In chapter 3. I wrote the situation of the 700.000 bedridden (bed-bound) elderly and the one million senile dementia elderly in Japan. And 37% the bedridden elderly and 74% of the senile dementia elderly are cared at home by the families in Japan. Table . 9 and Table . 10 shows the real i ty of the fami ly caregivers .

Table.

The Relationship between the Patients and the Care-givers

Wife or Husband	40.8%.
Daughter in Law	28.4%
Daughter	21.8%
Son	4 . 60%
Others	4 . 5%

Table.1

The Age of the Care-givers

( Age )	30-39	40-49	50-59	60- 69	70-
Husband				11.6%	83.7%
Wife			3.4%	44.l%	52.4%
Daughter in Law	10.6%	32.6%	44.7%	12.1%
Daughter ( married )	8.6%	19.0%	48.3%	22.4%	1.7%
Daughter ( unmarried )		39.5%	20.9%	34.9%	4.6 %
Son	10.0%	35.0%	25.0%	25.0%	25.0%

Source :

Bureau of Social Welfare,Tokyo Metropolitan Government 1991

 
  About 85% of the care-givers are women and 28.4% are the daughter in law and the average age is 54 years old.  About 30% of them are over 70 years old. Moreover only l0% of the families who take care of such elderly at home get the help by the home helpers in Japan.

   The reasons why families do not or can not get the help by home helpers are as follows;  

<1>	Number of Home Helpers is Very Few
<2>	Japanese People Hesitate to Depend on the "Welfare" Service,  because in Japan to Depend on the "Welfare" is Seemed to be Shameful.
<3>	It is a Japanese Moral that the Family Take Care of their own Families. And Only Poor People can Depend on "Welfare".
<4>	It is not so Common in Japan to Invite Other People at Home. So They Hesitate to Call for the Home Helpers
<5>	In Japan "the Duty of the Children to Take Care of their Parents" is written in Japanese Civil Law

 

(but there is no punishment, if the children do not take care of their parents)

 

Fig.10

THE NUMBER OF HOME HELPERS PER 100,000 POPULATION

                 PERSON 

(Source:

report "Rojinhukushi to Kaigo Manpower"  by Dr.Yuji Ogasawara -Elderly Statistic Report in 1991-)

  The number of home helpers per elderly in Japan is about 1120 compared to that in Sweden. The biggest reason is that most of the cases elderly are cared by their own families. There are so many housewives and about 60%. of the elderly live with their children in Japan. So in the past only few Japanese people real i zed the importance of the public home help service especially home helpers. But recently more and more Japanese people have realized that they need better public home help service .

Ministry of Health and Welfare also realized the importance of the home service and has the plan, so called "Gold Plan", to increase the number of home helpers from 23,629 (in 1987) to l00.000 (in 2000).

In the current Japanese situation, it usually takes one week or one month to get the home helpers' visit after the farmilies apply for the social welfare office at the district. Moreover the families can get the home help service only on the week days at the day time from 9 o'clock to 5 o'clock. Only once a day, maximum three or six times in a week(one visit is about two hours help , the frequency of the service differs at the municipalities ) . On the other hand, in Sweden they can get the home help service 24 hours including sunday and several times in a day.

Japanese Ministry of Health and Welfare forecasts that about l million "Bedridden Elderly" will exist in 2000. More and more home help service is needed in Japan, otherwise the families who take care of the "Bedridden Elderly" by themselves will "burn out" sooner or later.

And there are two main reasons why so many bedridden elderly and the senile dementia elderly stay at home in Japan. One of the reasons is that the number of institutions are very few. And another reason is that the QOL at the institutions in Japan is too bad.

   In chapter.5, I will write about the facilities for the aged in Japan.

　

4.2	Home Care in Sweden

    Since the mid-1960's the number of handicapped and elderly people receiving home help has more than trebled. These groups increased particularly during the late 1960's and the 1970's. In 1990 some 17% of Sweden's old-age pensioners(>65) received some form of home help; for those aged 80+ the figure was around 40% .

In 1990, the number of home helpers  (including home helpers at the old age homes and sheltered housings, both part-time and full -time ) is 72 , 400 . In 1990 in Japan the number of home helpers is 38,000(excluding home helpers at the old age homes, calculated as full-time job) . The number of home helpers per 100 elderly(>65) is in Sweden 4.73 and in Japan 0.24. 

"Home Care in Japan" usually means the "Care by the Family at Home" because the number of home helpers are very few. But "Home Care in Sweden" means "Care at Home" . From the result of ULF study in 1980/81, about one third of the care at home is provided by the home helpers in Sweden.

Table.11

The Comparison of Home Care in Japan and In Sweden In 1990

	SWEDEN	JAPAN
Aging Rate(>65)	18%	12%
Number of Elderly(>65)	1,530,000	1,560,000
Number of Home Helpers	72,400	38,000
Number of Home Helpers  / 100 Elderly(>65)	4.73	0.24
Ratio of Elderly*  Who Stay at Home	92%	98%
Ratio of Elderly  Who Live Alone	33%	11%
Ratio of Elderly  Who Live with  their Children	6%	61%

(Source :

in Sweden "Fact Sheets on SWEDEN"  in Japan Ministry of Health and Welfare)

*	"At Home" does not include those who live at the sheltered housing ( servicehus ) .

    In Sweden if relatives quit job and take care of their elderly parents, they can be employed by municipalities as care-givers. In 1990,6,681 persons were cared under this program. But in Japan there is not such system as support family care givers. So if relatives quit job and take care of their families, such families would become poorer and poorer.