As the most aged country in the world which attracts international attention in the 21st century, there are urgent needs in Japan to study an aged society, life activities of senior citizens and their social and economic impact on a society.
Japan NGO Council on Ageing (JANCA) is an organization that promotes social participation among senior citizens, and its various activities are based on “JANCA Opinion Surveys” with members of affiliated organizations. It has also made several “JANCA’s Recommendations” and appealed to the society. JANCA organized this research forum, in collaboration with the University of Tokyo Institute of Gerontology, to examine social and economic issues based on JANCA Opinion Surveys and JANCA’s Recommendations. The first forum was held on November 9th (Mon.) from 2 p.m. to 5 p.m. at the University of Tokyo Medical Library Room 333.
The latest JANCA’s Recommendations（2009janca-recommendations-_20091130_110132） were submitted to policymakers on August 11th, and we have received feedbacks from many of them, including current Cabinet members. At this first forum, Shigeyoshi YOSHIDA (Executive Director, JANCA) first read the Recommendations. Based on the Recommendations, a symposium followed to discuss the ideal social security system and lives of senior citizens to build a society with rich spirit under the projected population and social structure.
The following is a summary of the symposium.
Symposium
Moderator: Mr. Tsutomu HOTTA (Co-chair, JANCA)
Panelists: Ms. Keiko HIGUCHI (Co-chair, JANCA), Dr. Ichiro KAI (Professor, the University of Tokyo; Chief Director, the Japan Socio-Gerontological Society)
Adviser: Mr. Shigeyoshi YOSHIDA (Executive Director, JANCA)
Hotta: At this symposium, we would like to discuss 1) a society we aim for (Recommendations 1 and 2), 2) social security (Recommendation 3) and 3) work and social participation (Recommendation 4). After the presentations by panelists and a moderator, we would like to have some comments from the floor.
1. A Society We Aim for
Kai: Because of my professional background, I usually work with the elderly with disabilities. Yet, the fact is that the majority of older persons are healthy. Therefore, it is important to find ways to keep productivity of healthy older persons and to utilize their skills and knowledge. When I say “productivity,” it includes not only paid work and volunteer activities but also hobbies and recreational activities.
According to studies in Western countries, physical health and the young state of mind are associated with productivity. However, a new concept of “Quality of Life” has emerged recently. That is, even with disabilities, people can feel happy under the given physical conditions. “Adaptability” is the key because it enables us to find new Ikigai (i.e., meaning of life) and encounters.
Higuchi: We now have 100 years to live. So there should be places and chances for every generation. In the last 100 years or so, our nation has experienced 3 major “reforms.” The first reform was Meiji Restoration with cultural enlightenment. The second reform was the defeat at World War II, when democracy and peace became important issues. I would call the 3rd and current reform “Heisei Restoration” which started around 2000. This is an era in which people can enjoy longevity, 100 years of their lives. In my opinion, this Heisei Restoration has the biggest impact on people’s ways of living.
Although Japan is a front runner in terms of population aging, I think people are not ready for it. It is true particularly for governments, researchers and men. An aged society has a lot to do with gender, and I advocate “BBBP”, or Bimbo (poor) Bahsan (granny) Boushi (prevention) Plan because poverty among older women will become an even more serious problem in the future.
Another challenge is how to keep our health for the 100 years of life. I recently had a severe illness and have reconsidered my lifestyle. Likewise, policies, such as long-term care insurance, and the society as a whole should also need to be readjusted for the centenarian society.
Hotta: From now on, we should aim for a society which lets each person blossom, rather than a society led by government and corporations. Right now, we have certain jobs and we make adjustments to do the jobs. Yet, it is important to think of what this person can do first and fully utilize his/her skills and knowledge. Therefore, I totally agree with the society we aim for that is mentioned in Recommendation 2, “A society where every generation, including older persons, can live with Ikigai and rich spirit.”
Participant ①: I agree with the Recommendations. While the majority of older persons are healthy, I think there are not enough places and chances for us. The government says “the young-old should work,” but do corporations provide enough places for us to work? Also, it is quite difficult for private entities alone to build a safety net. I believe in JANCA’s importance in these regards.
Participant ②: I think Ikigai and successful aging are subjective concepts. I would like young people to learn fundamental subjects, such as psychology and philosophy, as well as presence of Japanese people.
Participant ③: An aged society is a result of our efforts to attain longevity rather than a problem. I think we need to emphasize this point further. I would like young people to recognize that an aged society is an example of our successes.
2. Social Security
Kai: Regarding the last part of Recommendation 3, it is quite difficult to determine the terminal phase or “end-of-life.” It is relatively easy for cancer patients. In the past, older people were considered to have 1 month to live once they could no longer eat. Yet, it is not the case any more due to development of life-extension technology. Another challenge is that patients can not always make decisions on whether or not to use life extension technology. In such cases, families and/or doctors have to make such decisions. It is a difficult issue in terms of respecting patients’ wishes as well as possibilities of criminal charges (particularly when pulling the plug).
Yoshida: According to our Opinion Survey, as the Recommendation says, a lot of people would like to know how long they would be dependent on other people before death or the average length of terminal phase.
Kai: We could calculate the average to a certain extent. For example, there is a concept of “healthy life expectancy (i.e., the average number of years that a person can expect to live in full health). Hence, “life expectancy – healthy life expectancy = “unhealthy life expectancy” in which people are likely to be dependent on others. We can also have data on the average medical cost in the last year of people’s lives as well as the average time period between the onset of dementia and death.
As for the subject other than the terminal phase, there has been more emphasis on prevention recently. In the field of long-term care, preventive measures are taken in social isolation, falling and nutrition. However, the effects of preventive efforts are difficult to measure, and it takes time to see the effects. We have not found clear effects of preventive measures yet because they have just started. Yet, it is an important issue.
Higuchi: In this fragmented society, we truly need policies that put us all together. Looking at our social security expenditure in Japan, its proportion to GDP is just above U.S. But the share of burden is also lower. It is a time to reconsider this. Even among older persons, some must be able to pay more. Yet, the burden should be more progressive.
As for birth rates, most developed countries experienced a decline then the rates started rising again thanks to child care policies and gender equality measures. However, Japan, South Korea and Canada are exceptions and have yet to see rising birth rates. I believe that this phenomenon reflects a society which makes it hard to bear and raise children while working.
Hotta: There are problems with the new health care system for the old-old regarding burden. Yet, things will get even worse if we try to bring it back to the old system. We need a fundamental and comprehensive reform (including health care, long-term care and pension) with a clear goal. While it is important for everyone to share the burden, there are still some people who find this society difficult to live even with their full capacity. The society as a whole should support those people. Some examples of challenges include reconsideration of social security burden, measures to increase child births and measures for older people who are in less severe needs under the long-term care insurance. Furthermore, although many people object, I think we should promote immigration to support this country at least for the foreseeable future.
3. Work and Social Participation
Higuchi: After age 60, it is also important for older persons themselves to make a move to attain jobs. It is also natural, considering factors such as health status, for pension recipients to have different work arrangements than other people. Then, how do we create work places for pension recipients? For example, a corporation can build a 2nd company for retirees. Older persons can also start their own businesses. JANCA can introduce these best practices.
As for political participation among older persons, some political parties have age restrictions when running for the Diet, leading to the lack of age balance. A retirement age is also set at government’s councils. It is critical that older persons, including JANCA, come together, become a pressure group and express our opinions particularly on issues that directly affect our living.
Hotta: I think age restrictions are unconstitutional. There must be some jobs that create a “win-win” situation for both older people and employers. For example, older persons will be great at staff training and complaint handling. I hope there will be more job opportunities for older persons in the future.
Kai: The University of Tokyo is currently conducting a project “Aging in Place,” in which I would like to include social participation among older persons (e.g., volunteer activities by the healthy elderly). Also, I would like to learn more about AARP, which has a lot of member benefits. I think JANCA should start a similar system. It is also true that older persons’ voices are not loud enough and should become stronger. The Baby Boom generation had been active in social movements when they were young, and I look forward to seeing how this generation will play roles as senior citizens.
○ Comments by Ms. Norie HONDA (Cabinet Office)
I have learned a lot from this forum and have 3 questions and/or comments. First, how does age discrimination take place other than work places? Policies that take age into account are usually made so that a given age group can benefit from such policies. Second, I agree that older people’s skills and knowledge should be utilized more fully. For example, older persons can support working families through such entities as Silver Human Resource Centers. Third, I keep hearing that community participation should start before retirement. Considering the work-life balance, I will appreciate some advice from senior citizens to the working-age group.
The moderator (Hotta) closed the forum with a comment that we would like to hear more comments and make the Recommendations more realistic.
The information on the next forum is as follows.
