Growing Old in Japan: the Shadows of Elder Abuse by the TELL Lifeline
As we come up to World Elder Abuse Awareness Day on June 15, we would like to take a closer look at elder abuse and raise awareness of an issue that has, does and will affect our community.
Since the implementation of Act on Prevention of Elder Abuse and Support for Caregivers of Elderly People (the Elderly Abuse Prevention Act) in 2005, the national government and research institutes have been conducting surveys, implementing and examining measures and support that are in place. In the government’s latest report, 57.6% percent of cases involved some form of physical abuse including 22.5% of cases involving involuntary restraint; psychological abuse is the second most common (33%) followed by neglect / abandonment (23.2%). Disconcertingly, the more care an individual needs, the more severe abuse they are prone to. In Japan, 1 in 15 older adults have reported experiencing some form of abuse.
Recently, TELL had the opportunity to talk with Professor Etsuko Yuhara of the Department of Social Welfare at Aichi Prefecture’s Nihon Fukushi University who provided some insight into the situation that the elderly population faces in Japan.
AGING POPULATION
Professor Yuhara explains that “as medical advances have allowed people to live longer lives, the elderly population continues to increase, and so does the need for assistance. At the same time, the age of caregivers is also increasing. As people live longer, the length of care is also extended bringing additional challenges.”
Picture of Professor Etsuko Yuhara
In Japan, this is particularly felt in rural areas which are experiencing aging rates in excess of 35%. That is, 35% of the population is 65 years or older. Of the domestic elder abuse cases that occurred in 2022, 39% of abusers were sons, 22.7% were husbands, and 19.3% were daughters.
ISOLATION
In metropolitan areas, the elderly often struggle with isolation. In Tokyo alone, more than one million people aged 65 years or older live by themselves and have little to no support from family. Only half of men and 60% of women over 65 are able to talk with someone every day. In addition, there is the real danger of poverty–particularly among elderly women. A recent survey indicates that 44.1% of Japanese women over 65 are living in poverty. The lack of family support also makes securing services from care facilities or receiving hospital care even more difficult as elderly people with no relatives often tend to be denied service.
A STRAINED WORKFORCE
If they are able to secure a place at a care facility, there are also challenges to receiving adequate care. Nearly 70% of Japan’s care facilities are facing shortages in staffing with 83.5% reporting that they do not have the ability to provide adequate service. Many caregivers are not sufficiently trained and are often overwhelmed by their responsibilities. Prof. Yuhara explains that, “The nursing care industry is facing a serious labor shortage. It is important to raise public awareness about nursing care work, set higher compensation for nursing care, and secure enough staff so that they can afford to assign more people, as well as improve working conditions…If the caregiver is exhausted, neglect tends to occur.”
Though there is better understanding of the reasons for elder abuse and availability of support for those vulnerable, Prof. Yuhara points out that “it may be the tip of the iceberg, especially since there are aspects of abuse in the home that are difficult to understand.” Despite that, there are still things people can do, especially if they find themselves in the position of looking after someone.
CAREGIVER FATIGUE
Caregiver fatigue (caregiver burnout) is often cited as one of the key drivers leading to elder abuse. Caregiver fatigue can happen to any caregiver in any setting and can occur at any time. For most caregivers, caring for a loved one is rewarding but the demands of caregiving also cause emotional and physical stress. It’s common to feel angry, frustrated, overwhelmed, and alone particularly when
- looking after a loved one such as a spouse or parent
- living with the person
- looking after someone requiring constant care
- receiving little guidance or skills required for caregiving
- feeling trapped or having no choice
“In many cases,” Prof. Yahara explains, “the caregiver becomes overwhelmed and burdened and often lacks the skills to overcome the various difficulties, resulting in caregiver fatigue. In a situation where people would not normally want to abuse others, they become perpetrators because they feel trapped. Nowadays, it is physically impossible to entrust caregiving solely to family members.”
When looking after someone, it is important to be mindful of how you are feeling.
- Are you feeling burdened or worried all the time?
- Do you feel exhausted?
- Has there been a dramatic change to your sleeping or mood?
- Are you experiencing sudden health problems such as headaches or stomach aches?
- Have you started or increased use of alcohol or medication?
- Have you restricted or altered your own self care?
If you are or have experienced any of these, take a moment to understand that the emotional and physical demands of caregiving can strain even the strongest person. Many resources and tools can help you care for your loved one and yourself.
Ask for and accept help.
You do not have to take on the full responsibility for looking after someone you love. In addition to family and friends, there are most likely resources available in your community that you can use. Many communities provide services such as food delivery, providing nursing supplies and living equipment, contacts for nursing homes or assisted living facilities as well as information about subsidies and community support activities. You can see what supports might be available by reaching out to your local ward or prefectural office.
Look after yourself.
Focus on what you are able to do. No one is a perfect caregiver so recognize your limitations. It is okay to say no if the task is outside of your bandwidth. Do not neglect self care. Find ways to sleep better and move more. Maintain a healthy diet. If you need to, seek a healthcare professional for any sudden changes in your body or contact a mental health professional to talk about the challenges you are experiencing.
If you or someone you know might be experiencing caregiver fatigue, you can talk about how you are feeling and get connected to some resources that might help by reaching out to the TELL Lifeline by phone (0800-300-8355 TOLL FREE) or chat https://telljp.com/lifeline/.
If you would like to make an appointment to speak to a mental health professional at TELL, please visit us at https://telljp.com/counseling/.
Sources
https://www.japantimes.co.jp/business/2023/10/07/caregiving-labor-shortage
https://mainichi.jp/english/articles/20230821/p2a/00m/0op/011000c
https://www.mhlw.go.jp/file/06-Seisakujouhou-12300000-Roukenkyoku/1.pdf