreign Press Center of Japan.