10 ms·

Tackling the crisis of care for older people: lessons from India and Japan

65 points by sohkamyung 5y ago

andi999 5y ago
Good article, but does anybody else feel weird about the:'what can these countries teach us'? It would be fine in a BBC article, where it is clear who is 'us', but in nature? I would feel the us vs india would be bad enough, but Japan? People from Japan publish regularily there, Japan is one of the bigger players in science. Maybe I am overthinking this though.
- dotancohen 5y ago
  "Us" is humanity. Not every "us" is against a "them".
88840-8855 5y ago
My thoughts on the topic after reading the article, which made gold points, especially on the low internal migration rate and women not working, but staying at home and taking care of household and family. The West has followed the path of freedom and free markets. The smallest unit in society is the individual, not the family (like in Asian countries). Freedom here is being celebrated, also by having the kid "finally" moving out at 18+. Those who stay are not doing it for cultural, but mostly for economical reasons. Taking care of elderly people is not very "cool" here in Germany. My friends haven't called or visited their grandmas for many months, while my Chinese friends try to use their holidays to visit home. They are also planning longterm how to move closer together and incorporate those thoughts into the partner selection. The Western approach is different and get often "it's me and it's my happiness".
- bsder 5y ago
  > My thoughts on the topic after reading the article, which made gold points, especially on the low internal migration rate and women not working, but staying at home and taking care of household and family. Japan is absolutely horrible to its women. Women are expected to take care of their family, their own elderly relatives and their husband's elderly relatives. It's one of the many reasons why so many Japanese women are refusing to marry and have families. Maybe the US doesn't have it right, but, with respect to its women, Japan has it very wrong. The biggest problem with the US is that you need a car to do anything. This includes things from basic groceries to the doctor. That's terribly limiting to the elderly.
  - nradov 5y ago
    Women in China are also increasingly refusing to get married for the same reason. https://www.cnn.com/2021/01/29/china/china-millennials-marriage-intl-hnk/index.html https://www.cnn.com/2021/01/29/china/china-millennials-marri...
  - notsureaboutpg 5y ago
  - mrkentutbabi 5y ago
    Really? very wrong? Have you ever talked to the average Japanese women and see how they want it? This is why westerners will always be a gaijin.
    - TheGigaChad 5y ago
  - px43 5y ago
    Just one data-point, but my Japanese friend who lives in Japan just finished up her ONE YEAR maternity leave, so there are definitely a few things that they do much better than the US. The 6 weeks before the due date is also required by law to be protected leave as well, but most places do more. The US simply doesn't have any protected leave at all, which is incredibly hostile to women trying to contribute to the labor force.
    - fomine3 5y ago
      Big corps are tend to be good, small local corps tend to be bad for maternity leave. They don't want employee to leave even though it's guaranteed right and they don't pay salary but insurance pay some money.
- msh 5y ago
  Well the women defacto being "forced" to not work part is more, women sacrificing their freedom to make life easier for the men.
  - 88840-8855 5y ago
    CORRECT! And this is what perplexes me so much. I lived in Japan and saw this with my own eyes, it was such an ultra conservative society, especially in respect how women are treated. And then you meet Western people who adore, even feteshize Japan SO heavily without reflecting anything what is going on. People have to understand that most of the things they love in Japan (cleaness, extreme degree of quality in customer service, orderliness) is due to those ultra conservative values and norms. Hence, I am very critical towards Japan and I find people naive who one the one hand adore Japan so much (also the super conservative government) and at the same time hate the Chinese values, system and even people.
    - fxtentacle 5y ago
      It might be that this is so fetishized in western culture precisely because there are many people who are conservative but cannot find a socially appropriate outlet for it. Try saying "The man should work to feed the family, the woman should raise the kids." on American TV ;) But I'm sure there are Americans (of both genders) who feel like that is how they would want their marriage to be. Similarly, Japanese women are usually portrayed as very submissive in Anime and Japanese movies. Probably, some people find that sexually attractive, or else they wouldn't do it. Looking at what westerners desire of Japanese culture might be a good way to find suppressed urges in the western culture. Whether or not we as society decide to act on that knowledge is a different question.
      - throwaway91822 5y ago
        I studied Japanese and met maybe a hundred people that love Japanese culture. I never met any who would approve of the sexism, xenophobia or crazy work culture. Most people love the aesthetics, literature, history, architecture, food, music... I think you are describing a certain far-right weaboo subculture, but that's just a pocket of 4chan inanity.
- goodpoint 5y ago
  > having the kid "finally" moving out at 18+. You are generalizing aspects of US to the whole "west". Statistics show the opposite: in most EU countries people don't leave home at 18 by far. Also family is important in many EU cultures and people visit close relatives often.
  - jmrm 5y ago
    In the same comment you can read: > Those who stay are not doing it for cultural, but mostly for economical reasons. If you look statistics about young adults leaving home, and young adults who doesn't have a job (or don't earn enough to buy or rent a house), the correlation is pretty hard.
    - goodpoint 5y ago
      In the US, yes. In other cultures no.
    - fxtentacle 5y ago
      In the US, yes. In Asia, no. In Europe, it depends.
fxtentacle 5y ago
The first step is to convince people who grew up with the western "individualism and freedom are the most important" culture why they should care about elderly that they are not directly related to. Those old people who have lots of family that cares about them will be fine in any case. So the "problem" are those old people that are socially isolated and went all-in on the governments' promises of public retirement care. But now we're finding out that the old retirement system is too expensive for the young generation to handle, plus the young were taught not to care about anyone but themselves...
- pjc50 5y ago
  People making this kind of comment should disclose their age.
  - fxtentacle 5y ago
    Mid 30ies. But I used to work in a government retirement home for a year just because I was curious about it. And the loneliness in there is depressing. EDIT: BTW, if it weren't for the fact that tech pays 20x the hourly rate, I might even have stayed working in social places. But I have also experienced the other side, like when a restaurant refused to let us in because we came with kids. They argued that their mostly elderly customers would feel disturbed by the noisyness of kids talking to each other.
    - monkeybutton 5y ago
      My spouse is working in a government run long term care home. The conditions are bad and so is the pay. We're not the only couple like this I know, and at this point I feel like techs high salaries are indirectly subsidizing the system.
      - mrguyorama 5y ago
        Meanwhile my significant other works in our state government granting public money to help needy elderly people have somewhere to live out the rest of their lives. The amount of money these places get per individual is fucking staggering, like $15k per month, every month. What does that get you? Like a shitty bed in a shitty room with shitty daily food and 1/10th of a nurse, who, like you said, is paid garbage. But don't worry, some rich fucker's portfolio is doing great now that the elderly had to sell everything they've ever earned to afford end of life care, instead of letting their family, children, or even the next generation inherit it.
bongoman37 5y ago
kgin 5y ago
Sometimes I have to step back and note the whiplash of future predicted problems. When I was a kid, it was overpopulation. Then it became overpopulation combined with the prospect of automation taking all of our jobs. Now, very suddenly as it seems to me, we’re talking about declining population and a labor shortage.
- lotsofpulp 5y ago
  Depends what you are talking about. If the topic is pollution or climate change, then total energy consumption is the problem, which inevitably leads to overpopulation being the problem. If the topic is how much of society’s resources should be allocated to maintaining quality of life for those who cannot by themselves, perhaps due to old age, then a labor “shortage” will be the problem. More accurately, it is about which proportion of society’s resources should go towards supporting those who need assistance, changes which show up as changes in prices for labor. I am not too fond of the idea of using society’s resources to keep people of very advanced age living longer and longer with poor quality of life. This rationing of resources will exacerbate due to reduced birth rates compared to previous decades, in conjunction with increasing lifespans and medical interventions.
  - galfarragem 5y ago
    > I am not too fond of the idea of using society’s resources to keep people of very advanced age living longer and longer with poor quality of life. Completely agree with you. The "Trillion dollar question" is what to do and how to do it, once a "solution" is not enough, "democracies" have to find ways to enforce it. Edit: Euthanasia is a solution that is starting to be sold by some politicians. I wonder if people really understand what's behind it.
    - lotsofpulp 5y ago
      Assisted suicide. My grandpa lost his last kidney at 95 and was then picked up and dropped off for dialysis 3 times a week in the early 2000s. For a few years this went on, must have been tens of thousands of dollars or even $100k+ of labor and medical services, in those days. Paid for by future taxpayers. He should have been given an option to go peacefully.

65 points by sohkamyung 5y ago

Good article, but does anybody else feel weird about the:'what can these countries teach us'? It would be fine in a BBC article, where it is clear who is 'us', but in nature? I would feel the us vs india would be bad enough, but Japan? People from Japan publish regularily there, Japan is one of the bigger players in science. Maybe I am overthinking this though.

dotancohen 5y ago
"Us" is humanity. Not every "us" is against a "them".

88840-8855 5y ago

My thoughts on the topic after reading the article, which made gold points, especially on the low internal migration rate and women not working, but staying at home and taking care of household and family. The West has followed the path of freedom and free markets. The smallest unit in society is the individual, not the family (like in Asian countries). Freedom here is being celebrated, also by having the kid "finally" moving out at 18+. Those who stay are not doing it for cultural, but mostly for economical reasons. Taking care of elderly people is not very "cool" here in Germany. My friends haven't called or visited their grandmas for many months, while my Chinese friends try to use their holidays to visit home. They are also planning longterm how to move closer together and incorporate those thoughts into the partner selection. The Western approach is different and get often "it's me and it's my happiness".

bsder 5y ago
> My thoughts on the topic after reading the article, which made gold points, especially on the low internal migration rate and women not working, but staying at home and taking care of household and family. Japan is absolutely horrible to its women. Women are expected to take care of their family, their own elderly relatives and their husband's elderly relatives. It's one of the many reasons why so many Japanese women are refusing to marry and have families. Maybe the US doesn't have it right, but, with respect to its women, Japan has it very wrong. The biggest problem with the US is that you need a car to do anything. This includes things from basic groceries to the doctor. That's terribly limiting to the elderly.
- nradov 5y ago
  Women in China are also increasingly refusing to get married for the same reason. https://www.cnn.com/2021/01/29/china/china-millennials-marriage-intl-hnk/index.html https://www.cnn.com/2021/01/29/china/china-millennials-marri...
- notsureaboutpg 5y ago
- mrkentutbabi 5y ago
  Really? very wrong? Have you ever talked to the average Japanese women and see how they want it? This is why westerners will always be a gaijin.
  - TheGigaChad 5y ago
- px43 5y ago
  Just one data-point, but my Japanese friend who lives in Japan just finished up her ONE YEAR maternity leave, so there are definitely a few things that they do much better than the US. The 6 weeks before the due date is also required by law to be protected leave as well, but most places do more. The US simply doesn't have any protected leave at all, which is incredibly hostile to women trying to contribute to the labor force.
  - fomine3 5y ago
    Big corps are tend to be good, small local corps tend to be bad for maternity leave. They don't want employee to leave even though it's guaranteed right and they don't pay salary but insurance pay some money.
msh 5y ago
Well the women defacto being "forced" to not work part is more, women sacrificing their freedom to make life easier for the men.
- 88840-8855 5y ago
  CORRECT! And this is what perplexes me so much. I lived in Japan and saw this with my own eyes, it was such an ultra conservative society, especially in respect how women are treated. And then you meet Western people who adore, even feteshize Japan SO heavily without reflecting anything what is going on. People have to understand that most of the things they love in Japan (cleaness, extreme degree of quality in customer service, orderliness) is due to those ultra conservative values and norms. Hence, I am very critical towards Japan and I find people naive who one the one hand adore Japan so much (also the super conservative government) and at the same time hate the Chinese values, system and even people.
  - fxtentacle 5y ago
    It might be that this is so fetishized in western culture precisely because there are many people who are conservative but cannot find a socially appropriate outlet for it. Try saying "The man should work to feed the family, the woman should raise the kids." on American TV ;) But I'm sure there are Americans (of both genders) who feel like that is how they would want their marriage to be. Similarly, Japanese women are usually portrayed as very submissive in Anime and Japanese movies. Probably, some people find that sexually attractive, or else they wouldn't do it. Looking at what westerners desire of Japanese culture might be a good way to find suppressed urges in the western culture. Whether or not we as society decide to act on that knowledge is a different question.
    - throwaway91822 5y ago
      I studied Japanese and met maybe a hundred people that love Japanese culture. I never met any who would approve of the sexism, xenophobia or crazy work culture. Most people love the aesthetics, literature, history, architecture, food, music... I think you are describing a certain far-right weaboo subculture, but that's just a pocket of 4chan inanity.
goodpoint 5y ago
> having the kid "finally" moving out at 18+. You are generalizing aspects of US to the whole "west". Statistics show the opposite: in most EU countries people don't leave home at 18 by far. Also family is important in many EU cultures and people visit close relatives often.
- jmrm 5y ago
  In the same comment you can read: > Those who stay are not doing it for cultural, but mostly for economical reasons. If you look statistics about young adults leaving home, and young adults who doesn't have a job (or don't earn enough to buy or rent a house), the correlation is pretty hard.
  - goodpoint 5y ago
    In the US, yes. In other cultures no.
  - fxtentacle 5y ago
    In the US, yes. In Asia, no. In Europe, it depends.

fxtentacle 5y ago

The first step is to convince people who grew up with the western "individualism and freedom are the most important" culture why they should care about elderly that they are not directly related to. Those old people who have lots of family that cares about them will be fine in any case. So the "problem" are those old people that are socially isolated and went all-in on the governments' promises of public retirement care. But now we're finding out that the old retirement system is too expensive for the young generation to handle, plus the young were taught not to care about anyone but themselves...

pjc50 5y ago
People making this kind of comment should disclose their age.
- fxtentacle 5y ago
  Mid 30ies. But I used to work in a government retirement home for a year just because I was curious about it. And the loneliness in there is depressing. EDIT: BTW, if it weren't for the fact that tech pays 20x the hourly rate, I might even have stayed working in social places. But I have also experienced the other side, like when a restaurant refused to let us in because we came with kids. They argued that their mostly elderly customers would feel disturbed by the noisyness of kids talking to each other.
  - monkeybutton 5y ago
    My spouse is working in a government run long term care home. The conditions are bad and so is the pay. We're not the only couple like this I know, and at this point I feel like techs high salaries are indirectly subsidizing the system.
    - mrguyorama 5y ago
      Meanwhile my significant other works in our state government granting public money to help needy elderly people have somewhere to live out the rest of their lives. The amount of money these places get per individual is fucking staggering, like $15k per month, every month. What does that get you? Like a shitty bed in a shitty room with shitty daily food and 1/10th of a nurse, who, like you said, is paid garbage. But don't worry, some rich fucker's portfolio is doing great now that the elderly had to sell everything they've ever earned to afford end of life care, instead of letting their family, children, or even the next generation inherit it.

bongoman37 5y ago

kgin 5y ago

Sometimes I have to step back and note the whiplash of future predicted problems. When I was a kid, it was overpopulation. Then it became overpopulation combined with the prospect of automation taking all of our jobs. Now, very suddenly as it seems to me, we’re talking about declining population and a labor shortage.

lotsofpulp 5y ago
Depends what you are talking about. If the topic is pollution or climate change, then total energy consumption is the problem, which inevitably leads to overpopulation being the problem. If the topic is how much of society’s resources should be allocated to maintaining quality of life for those who cannot by themselves, perhaps due to old age, then a labor “shortage” will be the problem. More accurately, it is about which proportion of society’s resources should go towards supporting those who need assistance, changes which show up as changes in prices for labor. I am not too fond of the idea of using society’s resources to keep people of very advanced age living longer and longer with poor quality of life. This rationing of resources will exacerbate due to reduced birth rates compared to previous decades, in conjunction with increasing lifespans and medical interventions.
- galfarragem 5y ago
  > I am not too fond of the idea of using society’s resources to keep people of very advanced age living longer and longer with poor quality of life. Completely agree with you. The "Trillion dollar question" is what to do and how to do it, once a "solution" is not enough, "democracies" have to find ways to enforce it. Edit: Euthanasia is a solution that is starting to be sold by some politicians. I wonder if people really understand what's behind it.
  - lotsofpulp 5y ago
    Assisted suicide. My grandpa lost his last kidney at 95 and was then picked up and dropped off for dialysis 3 times a week in the early 2000s. For a few years this went on, must have been tens of thousands of dollars or even $100k+ of labor and medical services, in those days. Paid for by future taxpayers. He should have been given an option to go peacefully.