Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-21T14:29:23.317Z Has data issue: false hasContentIssue false
  • English
  • Français

The Japanese voluntary sector's responses to the increasing unmet demand for home care from an ageing population

Published online by Cambridge University Press:  21 November 2014

MAYUMI HAYASHI
MAYUMI HAYASHI*
Affiliation:
Institute of Gerontology, King's College London, UK.
*
Address for correspondence: Mayumi Hayashi, Institute of Gerontology, Department of Social Science, Health & Medicine, Faculty of Social Science & Public Policy, Strand, London WC2R 2LS, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

As Japan faces the challenge of the increasing demand for home care from its ageing population in an era of economic constraints, the expectation has evolved that the voluntary sector will fill the shortfall in statutory provision through semi-volunteers providing affordable home care. Drawing on qualitative interviews with managers from 15 voluntary organisations, this article explores their experiences in trying to meet this expectation. Even though most organisations provided supplementary home-care services, the empirical evidence indicates a limited capacity to deliver this expectation, with respondents aware of the deteriorating situation. It has been ascertained that supply mechanisms differ between the traditional voluntary – and the new hybrid – organisations. The former employ ‘cost-efficient’ labour such as ‘paid volunteers’ on below minimum pay rates. In contrast, the ‘hybrids’ use paid employees at regular pay rates, a finding that contradicts optimistic assumptions about the ideological role of ‘traditional’ voluntary organisations. This article suggests the importance of acknowledging diverse responses from the voluntary sector, including the new hybrids with their acknowledgement of voluntary and commercial imperatives. Open mindedness and a preparedness to revise interpretations of the earlier ‘models’ of the voluntary sector are essential. The conclusion proposes that the best strategy to unlock the voluntary sector's full potential to deliver supplementary home care is a multi-platformed approach, with adequate public purse funding, which pragmatically maximises resources.

Keywords

voluntary sectorJapanhome caredomestic supportolder peoplehybrid organisationssupplementary home care
Type
Articles
Information
Ageing & Society , Volume 36 , Issue 3 , March 2016 , pp. 508 - 533
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adachi, K. 2000. The development of social welfare services in Japan. In Long, S. O. (ed.), Caring for the Elderly in Japan and the US. Routledge, London, 191–205.Google Scholar
Adachi, K. 2008. Fukushi-NPO-no Shakai-gaku [The Sociology of Non-profit Welfare Organisations]. University of Tokyo Press, Tokyo.Google Scholar
Bode, I. 2006. Disorganized welfare mixes: voluntary agencies and new governance regimes in Western Europe. Journal of European Social Policy, 16, 4, 346–59.CrossRefGoogle Scholar
Campbell, J. C. and Ikegami, N. 2003. Japan's radical reform of long-term care. Social Policy and Administration, 37, 1, 21–34.CrossRefGoogle Scholar
Colombo, F., Llena-Nozal, A., Mercier, J. and Tjadens, F. 2011. Help Wanted? Providing and Paying for Long-term Care. OECD Health Policy Studies, OECD Publishing, Paris.CrossRefGoogle Scholar
Costa-Font, J. 2011. Reforming Long-term Care in Europe. Blackwell, Chichester, UK.CrossRefGoogle Scholar
Coulmas, F. 2007. Population Decline and Ageing in Japan. Routledge, London.Google Scholar
Cyoju, ShakaiBunka, Kyokai (ed.) 1998. NPO-ga-egaku fukushi-chizu [A Welfare Map Drawn By NPOs]. Gyosei, Tokyo.Google Scholar
Evers, A. 2005. Mixed welfare systems and hybrid organisations: changes in the governance and provision of social services. International Journal of Public Administration, 28, 9/10, 737–48.CrossRefGoogle Scholar
Fujimura, M. 1999. Fukushikokka-no saihensei [Restructuring Welfare State]. University of Tokyo Press, Tokyo.Google Scholar
Hashimoto, S. 2000. Koteki kaigohoken seido-ka ni okeru shimin katsudo dantai no doko [Trends of civic-led organisations under the long-term care insurance system]. In Jichitai, OsakaKenkyujo, Mondai (ed.), Kaigohoken [The Long-term Care Insurance System, Number 3]. Bunrikaku, Kyoto, Japan, 95–113.Google Scholar
Hayashi, M. 2011. The care of older people in Japan: myths and realities of family ‘care’. History and Policy, 3 June. Available online at http://www.historyandpolicy.org/papers/policy-paper-121.html [Accessed 1 April 2014].Google Scholar
Hayashi, M. 2012. Japan's Fureai Kippu time-banking in elderly care: origins, development, challenges and impact. International Journal of Community Currency Research, 16A, 30–44.Google Scholar
Hayashi, M. 2013. The Care of Older People: England and Japan, A Comparative Study. Pickering and Chatto, London.Google Scholar
Hayashi, M. 2014. What Japan teaches us about better care for older people. Health Service Journal, 4 April, 26–7.Google Scholar
Hongo, H., Araki, T., Matsuoka, S. and Sodei, T. 2011. Kaigo-kei-NPO-no genjo-to seido-gai-sa-bisu tenkai-ni muketa kadai [The situation of care-giving NPOs and the challenges of non-statutory service functions]. Fukuoka-kenritsu daigaku ningenshakaigakubu kiyo [Journal of Fukuoka Prefecture University, Faculty of Integrated Human Studies and Social Sciences], 19, 2, 1–18.Google Scholar
Hotta, S. 2007. Toward maintaining and improving the quality of long-term care: the current state and issues regarding home-helpers in Japan under the long-term care insurance system. Social Science Japan Journal, 10, 2, 265–79.CrossRefGoogle Scholar
Hyogon Fukushi Net 2010. Kobe-no hieirisoshiki ni-yoru kaigohoken-seido-gai-sabisu jittai-chosa hokokusho [Report on the Current State of Supplementary Services of Kobe Non-profit Sector Outside the Long-term Care Insurance System]. Kobe-no Hieiri-soshiki-ni-yoru Kaigohoken Seido-gai-Sabisu Jittai- Chosa-Iinkai, Kobe, Japan.Google Scholar
Ito, S. 1996. Shakaifukushi ni okeru riyosha-sanka [User participation in social welfare]. In Social Security Research Institute (ed.), Shakaifukushi-ni-okeru shimin-sanka [Citizen Participation in Social Welfare]. University of Tokyo Press, Tokyo, 41–61.Google Scholar
JSZSDZR (Jumin Sanka-gata Zaitaku-fukushi Sabisu Dantai Zenkoku Renraku-kai) 2006. Jumin sanka-gata zaitakufukushi sabisu [Report on Resident Participatory-type Homecare Provider Organisastions]. JSZSDZR, Tokyo.Google Scholar
Kanaya, N. 1999. Fukushi, iryo-to NPO [Welfare, health and NPO]. In Yamauchi, N. (ed.), NPO De-ta Bukku [NPO Data Book]. Yuhikaku, Tokyo, 114–31.Google Scholar
Kanaya, N. 2003. Is the home-visit care market on equal footing? Differential of conditions affecting performance [Homon-kaigo-shijo wa equal-fotting-ka? – kakusa-no sonzai-to sono-eikyo]. The Nonprofit Review, 3, 1, 1–23.Google Scholar
Kanaya, N. 2012. Kaigo-kei NPO-no jizokusei-to tayosei: kaigohoken seido-gai-sa-bisu no jittai-bunseki-kara [Sustainability and diversity of citizen-driven nonprofit care providers for the elderly: an analysis of services of non-profit organisations extending beyond statutory long-term care insurance services]. Hiroshima Journal of International Studies, 18, 55–70.Google Scholar
Kase, H. 1993. Zaitaku-kea-to shiruba-sa-bisu [Homecare and silver service]. Jurist, April, 60–68.Google Scholar
Kawai, K. (ed.) 1990. Korekara-no zaitaku-fukushi-sa-bisu [Home-based Care for the Future]. Akebi-Shobo, Tokyo.Google Scholar
Kingston, J. 2004. Japan's Quiet Transformation: Social Change and Civil Society in the Twenty-first Century. RoutledgeCurzon, London.CrossRefGoogle Scholar
Kono, M. 2000. The impact of modernisation and social policy on family care for older people in Japan. Journal of Social Policy, 29, 2, 181–203.CrossRefGoogle Scholar
Lee, H. K. 1987. The Japanese welfare state in transition. In Friedmann, R. R., Gilbert, N. and Sherer, M. (eds), Modern Welfare States. Wheatsheaf, Brighton, UK, 243–63.Google Scholar
Ministry of Health and Welfare (MHW) 1975. Kosei Hakusho [The Year 1975 Annual Report of the Ministry of Health and Welfare]. Gyosei, Tokyo.Google Scholar
Ministry of Health and Welfare (MHW) 1993 a. Kokumin-no shakaifukushi ni kansuru katsudo e no sanka-no sokushin-wo hakaru tame-no sochi ni kansuru kihonteki-na shishin [Announcement Number 117: Basic Guidelines to Achieve Greater Public Participation in Welfare Activity], 14 April. MHW, Tokyo.Google Scholar
Ministry of Health and Welfare (MHW) 1993 b. Vorantia-katsudo no cyu-choki-tekina shinko-hosaku ni tsuite [Mid- to Long-term Plans for Voluntary Activity], 29 July. MHW, Tokyo.Google Scholar
Ministry of Health and Welfare (MHW) 1996. Kosei hakusho [The Year 1996 Annual Report of the Ministry of Health and Welfare]. Gyosei, Tokyo.Google Scholar
Ministry of Health and Welfare (MHW) 2001. 1999nen shakai-fukushi gyousei-gyoumu-houkoku [The Year 1999 Report on Social Welfare Administration]. Kosei-Tokei-Kyokai, Tokyo.Google Scholar
Ministry of Health, Labour and Welfare (MHLW) 2002. Heisei-12nen kaigo-sabisu-shisetsu jigyosho-chosa [The 2000 Survey of Long-term Care Insurance Care-provider Agencies]. Kosei-Tokei-Kyokai, Tokyo.Google Scholar
Ministry of Health, Labour and Welfare (MHLW) 2012 a. Kaogohoken-seido kaisei-no gaiyo oyobi chiiki-hokatsu-kea no rinen [Summary of Long-term Care Reform and the Philosophy of Comprehensive Community Care]. MHLW, Tokyo.Google Scholar
Ministry of Health, Labour and Welfare (MHLW) 2012 b. Heisei-23nen kaigo-sabisu-shisetsu jigyosho-chosa [The 2011 Survey of Long-term Care Insurance Care-provider Agencies]. Kosei-Tokei-Kyokai, Tokyo.Google Scholar
Ministry of Health, Labour and Welfare (MHLW) 2013. Seikatsu-shien-sa-bisu no jujitsu- to koreisha-no shakai-sanka [Enhancing the Daily-living Support Service and Public Participation Among Older People]. Available online at http://www.mhlw.go.jp/seisakunitsuite/bunya/hukushi_kaigo/kaigo_koureisha/chiiki-houkatsu/dl/link5.pdf [Accessed 1 April 2014].Google Scholar
Mori, U. 2008. Gendai nihon no kaigohoken kaikaku [Long-term Care Insurance Reform in Contemporary Japan]. Horitsu Bunkasha, Kyoto, Japan.Google Scholar
Morikawa, M. 1999. Zaiitaku-kaigo-rodo-no seiritsu-katei [The process of systemising home care work]. The Journal of Ohara Institute for Social Research, 486, 23–39.Google Scholar
Nakanishi, S. and Ueno, C. 2003. Toujisha-shuken [Person-centred rights]. Iwanami-Shoten, Tokyo.Google Scholar
National Institute of Population and Social Security Research 2012. Nihon-no shorai-suitei-jinko [Population Estimation of Japan]. National Institute of Population and Social Security Research, Tokyo.Google Scholar
National Welfare Council (NWC) 2011. Heisei-22nendo jumin-sanka-gata-zaitaku-fukushi-sabisu-dantai katsudo-jittaicyosa [The Year 2011 Annual Report on Resident Participatory-style Homecare-giving Organisations]. Zenkoku-shakai-fukushi-kyogikai, Tokyo.Google Scholar
Noguchi, S. 1990. Fukushi-kosha-gata zaitaku-fukushi-sa-bisu [Homecare services of welfare corporations]. In Kawai, K. (ed.), [Home-based Care for the Future]. Akebi-Shobo, Tokyo, 56–84.Google Scholar
Okifuji, N. 2010. Kaigohoken-wa oi-wo-mamoruka [Can the LTCI Scheme Guarantee a Good Old Age?]. Iwanami-Shoten, Tokyo.Google Scholar
Pekkanen, R. and Simon, K. 2003. The legal framework for voluntary and non-profit activity. In Osborne, S. P. (ed.), The Voluntary and Non-Profit Sector in Japan: The Challenge of Change. RoutledgeCurzon, London, 76–101.Google Scholar
Peng, I. 2002. Social care in crisis: gender, demography, and welfare state restructuring in Japan. Social Politics: International Studies in Gender, State and Society, 9, 3, 411–43.CrossRefGoogle Scholar
Shibukawa, T. 2001. Fukushi NPO [Non-profit Welfare Organisations]. Iwanami-Shoten, Tokyo.Google Scholar
Shimizutani, S. and Suzuki, W. 2007. Quality and efficiency of home-help elderly care in Japan: evidence from micro-level data. Journal of the Japanese and International Economies, 21, 2, 287–301.CrossRefGoogle Scholar
Silver Service Shinkokai 2009. Homonkaig- sabisu ni okeru ‘kongokaigo’-no sokushin-ni-muketa cyosakenkyu-jigyo hokokusho [Report of Research to Promote ‘Mixed Care Services’ in Homecare Provision]. Silver Service Shinkokai, Tokyo.Google Scholar
Suda, Y. 2011. For-profit and nonprofit dynamics and providers’ failures: the long-term care insurance system in Japan. Public Management Review, 13, 1, 21–42.CrossRefGoogle Scholar
Swartz, K. 2013. Searching for a balance of responsibilities: OECD countries’ changing elderly assistance policies. Annual Review of Public Health, 34, 397–412.CrossRefGoogle ScholarPubMed
Takagi, K. 1992. Koreisha-no zaitakufukushi [Home-based care for older people]. In Sumitomo Life and Health Foundation (ed.), Zaitaku-koreisha-no life-plan [Life-plan for Older People at Home]. Yuhikaku, Tokyo, 1–19.Google Scholar
Takano, K. 1993. Zaitakufukushi-sabisu no zairitu-kozo [The structure of home-based social services]. Kikan Shakai-hosho Kenkyu [Quarterly of Social Security Research], 29, 2, 155–64.Google Scholar
Takechi, H. 1993. Fukushi-kosha ni yoru zaitakufukushi-sa-bisu [Homecare services of welfare corporations]. In Imamura, T. (ed.), Daisan-sector no kenkyu [Research on the Third Sector]. Chuohoki-shuppan, Tokyo, 347–94.Google Scholar
Tanaka, N. 1996. Shimin-shakai no borantia [Volunteering in Civil Society]. Maruzen, Tokyo.Google Scholar
Tanaka, N., Asakawa, S. and Adachi, K. 2003. Kaigo-kei-NPO no saizensen: zenkoku top-16 no jutsuzo [The Frontier of Welfare Non-profit Organisations: The State of National Top 16 Welfare NPOs]. Minerva, Kyoto, Japan.Google Scholar
Totsuka, K. 1992. Zaitaku koreisha-wo enjo-suru hieiri-soshiki [Non-profit organisations supporting older people at home]. In Life, Sumitomo and Foundation, Health (ed.), Zaitaku-koreisha-no life-plan [Life-plan for Older People at Home]. Yuhikaku, Tokyo, 20–66.Google Scholar
Tsutsui, T. and Muramatsu, N. 2007. Japan's universal long-term care system reform of 2005: containing costs and realizing a vision. Journal of the American Geriatrics Society, 55, 9, 1458–63.CrossRefGoogle ScholarPubMed
Ueno, C. 2011. Kea-no Shakai-gaku [Sociology of Care]. Ota-Shuppan, Tokyo.Google Scholar
Yamada, M. (ed.) 2005. Kaigohoken to 21seikigata chiikifukushi [Long-term Care Insurance Scheme and 21st-century Community Care]. Minerva, Kyoto, Japan.Google Scholar
Yamaguchi, M. 2000. Syakaifukushikyogikai-riron-no keisei-to-hatten [Formation and Development of the Theory of the Welfare Council]. Yachiyo-shuppan, Tokyo.Google Scholar
Yamaguchi, N. and Takahashi, H. (eds) 1993. Shimin-sanka to koreisha-kea [Citizen Participation and Elder Care]. Daiichihoki-Shuppan, Tokyo.Google Scholar
Yamashita, J. 2011. Exploring the impact of the Japanese Long-term Care Insurance Act on the gendered stratification of the care labour market through an analysis of the domiciliary care provided by welfare non-profit organisations. Social Policy and Society, 10, 4, 433–43.CrossRefGoogle Scholar
Yamauchi, N. (ed.) 1999. NPO De-ta Bukku [NPO Data Book]. Yuhikaku, Tokyo.Google Scholar