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« Belief-O-Matic | Main | Power Up Friday »
November 25, 2008 |Permalink |Comments (4)
Kodokushi: tragedy of elder care in Japan
As mentioned in the previous post regarding the robot care in Japan, I have a concern about the concept of aging in place in relation to socialization. There was a newspaper article about “Kodokushi” a solitary death where one dies completely alone without being taken care of or accompanied by anybody. They are often found several days after, in some cases even over a month after one's death.
The living arrangements among family in Japan has changed dramatically in the last few decades. The number of elders who live alone has increased rapidly over the past 20 years. Males living alone has grown from approximately 190,000 in 1980 to 1.05 million in 2005. In the same period, females living alone has grown from approximately 690,000 to 2.81 million.
Japanese elders, as elders in other countries, would like to stay at home as long as they can, and avoid moving into senior care facilities. However, this creates a problem of social isolation for them. Due to the collapse of the conventional family system and the weakened networks to their local community, it may have caused the serious social problem of Kodokushi.
Based on the results of the World Value Surveys conducted by the Organization for Economic Cooperation and Development (OECD) which asked respondents about their contact with other people in their normal daily lives, Japan was one of the most “lonely” countries. People in Japan had the least communication with friends, work colleagues and other acquaintances in places of worship, and in sports and cultural associations in their everyday life.
It is important to ensure that elders can age in place at their own houses, however, our society should re-visit this concept and ask ourselves “why do people like to remain their own homes when they age? ” I believe that the answer is not just the attachment to their houses, but to maintain casual and continuum socializations within their familiar community. The social phenomenon of “Kodokushi” may be teaching us to challenge a shift in our thinking from individual focused to a community based approach.
We need a society where every elder can feel connected to someone who cares about them.
--- Emi Kiyota
Comments ( 4)
Hello Emi! So great to read your contribution here.
I'm curious about what "weakened networks to their local community" looks like in Japan? Are there structural issues in terms of what's available (meaningful opportunities to connect with others)?
What are the main barriers to elders in Japan spending time with friends, colleagues and others in social groups?
Does that World Value Survey report contain age differences in the distribution of the "loneliness" metric?
You hit on something that both bothers me and encourges me when I hear a Marketing friend give her sales pitch about why everyone should move into her CCRC. In hearing the message behind the message, she is really "cheerleading" the concept of community - whether it be "out in the community" or within the CCRC. The thought of social isolation is not appealing to her or to me - for that matter!
Lynette
Hi Joe,
Thank you very much for your comment.
I believe that "weakened networks to their local community" was originated from the weakened family ties. It has been discussed in academic studies that the social connection among Japanese elders is strongly based on the blood related family and relatives. When the family tie has weaken due to the Urbanization and Modernization, elders are having difficult time adjusting their social communications with non-family members. Moreover, rapidly growing number of institutional care facilities has negatively affected on creating social network with their neighbors.
In general, Japanese people are rather reserved when becoming friends with others because friendship is based on the deep level of trust. I think that the current barriers to elders in Japan spending time with others could be that we have not figured out the ways to create "safe and comfortable" environment where they can begin establishing their own trusting friendship with others. It seems that long term care facilities, adult day service, or senior centers have not met their need so far.
Because most of the Japanese elders are Buddhists who do not congregate weekly like other religion, Japan may need other "meaningful social opportunities" for elders in regular basis.
As for the World Value Survey report, I believe that the survey samples were over 60 years old. It would be interesting to see the result based on the different cohort group.
I am curious about your reaction to the result of this survey. Did you find the result predictable?
Thanks Emi -- very informative, especially the Buddhist insight.
Did they ask any other questions that got at loneliness directly - as an affective state, rather than using "rarely or never spend time with friends, colleagues or others in social groups" as a proxy?
Is a person at peace with solitude to be considered lonely? Or is she just an old Buddhist? :)
Were questions asked about spending time with family (I guess at this point I should look up the survey myself, huh?)
I have not read up on the literature re: any cross-cultural explorations of Carstensen's selectivity theory, but that's what comes to mind. If there is a greater investment in emotion regulation with age (as the theory posits), and if friendships among the present cohort of Japanese elders are based on a deeper level of trust (comparatively), Japanese elders might have even more tendency to live in solitude.
Emi, please shoot me an e-mail at jangelelli@phinational.org