Makiko Morita, Senior Research Associate
In Japan, there is a new intergenerational trend in care policy which has been largely informed by particular local practices. The government has introduced a new concept, “Regional Cohesive Society”, in 2016 wherein inclusion of individual citizens is sought regardless of their age, gender and social “categories”. In terms of care, the government implemented "Inclusive-type Service" in the revision of the Long-term Care Insurance System in 2018 with the endeavor to realize a "Regional Cohesive Society” which allows existing care centers to provide care services for the disabled and for the elderly at the same time which was not possible previously. The next step could be the integration of child care into some parts of the care scheme as well, although how it could be combined has to be discussed thoroughly. In fact, the governmental strategy states that combining care services for children, the disabled and the elderly is a prioritized agenda.
Despite these transformations in policy direction, generally relevant discussions on care have not paid sufficient attention to the effects of the combined care of seniors and children, therefore it is not clear what values the new intergenerational care brings about. Only a couple of studies have pointed out that intergenerational care is encouraged without reviewing scientific evidence of its effects. This paper takes this as its point of departure and aims to
1) review existing literature and identify advantages (and disadvantages if there are) of intergenerational care,
2) investigate how positive (and negative if applicable) effects are produced in real care settings.
In particular, this paper focuses on care centers where seniors and children spend a long time together in the same space, and in-depth interviews were conducted on the actual situation of symbiotic care provided by private enterprises.
This study has revealed 1) an evolution in the view of nursing care derived from an increase and a change in relationality, 2) the changing definition of nursing care service from satisfying static “needs” to optimizing potentials of users with a more substantiated observation of care workers which puts the care environment in everyday contexts rather than making users feel they are in care facilities, 3) the similarities between child care and nursing care.
The view of nursing care in care institutions and the content of service are gradually evolving away from conventional care. With the inclusion of a variety of people including children, care facilities will no longer be places specializing only in nursing care and will include aspects of chaos and the everyday. As a result, the behavior of elderly users will change from service recipient to an individual living in a community. Users themselves will search for their own roles as individuals in a more regular environment, and the staff members gradually recognize that watching over and appropriately supporting this behavior is one of their main daily tasks. Although this "watching over" is understood by staff as an element that connects childcare and nursing care, the focus is placed on how to provide support that draws out the potential through observation by watching attentively rather than watching over as more traditional “monitoring”.
While the perception of the profession of care workers including nursing staff is changing among the caregivers themselves, new challenges have emerged such as that the heavier workload in coordinating services which provide a sense of daily life and the increased difficulty in identifying what “care needs” really are. Now that the practice of nursing care is changing, a new system to support these challenges is necessary.
The full version of this report is available in PDF format below. This report is only available in Japanese.
The Transforming Nature of Nursing Care Service in Japan: A Qualitative Study of Intergenerational Care of Seniors and Children