The elderly who need help

The rapid aging of Japan’s population has created a situation in which more than half the elderly people who are incapacitated and live in their own homes are being cared for by other elderly family members. In some cases, the caretakers become physically exhausted and stressed out as they work alone to help their loved ones.

Financially strained social security programs such as nursing care insurance do not provide sufficient help. Multiple layers of support, including community-level efforts, are needed to avoid isolating both the senior citizens needing care and those looking after them.

In 51.2 percent of households nationwide that have a member aged 65 or older in need of nursing care, the person providing the care is also above the age of 64, the Health, Labor and Welfare Ministry’s 2013 survey on people’s lives shows. The figure — a record high — was 5.3 percentage points higher than in the previous survey in 2010. In 29 percent of the households, both the person receiving care and the one providing care are at least 75 years old. The ministry estimates that such households will increase as the aging of the nation’s population accelerates.

According to the survey, many of these elderly people are in need of nursing care after suffering a stroke, developing senile dementia or being hit by age-related disabilities. About 61 percent of them are primarily cared for by family members who live with them at home, while about 15 percent rely on professional nursing care providers. In about 70 percent of the households, the family members who mainly provide the care are women — either wives or daughters.

The nursing care insurance system introduced in 2000 was intended to relieve families of such a burden and provide nursing care as part of a social security program. However, care for the incapacitated elderly people today still appears to rely greatly on family members — in many cases, elderly spouses. Nursing care services are available under the insurance program, but people need to first apply and, depending on their conditions, be certified as needing care. Reports show that many elderly people — especially men — tend to prefer to be cared for by family members.

In addition to worrying about the health conditions of the elderly, many family member caretakers are also concerned about their own state of health, the health ministry survey shows. They are also troubled by household financial conditions and by their relations with other family members. They feel that they have no time to spare for themselves.

In recent years, there have been large numbers of tragic incidents in which elderly people who had been caring for family members for years ended up abusing or killing those they were caring for — or committed murder-suicide — after they became exhausted and stressed out by the heavy burden. In many of these cases they reportedly lived alone with the victims.

Some elderly households may not be able to afford medical and nursing care services, or they may not have people they can turn to for information about what public services are available. Various forms of public welfare support are provided only after the authorities have been alerted to the needs of specific families.

Elderly people who have little interaction with their neighbors may keep their problems to themselves without asking for help, further exacerbating the situation. Local authorities need to make proactive efforts to ensure that such households do not become socially isolated and to let them know that help is available if they ask for it.