29/05/2002

Housing for Elderly Persons -- Reconsidering the Role and Function of Special Skilled Nursing Homes

Koji Kishida 

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1. Introduction

In Tales of Tono (Tono Monogatari), ethnologist Kunio Yanagida describes an old village custom of casting away 60-year-old people into the denderaya, the wilderness that will be their final resting place. In the daytime, the castaways would come to work in the fields, earning bare sustenance; and at nightfall they would return to their resting place. To this day, local expressions used for commuting to and from work (haka-dachi and haka-agari) are thought to derive from the word for grave (haka). The Tales of Tono were chronicled by Yanagida in 1909 based on interviews with a local resident named Kyoseki Sasaki.

Almost a century later, Japan has implemented a new long-term care (LTC) insurance system that provides universal coverage for the elderly. The system, which shifts the burden of care from individuals and families to society, represents a huge leap in the quality of elderly welfare from the old days. But in a sense, while no longer being mercilessly cast away, elderly persons today are still compelled to choose to leave home and live in a facility. This choice, which comes from a strong sense of obligation not to burden one’s family, in many ways resembles the haka-agari of old. Of course, we are not saying that facility care is at fault here; the withholding of care and other rampant cases of elderly abuse painfully demonstrate the need for such facilities. But there is something deplorable about a situation in which elderly persons move into a facility simply to await death. This paper examines issues regarding housing for the elderly and the provision of long-term care.

Koji Kishida

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