Long-Term Care Policy Reform in Japan

Summary

The implementation of Japan's Long-Term Care Insurance Scheme in April 2000 was the culmination of some 30 years of policy deliberation on aged care. Understanding the policy debate surrounding the Long-Term Care Insurance scheme and its financing arrangements requires an appreciation of rapid demographic and social change, especially in family structures and attitudes to caring for aged parents; but the pressures that population aging and economic downturn are placing on Japan's pension and health insurance systems also must be recognized. Even more generally, the delicate balance of political interests in Japan's central governing body, the Diet, has shaped the implementation of Long-Term Care Insurance as a forerunner to other reforms in social security and health insurance.     

Keynote 3. Living in the Valley of Death

Abstract

In 2003 alone, HIV/AIDS killed more than three million people, of which between 2.2 and 2.4 million were from Sub-Saharan Africa. This disease is having a devastating effect on the previously firm foundations of intergenerational relationships in affected countries. For many nations in Africa, Asia and South America, life has become a mirage, a paradox in which almost everything is overshadowed by the pangs of death. Poverty, HIV/AIDS and, surprisingly, compassion are the combined common causes of death. Consequently, social, ecological, economic, political and educational systems are almost entirely dislocated. Traditions demand that the young ones should outlive their elders. So there is a deliberate effort on the part of the elderly to embrace death in attempting to be compassionate. This paper is an attempt to explore this scenario with the aim of articulating the linkage between poverty and HIV/AIDS, and proposing ways of reducing their impact through intergenerational programming.     

Risk,Recovery and Resilience

Abstract

From 1999 to 2004, the Child and Youth Care Agency for Development (CYAD), a South African Non-Government Agency (NGO), has been working in partnership with the University of Victoria's International Institute for Child Rights and Development (IICRD) and Aboriginal Liaison Office (ABLO) to identify and reinforce community and cultural assets in supporting child and family resilience. The project, entitled Circles of Care: Community and Support for Children Affected by HIV/AIDS, has developed and piloted a model for community capacity building that supports traditional African community values, beliefs and governance structures (understood as Setso) in reinforcing child resilience through child rights based advocacy that partners children and traditional leaders (identified as Morena) and healers (called Dingaka).     

Generations Linked: A Case Example of Māori Grandparents

This article offers an analysis of the significance of intergenerational living patterns and relationships as the mechanisms by which Pacific grandparents preserve and transmit indigenous cultural values, beliefs, and practices. A case example from a study conducted among Māori grandparents in Aotearoa, New Zealand, serves as the core focus of discussion. Seventeen grandparents were interviewed about their lived experiences in their multiple generation homes. Findings indicate that intergenerational life is a means for linking generations and transmission of indigenous culture to the next generation. Participants discussed their intergenerational relationship with much affection and love for their grandchildren and family. Discussion and implications for future research and practice are provided.     

The Social Relationships and Social Support of Aging Mothers Whose Adult Daughters Are Mentally Ill

Guided by a conceptual framework highlighting multiple facets of social relationships and social support, this study examined the extent to which aging mothers of adult daughters with a serious mental illness were socially integrated with members of their network. It further examined the relational content of these mothers’ social ties as tangible or intangible support and the nature of their supportive exchanges with network members, particularly their adult daughters with mental illness. A structured face-to-face interview was conducted with 22 aging mothers of these adult daughters. Two methods of analysis were used to analyze data: counting and content analysis. Findings showed aging mothers of daughters with mental illness were socially integrated with relatives and nonrelatives, evidenced relational content of tangible and intangible support in their social ties and engaged in bidirectional and asymmetrical support exchanges with network members, including their daughters with mental illness. These findings suggest that social resources in the form of social relationships and support are embedded in the networks of aging mothers who have adult daughters with serious mental illness. Practitioners should assess support contributions to the aging mothers of adult daughters with serious mental illness from a wide range of social relationships including their daughters.     

Parents' Partnership Decision Making After Divorce or Widowhood: The Role of (Step)Children

Using data from the Netherlands Kinship Panel Surveys, this study investigated divorced and widowed parents' (N = 350) decision making about living arrangements after repartnering: Twenty‐eight percent lived apart together (LAT) and others lived together (remarried or cohabiting). The focus was on determinants of LAT: Women, older respondents, residents of larger cities, and parents of 2 or more children are more apt to LAT. On the basis of additional qualitative interviews with LAT respondents (n = 25), the reasons for LAT were investigated. Data showed that many children are involved in pure boundary work in an effort to guarantee the continuation of their family. Other (step)children use the sabotage or refusal types of boundary work, not accepting the new partner or excluding a parent from contact, especially with grandchildren. Many of these efforts are successful. To preserve the ties with their children, parents often adapt their decision making about the living arrangements with a new partner accordingly.     

Intergenerational Support and the Emotional Well‐being of Older Jews and Arabs in Israel

This investigation examined the cultural context of intergenerational support among older Jewish and Arab parents living in Israel. The authors hypothesized that support from adult children would be more positively consequential for the psychological well‐being of Arab parents than of Jewish parents. The data derived from 375 adults age 65 and older living in Israel. Psychological well‐being was measured with positive and negative affect subscales of the Positive and Negative Affect Schedule. Overall, positive affect was highest when filial expectations for support were congruent with whether or not instrumental support was received. Findings by cultural background revealed that, among older Jews, receiving instrumental support raised positive affect and stronger filial expectations lowered it. Among older Arabs, receiving financial support raised positive affect and receiving instrumental support lowered it. Culture appears to serve as a potent force in determining which types of intergenerational support functions are expected and accepted means of serving the everyday needs of older parents.     

What Narrows the Stepgap? Closeness Between Parents and Adult (Step)Children in Germany

Using data from the German Family Panel (pairfam) based on 11,746 intergenerational family relationships, the present study examined differences in parental closeness across relations with multiple, coresidential, and non‐coresidential adolescent and adult children. Replicating previous research in a multilevel analysis across families, the authors found a strong positive effect of biological descent on closeness in comparison to adoptive and steprelations; this parental favoritism toward biological offspring was partly explained by selection via parental resources and attitudes. Supplemental within‐parent fixed effect analyses suggested that the relative disadvantage of stepchildren was offset by longer duration of the stepparent–stepchild relationship, lower household income, fewer children in the household, and high parental affirmation of familism.     

Child Care and Child Births: The Role of Grandparents in the Netherlands

This study explored the involvement of grandparents in the care for young children and its effect on subsequent child births in dual‐earner families, using data on 898 Dutch men and women aged 18–49 from the Netherlands' Kinship Panel Study. Three theoretical perspectives were used to develop hypotheses: (a) needs and opportunities, (b) normative preferences, and (c) gendered involvement of grandparents. The findings showed that needs and opportunities informed involvement of grandparents but that the availability of formal child care did not predict grandparents' involvement. Maternal grandparents were more likely to provide child care than paternal grandparents, and grandmothers were more likely to do so than grandfathers. Involvement of both maternal and paternal grandparents in turn increased the likelihood of additional child births. The authors conclude that grandparental child care may be part of an emerging reproductive strategy. Implications of these findings for the theoretical approaches used are discussed.