Leaving jobs for nursing care

What Prime Minister Shinzo Abe has dubbed the “new three arrows” of his trademark economic policies are in fact targets raised without readying the arrows — the means to achieve them. Along with the vow to achieve a robust economy with a target of boosting Japan’s gross domestic product to ¥600 trillion and beef up child-rearing support to increase the nation’s total fertility rate from 1.42 last year to 1.8 by the early 2020s, Abe has said his administration would reduce the number of people leaving their jobs to care for their ailing family members to zero by enhancing social security programs.

People leaving jobs in large numbers to care for their relatives is indeed a serious problem that needs to be addressed. It not only affects the livelihood of the people who have to quit work but also threatens to deplete the nation’s labor force at a time when its working-age population is rapidly falling. The target needs to be backed up with specific policy measures, although it’s viewed that the goal will be hard to achieve by merely increasing the number of nursing care facilities.

Roughly 440,000 people are estimated to have left their jobs between 2007 and 2012 to care for their ill or incapacitated parents and other relatives — with workers in their 40s and 50s accounting for a majority of such people, according to the Internal Affairs and Communications Ministry. The number is increasing and hit 100,000 during the year to September 2012. The proportion of women is high among these people, but the number of men quitting their jobs for such reasons has also reportedly been rising in recent years, as has the number of younger workers. If the people who decide to permanently retire when they reach their companies’ mandatory retirement age instead of seeking new work so they can care for ailing relatives are included, the number is even higher.

The phenomenon is attributed to a combination of multiple factors. One is the sheer increase in the proportion of elderly people in the population, which inevitably raises the number of people requiring nursing care. The latest estimate shows that people 65 or older accounted for nearly 27 percent of the population, with the number of those 80 or older topping 10 million for the first time.

Another is that the public nursing care insurance program, introduced in 2000 supposedly to reduce the burden on family members of caring for the elderly, is not sufficiently functioning as a social security system to meet growing needs. The nation’s total nursing care expenses, meanwhile, shot up from ¥3.6 trillion in 2000 to ¥10 trillion last year.

The number of nursing care service providers is not keeping up with the growing demand, especially the tokuyo homes for elderly people who require intensive care. As of 2013, 520,000 people were on the waiting list to enter tokuyo facilities nationwide — roughly the same number as the current capacity of those homes combined. The number of tokuyo homes is rising, but not fast enough to accommodate the growing demand. About half of those on the waiting list — including people who require full support in their daily activities — are receiving care at home, in many cases requiring help by their family members.

Many nursing care service providers, meanwhile, face a chronic shortage in manpower. The average turnover of nursing care staff is high and recruitment is increasingly tough because the work is seen as physically demanding and the salaries of nursing care employees are typically far lower than the all-industry average.

The situation is projected to worsen in coming years. With the rapid aging of the population, the government estimates that the nation will need 2.5 million nursing care workers in 2025 — when all of the postwar baby boomer generation will have turned 75 or older — compared with about 1.5 million today. It is forecast, however, that at the current pace of increase, the number of care workers will fall short of demand by 380,000 a decade from now.

Abe has cited creating more tokuyo homes for the elderly and building manpower in the nursing care sector as possible means to help stop workers from being forced to quit their jobs to care for ailing relatives. Doubts have been raised, however, whether his administration’s track record is consistent with such policy goals. In fiscal 2015, the rates for nursing care services — which determines the revenue of the service providers — were reduced by 2.27 percent for the first cut in nine years as the government tried to trim the increase in nursing care expenses, although the allowances that can be used for raising the salaries of certified nursing care staff have been increased.

The system that allows people to take a leave of absence from work to care for their ill or incapacitated family members also needs to be improved. Under the current system introduced in 1995, a worker can take up to 93 days off to care for a relative who became ill or injured, with employment insurance covering 40 percent of their salaries. But the worker can take the time off only once in principle per illness or condition. The poor record of the system being used by workers suggests that the current system doesn’t match the needs of workers who must take time off to care for relatives. In addition to reform of the system, improving the work environment at companies and support of employers or managers will be indispensable to saving employees from being forced to choose between keeping their jobs or quitting to care for ailing relatives.

The Abe administration needs to flesh out its new policy goal with concrete steps to address the various causes of the problem.