A senior taking long-term care of another senior — a phenomenon called “rorokaigo” in Japanese — is becoming increasingly common. Putting in place a multilevel support system to help both the care recipient and provider in every aspect of their lives is an urgent task.
The 2016 Comprehensive Survey of Living Conditions has revealed that in 55 percent of all cases of at-home nursing care, the person requiring care and the caregiver are both age 65 or older. Both were age 75 or older in more than 30 percent of cases. Both figures have increased by more than 10 percentage points in the past decade.
This is because the number of households with only elderly residents has increased due to the graying of Japanese society and the trend toward nuclear families.
Rorokaigo does not only involve care given by elderly spouses. It is not unusual to have a combination of a child age 65 or older looking after their parent or parents.
Many of these elderly caregivers also suffer from their own health problems or a decline both physically and mentally. It is easy for them to become severely exhausted by taking care of someone, and there is a constant risk that both could end up falling into poor health. There has been an unending stream of tragic cases in which a caregiver pushed to the breaking point ends up abusing or killing the person they were caring for. This reality must be taken seriously.
The most common principal cause for requiring nursing care was dementia, which accounted for 18 percent of cases. Many observers believe both the care recipient and the caregiver have dementia in a significant number of cases. This makes it difficult to maintain their daily lifestyle and can easily result in the careless handling of fire in the home or neglecting to provide care. But they cannot call for support, so such a situation can be difficult for people around them to notice.
Give importance to caregivers
The most pressing issue is enhancing and improving at-home nursing care services. It would be effective to expand 24-hour visiting care and nursing services, and have more small, multifunctional facilities that can handle visits, dispatch staff and provide temporary accommodation services.
It also is important to provide meticulous daily living support that regular services provided under nursing-care insurance cannot fully cover, such as taking out garbage, meal deliveries and keeping watch over a care recipient.
The government aims to create “societies of regional coexistence,” in which residents support one another in taking care of seniors who need assistance. In fiscal 2015 the government shifted some operations for people who require low-level nursing-care insurance services to local governments. This is designed to realize flexible, diverse assistance that meets the actual conditions of each region.
Local governments should actively nurture providers of such care, including volunteer groups and nonprofit organizations, and provide support for the management of such groups.
Having members of a community look out for and support one another will be useful in detecting cases of dementia at an early stage.
Nursing-care insurance is based on providing nursing care to those who need it, but the importance of giving support to caregivers also is increasing. To prevent caregivers from becoming isolated, the establishment of places where people in similar positions can get to know each other, take a breather and seek advice and other measures should be promoted.
It also might be a good idea to consider a system that can assess a caregiver’s “ability to provide care” based on their sense of burden, physical condition and other factors, and then have local governments and other entities provide support that fits their level of need.