The Challenging Role of Informal Carers Within the Long-Term Care System in Japan: Focusing on Issues of Japanese Working Carers

Despite the increasing demand for long-term care (LTC) caused by demographic changes and several long-term care insurance (LTCI) program reforms, formal care in Japan is shrinking because of public financial constraints, leading to many problems for informal carers. Because more than half of the informal carers are employed in paying jobs, balancing working and caregiving roles is an important issue in the political agenda. Based on an online survey data of working carers of care recipients eligible for the LTCI program (N=600), this study aims to examine informal carers’ challenging role within the Japanese LTC system, and analyze the work-life balance issues of working carers. The results reveal that most of the respondents are their parents’ carers and more than half co-reside with the care-recipients. With the community promoting comprehensive care, many frail older adults now use a combination of formal and informal care services. Additionally, over three hours of informal caregiving per day, age, marital status, co-residence with the care recipient, self-rated health, and insufficient understanding of the caregiving role in the workplace are significantly related to the psychological well-being of informal carers. Furthermore, most of the aforementioned factors are also associated with turnover intention due to caregiving responsibilities. Informal care is a crucial component of the Japanese LTC system and to alleviate informal working carers’ struggles and decrease unwanted turnover, it is necessary to consider the link between formal and informal care, together with support programs for informal carers

Issues and Challenges in comparing Carers' Quality of Life in England and Japan: Lessons from developing a Japanese-version of the ASCOT-Carer

Improving the quality of life of carers is the ultimate goal of carers’ policy and support services. This paper discusses issues and challenges in conceptualising and comparing carers’ quality of life in England and Japan, based on developing a Japanese-version of the self-completion Adult Social Care Outcomes Toolkit for Carers (ASCOT-Carer). Since supporting carers in employment is a key concern in both countries, we particularly focus on this group of carers

Assessing the Structural Characteristics of the Japanese Version of the Adult Social Care Outcomes Toolkit for Carers

As there are no standardized measures of Quality of Life (QoL) of informal carers impacted by use of long-term care (LTC) in Japan, the development or translation and cross-cultural adaptation of LTC outcomes measures for carers is needed for LTC research and evaluation. In this study, we assessed the validity and reliability of the factor structure and response system of the translated and cross-culturally adapted Japanese version of the Adult Social Care Outcomes Toolkit for Carer (J-ASCOTCarer). Participants were 872 informal family caregivers of adults with LTC services, living at home. Almost half (46 %) were aged between 50 and 59 years and 60 % took care of their mother . We used a combined factor analysis and item response theory approach. Model fit indices consideredwerefactor loading, path coefficients, root mean square error of approximation, standardized root mean square residual, and comparative fit index. This study confirmed the one factor structure ofthe original English version of the ASCOT-Carer. The values for the model fit indices indicated a good fit. The validity and reliability of the response system wereconfirmed. The J-ASCOT-Carer is a promising assessment instrument to measure QoL of Japanese caregivers of adultswith LTC

Changes in work and life patterns associated with depressive symptoms during the COVID-19 pandemic: an observational study of health app (CALO mama) users

BACKGROUND: During the COVID-19 pandemic, many people refrained from going out, started working from home (WFH), and suspended work or lost their jobs. This study examines how such pandemic-related changes in work and life patterns were associated with depressive symptoms. METHODS: An online survey among participants who use a health app called CALO mama was conducted from 30 April to 8 May 2020 in Japan. Participants consisted of 2846 users (1150 men (mean age=50.3) and 1696 women (mean age=43.0)) who were working prior to the government declaration of a state of emergency (7 April 2020). Their daily steps from 1 January to 13 May 2020 recorded by an accelerometer in their mobile devices were linked to their responses. Depressive symptoms were assessed using the Two-Question Screen. RESULTS: On average, participants took 1143.8 (95% CI -1557.3 to -730.2) fewer weekday steps during the declaration period (from 7 April to 13 May). Depressive symptoms were positively associated with female gender (OR=1.58, 95% CI 1.34 to 1.87), decreased weekday steps (OR=1.22, 95% CI 1.03 to 1.45) and increased working hours (OR=1.73, 95% CI 1.32 to 2.26). Conversely, starting WFH was negatively associated with depressive symptoms (OR=0.83, 95% CI 0.69 to 0.99). CONCLUSIONS: Decreased weekday steps during the declaration period were associated with increased odds of depressive symptoms, but WFH may mitigate the risk in the short term. Further studies on the longitudinal effects of WFH on health are needed

地域包括支援センターにおける介護者支援の課題 ──介護者支援の困難性に焦点をあてて

本研究は、地域包括支援センターにおける介護者支援の困難性に焦点をあてて分析した上で、地域包括支援センターにおける介護者支援の課題を探ることを目的とした。A 県地域包括支援センター職員を対象に集合調査を実施し、事例の自由回答を質的に分析した。分析の結果、介護者支援の困難性は、1）介護者自身に支援が必要な場合の介護者支援の困難性、2）介護者が複数の役割を担う場合の介護者支援の困難性、3）サービス利用拒否の場合の介護者支援の困難性、4）要介護者への対応に苦慮する場合の介護者支援の困難性、5）複合問題・多問題への対応が求められる場合の介護者支援の困難性として把握できた。地域包括支援センターにおいて介護者のおかれた困難な状態をケアラーアセスメントにより包括的に把握し、介護者自身への支援体制を構築することが地域包括支援センターにおける介護者支援の課題といえる

要介護時のケア実態とケア選好 : ジェンダーとライフコースの視点からの事例分析

本研究の目的は、(1)フォーマル・ケア(FC)とインフォーマル・ケア(IC)組み合わせの実態、(2)夫・息子によるケア(3)介護の受け手と担い手のケア選好を中心に、ジェンダーとライフコースの視点から要介護時のケア実態と選好について探索的に分析することである。調査対象はN県C市の地域在住の要支援・介護高齢者(11事例、うち女性が8事例)とその主介護者である。事例分析の結果、(1)介護者の健康状況などによりFCとICの多様な組み合わせの実態があり、時間的変化も考慮すべきこと、(2)退職後などのライフコースにおけるタイミングが関連しジェンダー役割にとらわれずに夫や息子によるケアが行なわれる側面があること、(3)受け手と担い手のケア選好の違いや、適応的選好となることからケア選好把握に困難が伴うことがわかった。分析方法などの課題はあるが、本研究は要介護時のケア実態とケア選好を把握し、FCとICのあり方を議論することが、利用者の主体性を尊重したケアマネジメント実践に重要なことを示したといえるだろう

Working from home and dietary changes during the COVID-19 pandemic: A longitudinal study of health app (CALO mama) users

It is plausible that the coronavirus disease pandemic and related changes in work and life patterns affected dietary patterns, but existing studies have limitations owing to a cross-sectional design. Using longitudinal data, we examined dietary changes in people due to the pandemic and work and life patterns. We conducted an online survey on changes in work and life patterns during the pandemic from April 30, 2020, to May 8, 2020, among users of a health app called CALO mama provided in Japan. We retrieved and linked the dietary data for 5929 participants from January 1, 2020, to May 13, 2020. Generalized linear mixed models were used to estimate the frequencies of food intake associated with the pandemic and work and life patterns. During the state of emergency, the frequency of intake of vegetables, beans, seaweeds, fish, meats, dairy products, and snacks increased, whereas alcohol intake decreased. Working from home was associated with increased intake of vegetables, fruits, dairy products, and snacks but decreased intake of seaweeds, meats, and alcohol. Time spent on childcare was associated with decreased intake of vegetables and fruits but increased intake of meats. Probable depressive symptoms were negatively associated with the frequency of food intake other than snacks and alcohol. We conclude that diet quality improved during the pandemic in general, but attention must be paid to overconsumption of snacks and negative factors such as increased burden of childcare and depression for healthy eating

Šiuolaikinės technologijos ir socialinio darbo profesijos bei studijų transformacija: Lietuvos ir Japonijos aukštųjų mokyklų dėstytojų įžvalgos

This article explores the attitudes of Japanese and Lithuanian social work program teachers towards the challenges posed by modern technologies that may transform social work profession and studies. Study data revealed that scientists from both countries admit that “taming” technologies and optimally “cooperating” with them is the main challenge of social work practice and studies. On the one hand, belief that technological development will provide more opportunities to fulfil the mission of social work was prevalent among the study participants, on the other hand, they had expressed concern that eventually the use of technology will change the essence of social work as a profession of human relations or will create modified forms of social exclusion. Additionally, a niche for the new role of the social worker was identified: to help the world “occupied” by technology remain “social”. Attitudes of research participants from both Lithuania and Japan can be linked to traditional concept of sociality and vision of social work as profession that belongs exclusively to area of human relations. B. Latour’s asocial sociality concept can be applied for broader look into this situation. This concept states that efforts to trace the contribution of actors of an inhuman nature to what belongs in the human world may be more successful when one ceases to view the world exclusively through human eyes and tries to reveal the inner perspectives of phenomena of a mixed nature.Straipsnyje atskleidžiamas Lietuvos ir Japonijos socialinio darbo studijų programų dėstytojų požiūris į iššūkius, kuriuos kelia šiuolaikinės technologijos, transformuodamos socialinio darbo profesiją ir studijas. Atvejo analizė atskleidė, kad „prisijaukinti technologijas“ ir optimaliai su jomis „bendradarbiauti“ yra pagrindinis šių laikų socialinio darbo praktikos ir studijų tikslas. Nors manoma, kad technologijų plėtra suteikia daugiau galimybių įgyvendinti socialinio darbo misiją, jaučiamas nuogąstavimas, kad technologijos pakeis socialinio darbo, kaip žmogiškų santykių profesijos, esmę, sukurs modifikuotas socialinės atskirties formas. Visgi įžvelgiama ir nišų naujiems socialinio darbuotojo vaidmenims padedant technologijų „okupuotam“ pasauliui išlikti „socialiam“. Tyrimo dalyvių vertinimus galima sieti su tradicine socialumo samprata ir socialinio darbo, kaip išskirtinai žmogiškų santykių sričiai priklausančios profesijos, vizija. Šioje situacijoje vertinga prisiminti B. Latouro nuostatą, kad pastangos atsekti nežmogiškos prigimties veikėjų indėlį į tai, kas priklauso žmonių pasauliui, gali būti sėkmingesnės tada, kai į pasaulį nustojama žvelgti išskirtinai žmogaus akimis, o bandoma atskleisti vidines mišrios prigimties reiškinių perspektyvas arba asocialaus socialumo sampratą