A time-deposit system for providing assistance and care to elderly people who are handicapped is gradually spreading in Japan. Under this system, the time a volunteer spends giving care or helping an elderly person with housework is saved up. In the future, if the caregiver or members of her/his family require care, this time can be drawn on to receive services. In Japan, the world's most rapidly aging society, such private systems of mutual assistance are seen as a very effective way of supplementing public care services, and the national and local governments are pushing them.
These service systems operate in various ways. One of the most common is to assign a monetary value to the time spent in service activities; this amount is deposited for some future time when the caregiver withdraws either a commensurate amount of service or cash. Another method is to save up time as such and later withdraw the equivalent in either service or money.
Local governments and private organizations around the country have already begun such programs. One private organization in Setagaya Ward, Tokyo, illustrates how the system works. This organization adopted a time-deposit system 10 years ago. The services it offers focus on help with household tasks, such as cleaning, laundry, shopping, preparing meals, or simply giving an elderly person someone to talk to, and caregiving, which includes feeding, bathing, assisting in using the toilet, changing diapers, rehabilitation, and organizing outings. These services are offered from 7:00 AM to 9:00 PM.
The fees care recipients pay vary with the service and the time of day it is provided. For example, meal services provided between 9:00 in the morning and 5:00 in the evening cost 700 yen per hour; this rises to 800 yen if the service is given before 9:00 or after 5:00. Caregiving services cost 100 yen per hour more than housekeeping services. Those who provide services can choose whether they will save up the time spent or receive a cash payment.
Reportedly, however, many of this organization's registered service providers say that they are saving up the time for use by their parents or that although they are depositing the time, they hope that they will never need to use it and consider what they are doing at present to be volunteer work.
For those who receive the service, it makes no difference whether the caregiver is paid in time or money. What is more, the overwhelming majority of elderly people are reluctant to request services that are offered free of charge.
Those caregivers who plan to receive services in old age need to figure out how much time they should save up. One gauge might be to reckon on two hours a day, three days a week. This would come to 312 hours a year, meaning 3,120 hours over a period of 10 years. Networking of organizations conducting activities under the same system holds the key to effective operation. Otherwise people who have deposited time in this fashion may become unable to receive care services in the future if they move away from the area where they served as caregivers. If a nationwide network is established, moreover, it will become possible for those who have saved up time in Tokyo, for example, to give it to parents living in other areas.
This led organizations in Tokyo's 10 wards to start networking early in the game, and at present services are interchangeable among them, although fees differ slightly in some organizations. A growing number of organizations in other areas are also making efforts to develop networks. According to the Ministry of Health and Welfare, Japan currently has about 800,000 bedridden elderly people and about one million who are senile. These people are being cared for in a wide variety of ways. Some are living at home, where they are cared for by family members and receive services offered by local governments or volunteer organizations; others are in homes for the aged or hospitalized and receive care along with medical treatment. It is estimated that at the beginning of the next century one Japanese in five will be over age 65, and the need for caregiving is bound to increase.
This has led the Ministry of Health and Welfare to consider introducing a public care insurance system. This plan calls for setting up a system of insurance specifically for receiving care, separate from the present health insurance and pension programs. The proposed plan would provide elderly people who need care with appropriate services at low cost; the necessary financial resources would be covered by insurance payments made by the general public and budget allotments from national and local government coffers. It is difficult, however, for custom-tailored services to be offered under a public insurance system, and it is hoped that a very effective system of preparation for old age can be arranged by supplementary combinations of time-deposit systems and care insurance plans offered by private insurance companies.
(The above article, edited by Japan Echo Inc., is based on domestic
Japanese news sources. It is offered for reference purposes and does
not necessarily represent the policy or views of the Japanese
Government.)