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Japan as the World’s Most Rapidly Aging Society (3) Elderly Care

New Day Care Service Makes Elderly Feel at Home

It looks just like a private home, but is actually a day care center (a non-residential facility) for elderly people where they can relax on the sofa or enjoy chatting around a dining table.

Small-scale day care centers dubbed Sawa Honpo, using the Japanese characters meaning “tea,” “talk” and “store,” have gained popularity across Japan for their comfortable homey atmosphere and meticulous service compared with conventional centers.

The operator, Japan Care Wellbeing-Group Co., was founded in May 2005 by Hideaki Fujita, 37, who used to work at a nursing home and currently serves as chairman of the Tokyo-based company.

Instead of building new facilities, the company set up the centers at vacant private homes after adding handrails and making other necessary refurbishments.

Behind the popularity is the feeling they give users that they can relax as if they were in their own homes, sometimes making cookies together with care givers and taking baths as many times as they want.

The company places four workers at each center to take care of up to 10 elderly people, about two times more than the number of care givers serving at conventional nursing homes.

Fujita said he created the centers as he wanted to provide elderly people services that could respond to their individual requirements instead of an off-the-shelf service.

“I learned that each elderly person has different experiences and prefers different things,” he said recalling his time in the nursing care business.

After gaining a degree in sociology and social work at Meiji Gakuin University, Fujita joined a special elderly nursing home (residential facility) where he saw residents having to wait in a long line to take a bath and living what seemed a very inconvenient life.

He said he also questioned the situation of the care givers who had to work for very low wages despite being required to do hard work.

Fujita then opened the first of the small-scale around-the-clock centers hoping that to satisfy both elderly users and care givers.

For Sawa Honpo homes, he uses vacant buildings to help him cut back on construction and maintenance costs. He diverts the money saved to wages for care givers.

Over the years, Fujita has extended the business on a franchise basis, running a total of 678 centers nationwide as of mid-July, with the number of elderly users amounting to more than 13,000.

Fujita has received a number of inquiries about the service from Singapore, South Korea and European nations whose societies have also been graying.

Fujita said he has already been considering advancing into Taiwan. “Every country will be aging,” he said. “I would like to convey good things about Japan’s nursing care insurance system and promote our service where I believe elderly people can enjoy their lives.”

Exporting Japan’s Elderly-care Service

By Ryoji Shimada, staff writer

Hideaki Fujita, founder of Sawahonpo day-care center

Hideaki Fujita, founder of Sawahonpo day care center, shared his views about his company’s service and the general state of Japan’s elderly care industry.

“Often times we talk about Sweden as a good model for elderly care, but its service is run by the government. In fact Japan’s service is the best in the world,” Fujita boasted. “Since private companies became involved in 2000, the service or management system has been brushed up.” Now, he’s looking for ways to export his company’s care services abroad.

Ever since Japan inaugurated its public long-term care insurance system in 2000, the market has expanded consecutive year-on growth, more than doubling from 3.9 trillion yen (about $39 billion) that first year to over 8 trillion yen ($80 billion) in 2012. Projections are for this market to grow at the rate of 1 trillion yen yearly, growing to 21 trillion yen by 2025.

Before this public insurance system went into effect, all elderly care services were operated by local governments or social welfare service corporations. Now many private companies have entered the market and the quality of services has improved.

  “Even elderly people with mild dementia can prepare their own meals and are still good at cleaning, so we help by working with them together,” said Fujita. “Some of the men go fishing with our staff. Some are happy to recollect their wartime experiences, and others are not. We have various kinds of people with varied orientation. We try to adapt our service to their individual needs.

  “We have this kind of person, so we have this care program. We experiment with it and if it goes well, we continue the same service and if not, we change it,” Fujita said, explaining Sawahonpo’s day-care service. “We customize our service individually. It is a meticulous process.”

  Asked why he started this service, he told he wanted to create a new type of service between old people’s nursing homes and so-called day-care centers.

“Those nursing homes are the place where elderly requiring physical assistance spend the rest of their lives, whereas day-care centers are where seniors people are taken a couple of days in a week for meals, to take a bath or to receive rehabilitation. They are two totally different types of facilities. Sawahonpo can put up visitors overnight for only 800 yen,” said Fujita. In a nutshell, old people have the option of visiting there for day care or to stay overnight, basically for as long as they want.

  “Old people moved into nursing homes at their family’s requests,” said Fujita. “Their family members are all working and not able to take care of them, or else they have become exhausted from caring for a senile or bed-ridden person, and so on. But according to a survey by the Ministry of Health, Labour and Welfare, 80% of the aged want to spend the rest of their life in their own home. But if that incurs a burden on their family, they would rather stay in a nursing home. We want to be able to give nursing home residents a chance to spend some days at their own home,” said Fujita.

On another note, elderly care workers are in short supply in Japan. By 2020, another million will be needed. Right now, every year some 800,000 new workers enter this market and about the same number leave, resulting in no increase. The biggest reason for this is the generally low wages. Even at the managerial level wages range between 3 and 4 million yen a year, and an ordinary care worker earns considerably less.

To boost wages, Sawahonpo acquires use of a vacant house for its services, as a way of sustaining initial running costs. “Relatively speaking, those working as elderly care workers don’t have high management skills,” Fujita pointed out. “But one Sawahonpo facility only has seven or eight staff. Managing a small number of staff doesn’t require so much skill. But those who work their way up to become head of the facility can earn around 5 million yen a year.” The company’s youngest facility head is 26 years old and the age of the average head is around 32. The wages they receive are commensurate with their counterparts in Japan’s other service industries.

Japan Moving Toward Promoting Nursing Robots for Elderly

An equipment to carry a bedridden person is under development.

In rapidly aging Japan, efforts are accelerating to make more practical and affordable robots for helping the elderly perform daily tasks to cope with a projected future shortage of caregivers.

Prime Minister Shinzo Abe’s government has allocated 2.39 billion yen ($23.9 million) in the budget for fiscal 2013 to help develop nursing care robots and spread their use.

The Ministry of Economy, Trade and Industry chose last month 24 companies that will receive subsidies covering half to two-thirds of the cost of developing what it calls “nursing care robot equipment.”

The tasks designated for such robots include helping the elderly move between rooms, providing help with toilet needs and tracking those prone to wandering.

The number of people aged 65 or older in Japan is expected to increase by about 7.09 million over the 15 years from 2010, with the percentage of the elderly in the overall population rising from 23 percent to 30 percent during that period, the government estimates.

It forecasts around 2.32 million to 2.44 million caregivers will be necessary, up more than 1.5 times from the 2010 level.

But the elderly care industry is suffering from a high job turnover rate due partly to relatively low pay. In addition, about 70 percent of caregivers are said to be suffering from back pains due to constant lifting of the elderly between bed and wheelchairs as well as helping them take baths and do other daily activities, the government said.

Robots can be “one of the few solutions” to this situation, said Akifumi Kitashima, deputy director of the industry ministry’s industrial machinery division in charge of the project.

“We aim to realize mass marketing of cheap robots costing 100,000 yen to 200,000 yen (about $1,000 to $2,000), no matter whether they look like a typical humanoid robot,” Kitashima said.

He noted that high prices have been an obstacle to the robots’ introduction in elderly care facilities, with some sophisticated robots costing over 10 million yen (about $100,000).

“By 2018, the lineup (of nursing robots to be developed under the project) should increase to a significant volume and people will be able to buy them,” he said. “We aim to achieve a situation where every senior citizen’s home or one in three to four houses have at least one unit.”

Companies to receive the subsidies include Toyota Motor Corp. for its development of a device to help carry the elderly, as well as Sekisui Hometechno Co., working on a mobile flush lavatory, and Toli Corp. with a wireless sensor mat that can report the wandering of the aged.

The government will also set a safety standard for nursing care robots so that manufacturers will have a clear idea of the safety level their products will be required to achieve.

“I find them very effective,” Akira Kobayashi, the head of Fuyouen senior citizens’ home in Yokohama, Kanagawa Prefecture, said, referring to the Palro humanoid robot and Paro seal-type therapy robot. They are leased free of charge under another project initiated by the Kanagawa prefectural government to promote the use of nursing robots.

The prefectural government began leasing the robots to the nursing home last year. It also leases a powered exoskeleton suit called HAL for assisting wearers to walk and perform other activities to a hospital in Kanagawa to help rehabilitation programs.

At the Fuyouen home for the aged, the 40-centimeter tall Palro conversation robot offers recreation services to residents, by playing games, singing and dancing together with the elderly.

“He knows everything very well. I learned a lot from him,” Tsugie Nakanishi, 88, said, referring to quizzes the robot gives. The robot can understand spoken words, and told Nakanishi that her answer was wrong while explaining the right answer.

A 92-year-old resident, Yukiko Kanesaka, told the baby seal-like Paro, “You’re so cute, look at me,” and the interactive robot responded as if it was alive, moving its head and legs, blinking its eyes and squealing.

Caregivers at the facility said their residents accepted the robots more easily than expected, with the robots having positive psychological effects on the residents, sometimes bringing smiles to the faces of even the mentally depressed.

In addition to such communication-type robots, Kobayashi expressed hope for the future development of more practical robots that can actually reduce caregivers’ physical burdens, such as by helping lift the elderly.

“I think people’s hearts, caring, and the warmth of physical contact can never be replaced by robots,” said Kobayashi. “But with many in the nursing care industry suffering from back pain, I am hoping that robots will be developed eventually so that they can ease such problems and enable them to work longer.”

In another development in the private sector, Orix Living Corp., an operator of elderly homes, began talks with some manufacturers to jointly develop nursing robots after offering tours of its facilities.

The government projects the Japanese market for nursing care robot equipment will expand from an estimated 16.7 billion yen ($167 million) in 2015 to 404.3 billion yen ($4.04 billion) in 2035.

Yumi Wada, a caregiver at Fuyouen, said, “If robots will be developed while giving thorough consideration as to how to have them collaborate with human beings, I think there is a possibility that they can widen the scope of nursing care services we can offer.”

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