Factors that Affect Older Japanese People’s Reluctance to Use Home Help Care and Adult Day Care Services

Abstract

The purpose of this study was to examine the factors related to the reluctance of older Japanese people to utilize home help services and day services. Home help services consist of three different types of services (i.e., assisting in bathing and toileting, doing household choirs, such as cooking and laundry, and counseling) and are provided by visiting home helpers at the homes of older people. Day services are services (e.g., providing bathing and meals, monitoring the health status of older people, and counseling) that are provided at day service centers in the community to improve the physical and psychological functioning of older people and to help the burden of caregiving of family members. The data used in the study came from the first wave of the Nihon University Japanese Longitudinal Study of Aging, conducted in November 1999 (and again in March 2000 for those people who had been unable to respond to the initial survey). Face-to-face interviews were conducted with a national probability sample of 6,700 people aged 65 and older. Logistic regression analyses were used to analyze factors that were thought to be related to older people's reluctance to use services. Approximately, one half of the respondents indicated reluctance to use home help services, and one quarter of the respondents showed reluctance to use day services. Respondents who were female and who lived in urban areas showed a higher probability of feeling reluctant about using both home-help and day services. Also, respondents who had had caregiving experience using these two types of services showed a lower probability of feeling reluctant about using the services. Furthermore, respondents who were older and had income showed a higher probability of feeling reluctant about using day services, whereas those who had had caregiving experience and who participated in social activities showed a lower probability of feeling reluctant about using day services. According to the 1999 survey, there were still many older Japanese people who felt reluctant about using either type of care service. But it is expected that the quality of services under Kaigo Hoken (the mandatory public long-term care social insurance system) will improve further and that older people's attitudes toward service utilization will change for the better. In the meantime, professional service providers will have to be sensitive to older people's perceptions about service utilization if they would like to continue to contribute to the improvement process of Kaigo Hoken as a positive force.

Trends in healthy life expectancy in Japan: 1986 - 2004

“…A recent study showed that the average entitlement rate rose from 13% in 2001 to 17.4% by 2006 (Mitchell, Piggott, and Shimizutani 2006). Despite initial reluctance to utilize care services when the program was first implemented (Tsukada and Saito 2006), utilization rates, particularly in the home health care area, have increased over the years (Mitchell, Piggott, and Shimizutani 2006).…”

Differences Between Users and Nonusers of Day Care Centers Among Frail Older Persons in Israel

“…If this is one of the reasons, then information, exposure, and experience with this type of service may encourage many more to use it. For example, in Japan (Tsukada & Saito, 2006) older people who did not experience formal homecare and day care center services were reluctant to use them, but after experiencing these two types of services, they had a lower probability of feeling reluctant about using them. However, because the present study did not examine the reasons for nonuse of this type of service this issue merits further in-depth scrutiny.…”

Why older persons seek nursing care: towards a conceptual model

“…2001; Walters, Iliffe, and Orrell 2001). On the other side, being familiar with care options increased the probability of using them (Cho 2005) and could help to overcome a possible reluctance to do so (Tsukada and Saito 2006).…”

“…Studies in countries which provide a welfare system showed that people with low income were more inclined to use home care (van der Heyden et al. 2003) or day services (Tsukada and Saito 2006). Economic obstacles depend thus on the perceived relation between income and cost of services.…”

“…The same may be the case if older persons require nursing care from a home care service or a nursing home. Tsukada and Saito (2006) reported reluctance among older Japanese to use home help and day care services despite existing health problems and available facilities and assumed cultural reasons. Cho (2005) identified economic factors for a decreased willingness to use home care services in Korea.…”