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People with serious disabilities have few places to go after caregivers' deaths

A group home is seen in Sapporo in July 2017. (Mainichi)

TOKYO -- Only 0.4 percent of group homes and 23.3 percent of residential facilities for people with disabilities have accepted bedridden survivors of traffic accidents with conditions so severe they cannot communicate with others, according to a nationwide survey by the Ministry of Land, Infrastructure, Transport and Tourism.

The finding bodes ill for traffic accident survivors with one of the most severe forms of disability -- persistent disturbance of consciousness -- because many of them are cared for by their aging parents, guardians and family members, and supporting them after their caregivers' deaths is a major looming social problem. Group homes are expected to accept people with such conditions, but the ministry survey shows that they are not living up to that commitment.

The survey conducted by the transport ministry, which is responsible for supporting traffic accident survivors, also found that few group homes have the capacity to provide medical support for those with severe disabilities, such as clearing phlegm, and are reluctant to accept them.

To improve the situation, the ministry began this fiscal year to shoulder part of the personnel and other costs for group homes and resident facilities accepting traffic accident survivors with severe conditions. The funds come from compulsory automobile liability insurance programs.

The ministry survey started in fiscal 2014, and covered 9,385 facilities across 46 prefectures, except the northernmost prefecture of Hokkaido, which will be surveyed this fiscal year. Of the total, 746 group homes and 412 residential facilities for people with disabilities, or 12.3 percent, responded to the questionnaires.

Among the residential facilities, 96, or 23.3 percent, said they had accepted people with persistent disturbance of consciousness. But only 0.4 percent or three group homes -- two in the northeastern prefecture of Fukushima and one in the western prefecture of Shimane -- said so.

People with spinal injuries, who tend to have severe disabilities, were accepted by 54.3 percent of the residential facilities and 1.8 percent of the group homes surveyed by the ministry. The ministry estimates that the numbers are equally low at facilities that did not respond to its inquiries.

Regarding medical care such as clearing phlegm, 30.1 percent of the residential facilities and 1.9 percent of the group homes said they are capable of offering such services. The ratios of facilities that can do gastrostomy procedures, or the direct provision of nutrition into the stomach, stood at 29.4 percent and 1.2 percent, respectively. Only 8 percent of the residential facilities and 0.5 percent of the group homes said they can accept people with a tracheotomy tube for breathing support.

Residential facilities for people with disabilities tend to have higher acceptance numbers, apparently because they tend to have more capacity and thus can offer medical and nursing services more effectively.

Under the current policy, the government intends to move people with disabilities from larger facilities to community care environments. Many aging family members of traffic accident survivors with severe disabilities hope, after the caregivers pass away, to entrust their loved-ones to small-scale group homes, where residents can have a home-like atmosphere.

In response, the transport ministry has allocated 148.9 million yen for those facilities this fiscal year. Of that, up to 10.8 million yen per year per place is used to support personnel costs, and up to 4 million yen per year per place is provided for the purchase of medical equipment such as beds designed to help caregivers perform their duties. Expenses to cover medical care training for workers are also covered.

Associate professor Kenji Takagi of Wayo Women's University, a specialist in medical welfare studies, pointed out that caring for people with severe disabilities can be very costly because they require round-the-clock support. Meanwhile, how to support them after their caregivers' deaths is becoming a pressing issue with the rapid aging of Japanese society. "The funding from the ministry has substantial meaning, even though it's limited to traffic accident survivors," said Takagi.

(Japanese original by Masayoshi Esashi, City News Department)

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