Men caring for aging parents not doing too well

TOKYO —

A health ministry survey in 2010 uncovered a shocking fact: one-third of caregivers nursing the growing ranks of the infirm elderly are male.

Why is that shocking? Perhaps it wouldn’t be elsewhere, but in Japan the traditional assumption has been that caregiving was a woman’s responsibility. No longer – or not to anywhere near the same degree. Women today have other goals and new freedoms. In 1968, 49.6% of caregivers were daughters-in-law. By 2010, only 16.1% were.

There was a vacuum to be filled, and who else could fill it but men? They’re trying, but not doing too well, reports Shukan Asahi (March 14).

They labor under certain disadvantages. Japanese males over the age of, let’s say, 50, are notorious for their lack of domestic skills. They didn’t need them. As children their mothers looked after them; as adults their wives did. Husband to the office, wife to the kitchen and nursery – that until recently was the generally accepted division of labor.

“There are guys who have never so much as made themselves a cup of coffee,” says Ritsumeikan University professor Masatoshi Tsudome, founder of the support group National Network of Male Caregivers. “They don’t know how to use the appliances.”

There are psychological issues too, Tsudome explains. It is hard for a man to walk into a lingerie store and buy underwear for his wife or mother. It can be hard for him to shop in a supermarket. He’s morbidly aware of being the only man in line at the checkout. He feels all the women looking at him – pitying him, perhaps. His pride rebels. He squirms. He tells himself he’s imagining things. Probably he is. It doesn’t help, somehow.

Shukan Asahi introduces “Mr Kimura,” age 64. Ten years ago, he left his wife at home and moved in with his mother, who was living alone an hour away by train. She wasn’t incapable of looking after herself – yet – but she did seem to be weakening. Her deafness was growing worse, and she couldn’t walk without support. Kimura worried about her – unnecessarily, perhaps, he thinks now. Maybe she could have managed on her own after all, at least as well as she did with him. Anyway, the decision was made and acted upon. On weekends, his wife would join him and help out. His sister too did her part, filling in while Kimura was at work.

An incident sometime afterwards showed Kimura how inadequate a caregiver he was. One day he got a call at work. It was his sister: “Did you know that mother can’t take a bath by herself?” No, he hadn’t known. His mother had always insisted she was fine in the bath. But she wasn’t. Fearing for some reason that something was wrong, the sister one day peeped into the bathroom. The secret was out. The mother’s legs had weakened to the point where she couldn’t get into the tub. She spent her bath time standing outside the tub, pretending to be bathing. Kimura hadn’t known. He would have insisted on helping, and she didn’t want a man bathing her, not even her own son.

There was another problem. His mother’s deafness made it necessary for Kimura to shout at her. A man shouting inevitably sounds angry; a woman, apparently, less so. The mother would burst into tears: “You don’t have to get mad all the time!”

Roughly 1.3 million caregiving men, and 1.6 million caregiving women, work at the same time. About 100,000 men, and 390,000 women, have quit jobs in order to provide care fulltime. The aging society – and no society in the world is aging as sharply as Japan’s – imposes burdens that so far have received little systematic attention.

Tsudome offers a word to the wise: “Don’t go it alone!” Keep in touch, he urges, with neighbors, friends, relatives, anyone who might help when it all becomes too much, as at moments it inevitably will. It’s sound advice, but to follow it requires reversing another seemingly inexorable social development – society’s growing fragmentation. Friendship tends to be casual, relatives drop out of touch, and as for neighbors, they are scarcely in the picture anymore. “Going it alone” is hard, but is there an alternative?

  • 4

    sillygirl

    There are alternatives. Day care for the elderly, nursing homes, assisted living. Out here in the provinces there seems to be quite a few daycare are opening with children on one side and the elderly on the other. I am assuming they get together sometimes. What better than a place where people can share? The elderly can interact with the little ones and the little ones get an extra "grandparent" or two.

  • 0

    TrevorPeace1

    The shouting at each other brings tears to my eyes. But I question Tsudome-san's 'word to the wise'. Not "go[ing] it alone" has nothing to do with loneliness, nor the sociological developments being blamed for "society's growing fragmentation". Aloneness is based on friendship, but not the kind the article ends with, "casual...out of touch...scarcely in the picture anymore."

    Indeed, "going it alone" has nothing to do with 'being' alone.

  • 5

    Himajin

    An incident sometime afterwards showed Kimura how inadequate a caregiver he was.

    This is much too harsh. What is his alternative, to barge in and embarrass her? If she wasn't washing herself at all it would have been readily apparent, she was probably sponge bathing, and just not getting in the tub.

    No one is perfect, and learning to read the signs of decline as well as the dodges that may be being pulled on you takes experience. He moved into her house 5 days a week to help her, and the article implies it's not enough?

  • 2

    kimuzukashiiiii

    sillygirl, they are slowly building new facilities, but the waiting lists are huge, and places given to those who are completely incapable of being looked after by a family member first.

    They must have serious issues like complete blindness, deafness, or advanced dementia. Also those given places are usually victims of stroke, or heart attacks, who need medical supervision. Sadly, Mr Kimuras mother would not qualify for a permanent place, but she may qualify for day service or a home helper, to ease the burden on her family a bit.

    I really feel for anyone, man or woman, being at home looking after an ailing parent. It really is incredibly difficult for anyone. Japan needs to reassess this... the problem is going to get an awful lot worse in years to come, but now so many people are not having children, its going to be entirely up to themselves (or the state, probably the latter) to support them.

    I wonder where we are going to get all these care staff from?

  • 4

    JoshuYaki

    This article made me sad for all involved. The whole concept of the retiree resorting to a comfy chair, some knitting needles and pictures of the grandkids is all Hollywood. Each and every senior has a different rulebook, needs, and dislikes. You cant just shuffle everyone off to the old folks home. Rule number one for most seniors is they want to live at home. Usually a house with a staircase and other things that put them out. Most seniors don't want to be labeled as seniors and in need of help so most of the day is spent coaxing them into accepting it. I feel for the mom and kids.

  • 5

    kimuzukashiiiii

    And this headline really has riled me. "Not doing too well?" Says who?

    If Mr Kimura is reading this, I would like to tell him that he is doing a FANTASTIC job. To keep going, one day at a time, but he should get the support he needs too.

    A home helper could do alot of the embarrasing things for him, like shopping for underwear or adult diapers. It would make his life an awful lot easier.

  • 6

    NathalieB

    I agree - this man is doing an amazing and thankless job and the article totally disses that.

    I also wonder about the feasibility of the carers network sharing the burden - not just support and camaraderie which is important in itself, but also nearby care providers helping each other - she does the undie shopping, he bathes her aging father, etc.

  • 2

    tmarie

    **Japanese males over the age of, let’s say, 50, are notorious for their lack of domestic skills. They didn’t need them. As children their mothers looked after them; as adults their wives did. **

    Um, they didn't "need" them is rather incorrect, as this article shows. Men, and the parents (let's be honest, mothers) who raised them assumed they wouldn't "need" them but anyone with any common sense knows this is not true The sad thing is, many chlildren here, be it male or female, are still being raised in a manner in which they are unable to look after themselves, let alone anyone else. Mommy does everything for them and when I've asked my university students what they'll do if/when they move out, the answers is "get a wife" for the males and "learn" for the females. Frightening in my opinion when such things can easily be taught to ele school kids.

    **There are alternatives. Day care for the elderly, nursing homes, assisted living. ** And the waiting lists for those in many places are worse than they are for daycare for children. My PIL are victims of the lack of support here with regards to this growing problem. They only got their lives back when GMIL was finally bad enough to be sent to a hospital. She's now a vegetable costing the tax payers millions because of the laws here with regards to life support. Another massive issue here.

    Japan needs to come to terms that people are living longer (though not always mentality) and that children are not able to care for their aging parents they like were in previous generations. It is one thing for a child to care for an ailing parent for two to three years when they are in their 60s. It's another when the "child" is 70 and the parents are in their 90s.

    Add in that no one wants to do this job because of the stress, the conditions and the crap pay and Japan has a serious situation that will only get worse in the next decade or two. The retirement age needs to be raised and the elderly really do need to start paying more in taxes because their need for care is going to be a serious issue on future generations.

  • 3

    Abe234

    "Indeed, "going it alone" has nothing to do with 'being' alone." but it can force the carer to end up feeling alone and being isolated. Looking after someone 24 hours a day,7 days a week can be hard on any carer.The daily life and grind of looking after a child is hard enough but looking after an adult can be much harder. Whereas parents with children can support each other,make friends, male carers may give up their jobs, gradually stop meeting their colleagues,loose self esteem, feelings of tiredness and depression can set in, friends they had may stop popping around and the support system they had all their working life has stopped. Male carers may see asking for help,as a sign weakness, they can't cope or a sign of failure. Men may not want to go out with their buddies and talk about the difficulties of bathing their mother or wife who has for E.G dementia and is violent,or wonders in the night or has incontinence problems. So they can feel alone,and even though there are some places where they can get help, many care givers do feel a sense of guilt at putting someone they love and have know all their lives into a nursing home. As you said loneliness is based on friendships,but being a 24 hour carer can make it difficult to go out with your friends.On top of that, when men retire they often loose contact with their work mates who may have their own problems too,or may not want to listen to your difficulties.

  • 0

    tmarie

    Abe i agree with your post but you do realise that women suffer everything you've written about, right? It isn't a male thing to suffer with feelings of helplessness, failure and being unable to speak to people about this issue. Women suffer - and probably in greater numbers.

  • 1

    Tessa

    I am really, really puzzled about the elder care system here. Is it some kind of postcode lottery? Or does it depend on how much you pay into the system as a young worker? And although I don't doubt for one minute that there are plenty of women - and men, too - who are suffering from the incredible stress of caring for their elders with very little support, I've noticed quite a lot of people, especially housewives, who are very nimbly working the system to their advantage.

    Case in point: one of my students is a pampered fifty-ish housewife who hasn't worked a day in her life except for one year as an OL after college. Her adult son lives away from home, and her life pretty much revolves around culture classes, coffee klatches, and overseas trips. Recently her husband announced, to her great shock, that he wished to move his elderly, half-senile parents into their home. After doing a bit of research, marching back and forth between city hall, and talking to a great number of experts in the field, this wily lady has worked it out so that helpers will come twice a day to take care of her in-laws. According to her, the program is partly public and partly privately subsidised. Her only role will be to play the part of dutiful daughter-in-law, and negotiate with care-center workers and public officials. Apart from that, she is determined that her own life will not change a bit, and she intends to enjoy it to the hilt, nasty in-laws or not. (She actually brags about this to me.)

    I don't think she's so unusual, actually. There was a time in the not-so-distant past that there were very strong taboos against outsourcing elder care, but those walls have certainly come tumbling down. Most of the middle-aged women I know are determined to hand over the care of their parents and in-laws to the state, as early as they possibly can. I don't really blame them - I'd probably do the same in their shoes - but just how long can the state support this?

  • 1

    kimuzukashiiiii

    Tessa, not long. I think in about 20 years the stories about "son kills elderly parents" or "elderly womans 6 month old skeleton found in home" are going to be so regular that they wont even be news anymore...

    Home helpers are the easiest help to get, even if your paying privately, they are very cheap. Day service is also relatively easy to enter. full time residential care is not...

  • 3

    Himajin

    who are very nimbly working the system to their advantage.

    Is this yet another diatribe against women in the home, or are we discussing elder care? My, my, my, off the top of my head as I recall the threads of this type, I can see that the list you and others are compiling of things a woman at home should not be allowed to do is getting longer and longer...no frozen food in obento, no shortcuts at all in housework, and now you say that they shouldn't use home helpers?

    To answer your question, everyone pays kaigo hoken. If you're over 40-something (I don't remember the start of payments because I was already past it when kaigo hoken started) it's taken out of your paycheck. It's mandatory, even if like MIL, you can't utilize the services because of hospitalization.

    Her only role will be to play the part of dutiful daughter-in-law, and negotiate with care-center workers and public officials.

    Ever think that she needs help dressing or bathing them? How many times a day could you lift and shift someone who weighs 50-60 kilos? MIL was only entitled to 3 hours a week even in mid-stage dementia when she had to be watched all her waking hours. At that time I didn't know that you could hire them out of pocket, I thought you could only have your allotted visits. 3 hours was not enough. I spent 40 hours a week at least supervising her.

    The woman you mention will end up paying for the time over and above what's allotted to the in-laws according to their condition. If they are allowed one visit a day and she asks for two, the second visit daily will be out of pocket.

    After you spend time taking care of someone with dementia (and she has two to care for!), perhaps lifting someone in and out of a wheelchair 15 times a day, dealing with aggression and confusion daily, maybe you'll understand.

  • 1

    Tessa

    The woman you mention will end up paying for the time over and above what's allotted to the in-laws according to their condition.

    The woman I mention has just asked if I can give her more English lessons in her home, which she spends talking about her day trips to Kyoto and her dance lessons, so I don't think she is unduly suffering by the presence of her in-laws. And let's not forget that she married into that family in the first place. Surely she knew what she was getting into? She's had a pretty cushy life for the past few decades, I don't know why she thought it would last forever.

    If they are allowed one visit a day and she asks for two, the second visit daily will be out of pocket.

    You are correct, but she's not the one paying for it all. The taxpayers are paying for the first visit, and her husband is paying for the second. The least she can do is pull her weight. It's not gonna be forever, after all.

  • 2

    Himajin

    And, she doesn't deserve help because she stays at home....

    It's payed for by kaigo hoken insurance payments, which both of her inlaws pay, as does her husband.

  • -2

    cleo

    helpers will come twice a day to take care of her in-laws

    It's good that the Japanese welfare system has come this far. But you say it like it was a bad thing.

    There was a time in the not-so-distant past that there were very strong taboos against outsourcing elder care

    A time when 'elder care' was maybe a couple of years of a middle-aged couple/person looking after someone in their early 70s who would shuffle off this mortal coil without too much hanging about. Nowadays it's anything up to 20 years of dealing with oldies who are physically fit - and bulky - but mentally gone. 70-year-olds looking after 90-year-olds. Not really surprising that 'wily housewives' are breaking down the walls.

    And let's not forget that she married into that family in the first place. Surely she knew what she was getting into?

    Yup, twenty-something and in the throes of Young Luv, foremost in anyone's mind is what age the in-laws are going to go senile.

    I don't think she is unduly suffering by the presence of her in-laws

    That won't do at all now, will it. If she's a housewife she should suffer.

  • -1

    Tessa

    Yup, twenty-something and in the throes of Young Luv, foremost in anyone's mind is what age the in-laws are going to go senile.

    Anyone who marries a chonan knows what she's getting into, love or no love.

    If she's a housewife she should suffer.

    Yes, like the rest of us do at work.

  • 0

    LH10

    "There are guys who have never so much as made themselves a cup of coffee. They don’t know how to use the appliances" WHAT?! LOLOL! that is embarrassing lol what spoiled men

  • 4

    Peacetrain

    It's beautiful the way Japanese people look after their elderly parents, but extremely difficult and I know many people who have from 5 to 20 or more years of never being able to be away from home for a day ahead of them.

    The solutions after reading this?
    First Japan needs lots of low cost, affordable retirement homes. Second, men have to learn how to do stuff around the house. A woman I know was called back home because her husband complained that the couldn't feed himself and didn't even know how to work the ofuro!!

    And, men just have to get used to buying stuff for women. But, women are wonderful creatures. All he had to do is say to a woman next to him "hey I have to buy underwear for my mother/wife etc and I'm a little embarrassed". He'd probably have every woman in the store thinking he's Mr Wonderful, and wanting to help him.

    I can't be the only husband who has had to buy feminine hygiene products for his wife. Embarrassment never killed anyone.

    But my heart goes out to anyone who feels they have no choice but to look after a parent. Some cope better than others.

    And another thing that people aren't thinking about is that many older people are looking after their parents and have sacrificed to put their own kids through private schools and uni etc, but know that when their time comes, their children probably won't feel the same obligation to look after them.

    So, if Japan doesn't hurry up and start coming up with more affordable facilities and ways of coping, look forward to huge problems ahead.

  • 4

    FightingViking

    @sillygirl

    I don't know if they're still doing it but in Denmark, they used to build special apartment flats where the ground floor was "reserved" for older people and the upper floors were for young couples with or without children. Those with children could "use" the older people as "baby-sitters" while the young mothers went shopping and bought groceries and "whatever" for the older people. The older people were kept "young" by the presence of children and the young mothers were happy to go shopping without having to worry about their children who were not "home alone". I do know the system worked beautifully, I don't know if it still exists.

  • 0

    Tessa

    First Japan needs lots of low cost, affordable retirement homes.

    Although I agree, if it were that simple it would've been done by now (you know how strong the construction industry is, after all). Who is going to staff these affordable retirement homes? Who would want to?

    A woman I know was called back home because her husband complained that the couldn't feed himself and didn't even know how to work the ofuro!!

    I worked briefly with a woman who went home every day during her lunch hour to cook a hot meal for her husband and 19-year-old son! Talk about making a rod for your own back.

  • -4

    cleo

    Anyone who marries a chonan knows what she's getting into

    Who says she married a chonan? Elder brothers have been known to die before their younger siblings.

  • -1

    Bellpeppers

    It's an unforgivable sin to send parents away to elderly/nursing homes. It's an indication that the children do not want to take care of their parents. As my parents are getting older, they start telling me stories about these bad kids who sent their parents to nursing homes. I think they're hinting something.

  • 0

    Peacetrain

    Although I agree, if it were that simple it would've been done by now (you know how strong the construction industry is, after all

    Good point, but sometimes simple things don't get done in Japan simply because...they haven't been done before. When I first got here ATMS were only open during normal banking hours! It was only when citibank started having them open at night etc and then 24 hours that other banks did it too. I could go on with example after example of things that could have been done, but just weren't.

    But yes, the construction industry has been making a killing for years here.

  • 0

    anbinh

    My idea is that each community MUST have a " community garden" so old people can get together, grow something talk about something , joke about something...nature/gardening is wonderful for all ages ,especially old age. My parents are in their 80's but still very active around garden.

  • -1

    tmarie

    Yup, twenty-something and in the throes of Young Luv, foremost in anyone's mind is what age the in-laws are going to go senile.

    I stopped dating Chonan's because of this exact thing. And it's a reason why many chonans are single J women don't want to look after ailing parents. Which I 100% understand. However, the cherry picking of things they want (rich guy, not having to work) vs. what has been traditionally done (look after the parents) amuses me.

    Japan very clearly needs more support in this area - as I said, I watched my PIL suffer with caring for a very nasty GMIL with limited help. However, the FIL MUST take part of the blame for that. He had a go at me when I suggested putting her in a home. Cue the "We Japanese don't just abandon of parents like you do". Okay, kill yourself, hurts yourselves and give you mother subpar care because you're a stubborn old goat. Fine by me.

    Should also say, these parents reep what they sow. Don't teach your kids how to cook, clean and the like? They're setting themselves up for the situation above. Is it sad? Yes but let's place some responsibility on the parents here who thought it was beneath their sons to learn how to cook and clean.

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