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Nearly 1/6 of care managers in Japan saw children looking after family members: survey

A man who cared for his grandmother, a dementia patient, since he was a primary school sixth grader is seen in Tokyo on March 16, 2020. He says shopping for her at a local supermarket was one of his daily chores. (Mainichi/Yuki Miyatake)

TOKYO -- Nearly one in six care managers in Japan have had past experiences with a household where a minor provided home care to a sick or incapacitated family member, for which an adult would usually be responsible, it was revealed in a joint survey conducted by the Mainichi Shimbun and a health care solutions business.

    There were also numerous claims that such "young carers," who look after family members while also attending school or working, are affected by negative impacts, such as a decline in educational performance as well as physical and psychological health. Care managers who asserted that "the support system is inadequate" accounted for 96.4% of all respondents, further highlighting the need to grasp the reality of such young caregivers and take appropriate measures.

    The joint survey was carried out between June 5 and 15, based on a questionnaire created by the Mainichi Shimbun, via Care Management Online, a website that provides information to care managers and is run by Tokyo-based nursing and health care solution services provider Internet Infinity Inc. About 92,000 care managers are registered members of the website, and responses from a total of 1,303 individuals were collected for the survey. The study is thought to be the first nationwide survey in Japan that asks care managers about young carers.

    Care managers create care service plans utilizing nursing care insurance benefits while providing consultations to individuals who need looking after and their family. This profession was implemented alongside the nursing care insurance system, which was launched in 2000, and it is mandatory for care managers to meet with users every month to grasp the situation of nursing care in the household.

    In the survey, a total of 215 individuals, or 16.5% of respondents, answered that they had been in charge of households where "there was a minor who was involved in providing care to family members, for which an adult would usually be responsible." When asked to mention one child that had left the greatest impression on them in those households, recorded responses showed a female-to-male ratio of 6-4, while the most recorded age group was high schoolers, followed by middle schoolers, teens aged 18 years or older, and elementary school students, in that order.

    The top three subjects of care provided by children were grandmothers, mothers, and grandfathers, in that order, while multiple answers were permitted. Regarding the specific nature of provided care (which also allowed multiple responses), more than half of the 215 care managers claimed to have witnessed young carers undertaking tasks of "chores such as cooking, cleaning, and laundry," "assisting family members when eating, changing clothes, and moving around, among other basic activities," and "grocery shopping for daily goods, making repairs inside the house, and carrying heavy items." Other tasks included "physical assistance when going to the toilet, bathing, and cleaning their bodies, among other things," "providing emotional support such as encouragement," and "medical care such as managing pills and phlegm clearing."

    Asked about the main obstacles to young caregivers' daily lives (multiple answers permitted), the respondents said they had "a tendency to be absent from school," "an inability to partake in extracurricular activities including afterschool activities," and "a state of emotional instability." Responses also included "feelings of loneliness," "unsatisfactory hygiene," and "poor educational performance." Only 30 out of 215 care professionals reported that there were no obstacles.

    Regarding institutions that should get involved to provide support, 35.1% of all 1,303 respondents, answered schools, including school social workers and school counsellors, while 31.5% mentioned local governments. Furthermore, as for impacts of the novel coronavirus pandemic (which allowed multiple responses), 82.5% said "an increase in fatigue and stress resulting from taking care of family members," 72.2% responded "an increase in frustration and clashing with family members," and 71.1% answered "further isolation due to temporary closure of schools and moves to refrain from going outdoors."

    (Japanese original by Hiroyuki Tanaka and Nao Yamada, Special Reports Department)

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