Abstract
Contemporary Japan is known both for its high tech culture and its rapidly aging population, with 22 % of people currently 65 years and older. Yet there has been little attention to the material culture of the elderly. This paper explores the way aging bodies, official ideology, and consumption of what are called “assistive devices” and “life technologies” come together in the experience of frail old people who depend not only on human caregivers but on “things” such as walkers, kidney dialysis machines, and electric massage chairs. It begins to consider the questions: What technology to aid failing bodies is available, and to whom? How does the advocacy of independence create new forms of consumption? How do “things” mediate ideological change regarding elder care and help to create new understandings of self and one’s relation to others? Data come from interviews conducted in 2003–2007 as part of a study of elder care in Japan under the public long term care insurance system that began in 2000. These interviews point both to acceptance of the technology as a way to avoid over-dependence on caregivers, and to resistance to the limitations of aging and to its 21st century definition by the state.
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Notes
This question comes from Miller’s (1998a) article on colas in Trinidad, and other work that set up a dichotomy in which Japan both fits and doesn’t, as seen in this paper when I discuss the “international” model of aging or international standards of aging in contrast to what might be considered stereotypically or “traditionally” Japanese.
This term is my own. “Silver” is the euphemism widely used in Japan to refer to old people and to the policies and institutions designed to meet their needs, such as “Silver Centers” to provide part-time employment for healthy old people; “silver cars,” which are wheeled walkers with seats, sometimes called rollators in English; and “the silver market,” that portion of the consumer market targeted to older, often retired people. (See Chéron 2011 on Japan’s silver market.). Although “silver products” are items and services associated with old people, their use is not limited to those of a certain age category, such as the use of wheel chairs by people with physical disabilities. “Citizen” here is used loosely as a way to capture the government’s interest in maintaining a population that can remain as independent of government support as possible for as long as possible, while recognizing that an increasingly large proportion of voters are over the age of 65.
The study was a 5-year longitudinal project with both quantitative and qualitative components. The first stage was a large-scale survey of family caregivers and care recipients who had been certified as eligible for long term care benefits in a largely working class ward of Tokyo and in a small city and surrounding area in Akita, a northern prefecture that has the second largest percentage of elderly in the country. Several months after the survey, we conducted semi-structured interviews with a subset of willing respondents, 15 care recipient-family caregiver pairs in each area. The interview sample was selected to include both men and women as care recipients, and a range of insurance system care levels and relationships to the primary family caregiver. Teams of at least two researchers visited the homes and spoke with both care recipient and caregiver, separately when possible, utilizing an interview guide but encouraging free conversation. Sessions lasted from one to two and a half hours. Informed consent was obtained for all interviews, which were audiotaped with permission. Interview topics included the nature of the care recipient’s health and daily living problems, daily life for the care recipient and caregiver, decisions about the use of medical and social services, family relationships, and the concerns and sources of pleasure for both care giver and recipient. We conducted follow-up interviews each year through 2007 for as long as the families were willing and able to participate, to track changes of status, learn about decision-making in conjunction with these changes, and hear about the participants’ experiences in greater depth. The members of the research group who conducted the interviews were: Asakawa Noriko, Asano Yūko, Izumo Yūji, Kodama Hiroko, Muraoka Kōko, Nishida Masumi, Nishimura Chie, Shimmei Masaya, Suda Yūko, Takahashi Ryūtaro, and Yamada Yoshiko
Although I recognize that these sources are not identical and may not provide as clear a view of the care recipient’s internal life as relying solely on self-reports, indirect sources such as caregiver interviews and observations provide important supplementary perspectives, especially in the situations in which the care recipient had mild dementia. The caregivers’ stories and comments utilized in this paper were generally related to us in the presence of the care recipient.
For example, the first occupational therapists were licensed in Japan in 1966. In 1987 Japanese Association of Occupational Therapists (JAOT) had a membership of over 2,000, but by 2008 there were 32,940 members. The JAOT explicitly attributes the growth of the field to the needs of a rapidly aging society (JAOT n.d.) The table below shows the dramatic growth in the number of occupational and physical therapists employed in Japanese hospitals in the early years of the long term care system
Therapists employed in hospitals by year (full-time equivalent)
2004
2005
2006
PT
25,949
28,509
31,386
OT
15,207
17,010
19,203
Loe (2011) notes that American old people also utilize such professional classification systems in thinking about their aging.
These have not necessarily met with commercial success, however. Sony’s robotic dog AIBO was intended to keep nursing home residents from feeling lonely, but when tested in both Japan and the US did not maintain the interest of the residents over time and was eventually pulled from the market. See for example, http://www.usatoday.com/tech/news/robotics/2006-02-01-goodbye-aibo_x.htm.
A video of this exposition can be viewed at http://www.hcrjapan.org/english/video.html. This event receives substantial media coverate in Japan and internationally. See for examples, Associated Press (2007) and Tabuchi (2007).
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Acknowledgements
I am grateful to the families who participated in the longitudinal study of family caregiving under the Japanese public long term care insurance system instituted in 2000. My work on this project would not have been possible without the leadership of project directors Suda Yūko and Takahashi Ryūtarō, and qualitative team members Asakawa Noriko, Asano Yūko, Ruth Campbell, Izumo Yūji, Kodama Hiroko, Muraoka Kōko, Nishida Masumi, Nishimura Chie, Shimmei Masaya, and Yamada Yoshiko. Financial support for data collection came from the Japanese Ministry of Education and Science, and the Ministry of Health, Labor and Welfare. Additional funding for data analysis came from the Univers Foundation and John Carroll University. Ruth Campbell, Brenda Robb Jenicke, Kelly Joyce, and [several anonymous reviewers] provided helpful feedback on earlier drafts of this chapter. Assistance in interpreting the data and the creation of the graphs for Figs. 1 and 2 was graciously provided by John Campbell.
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Long, S.O. Bodies, Technologies, and Aging in Japan: Thinking About Old People and Their Silver Products. J Cross Cult Gerontol 27, 119–137 (2012). https://doi.org/10.1007/s10823-012-9164-3
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DOI: https://doi.org/10.1007/s10823-012-9164-3