Can Japan’s Seniors Themselves Play an Effective Role in the Home Care Needs of Japan’s Elders?

1. Can Japan’s Seniors Themselves Play an Effective Role in the Home Care Needs of Japan’s Elders? Robert C Marshall, Ph.D.Department of AnthropologyWestern Washington University

2. Japan’s Senior Co-operatives • A network of hybrid co-operatives • Of, by and for seniors • In the context of: • demographic change • long term care for the elderly • co-operatives businesses

3. Demographic Change in Japan • 1947 Japanese men reached 50 years life expectancy • 1998 77.2 for men, 84 for women • 1998 > 65 = 16.2% • 1998 1.38 births/couple • 2007 Japan’s population will peak • 2025 > 65 projected at 27.4%

4. Long Term Elder Care • 2000: 50% live in three generation households • 1993: 2 million elders needing LTC • 2025: projected at 5.2 million • 2000: kaigohoken (national long term care service insurance) • Caregiver shift from 35~55 toward 55~75 year old women (and few men) • care to family members not reimbursed • policy aimed to create businesses & jobs

5. Co-operatives • Member owned and managed businesses • For benefit of members • Types of co-operative • consumer (food, credit, housing, electricity) • producer (marketing, branding, shipping and storage ) • worker (jobs)

6. Senior Co-ops: A Worker and Consumer Hybrid Co-op A. Organizational history 1995 first branch started in Mie Prefecture,150 members 2002 branches in 38 of 47 national administrative districts, > 100,000 members 2005 targets of • 1,000,000 members • a branch in each A.D. 1999 Kawasaki City branch: 350 members in three years.

7. B. Focus on the needs of the elderly for • paid work • home care/health related services • community connections

8. C. Members can both provide and receive services: • $30 annual fee • $50 to join • fees for services vary, but are low • pay is not as low, but not high

9. D. Home care services and senior co-ops • Home helper services offered from beginning • Growing focus since April 2000 on national home care insurance (kaigohoken) • Offer courses leading to home helper certificates (grades 2 & 3, and coordinator) • Collaborate with local government agencies • Start, staff and manage home helper dispatch centers

10. E. Other member opportunities • Transportation (therapy, dialysis) • Nursing home assistance (feeding, bed changing) • Tour and hobby groups (knitting, doll-making) • Clothing re-tailoring (“ReForm” group) • Home environment repair and renovation • Social service group volunteers • Fund raising organization • Reading and discussion groups, newsletter publishing • Lunches and dinners, both cooking and delivery • Day-care centers for seniors • Assisted living centers (only a few so far)

11. F. Social service component too • links provide members with a community • meaningful, valuable activity (ikigai).

12. Further Reading • Campbell, John C. and Naoki Ikegami. 2000 “Long-Term-Care Insurance Comes to Japan.” Health Affairs 19:3 (May-June), 26-39. • Long, Susan O., ed. 2000 Caring for the Elderly in Japan and the US: Practices and Policies. London and New York: Routledge. • Marshall, Robert C. 2004 Why Has an Expanding Movement of Worker Co-operatives Emerged in Japan among Middle Aged, Middle Class Housewives over the Past 15 Years? In: Paul Durrenberger and Judith Marti,eds., Labor in Anthropology (Society for Economic Anthropology, Vol. 22). AltaMira Press: Walnut Creek, CA. Chapter 7. • ----- 2003 The Culture of Cooperation in Three Japanese Worker Co-operatives. Economic and Industrial Democracy 24(4):543-572. • Nakano, Lynne. 2005 Community Volunteers in Japan. London and New York: Routledge. • Traphagan, John and John Knight, eds. 2003 Demographic Change and the Family in Japan’s Aging Society. Albany: SUNY.