Aging Japan: mid-term symposium

On May 22, the mid-term symposium for the Aging Japan project took place in Leiden. Several societal partners and exxperts in the field gathered to discuss the preliminary research findings and to give feedback.

The conference was opened by Prof. Dr. Katarzyna Cwiertka, with a special welcome to the colleagues from the German Institute for Japanese Studies in Tokyo, who are collaborating with the LeidenAsiaCentre on this project.

After the opening, Pam van Ipenburg and Anoma van der Veere presented the results of the comparative media analyses they conducted on the topic of the use of technology in elderly care in Japan during the last three years. The Dutch media mainly focuses on companionship (social) robots and the ethical debate surrounding robotic care. The use of robotics in Japan is admired but not deemed desirable for the Dutch society. To the contrary, the Japanese newspapers are not concerned at all with ethical issues and concentrate mainly on functional robotics rather than companionship robots [1]. Sensor and drone technology feature frequently in the Japanese media. No attention is paid to the causes of aging, instead the focus is placed on finding technological solutions to the problem. One important conclusion of the comparative media analysis seems to be that Japan has already accepted the necessity of technological solutions for the aging problem, while in the Netherlands this debate is still ongoing. Moreover, researchers found that the image of Japan and robotic solutions depicted by the Dutch media is not a reflection of the reality.

Following the presentation of the results of the comparative media analysis, dr. Suzanne Brucksch from the German Institute of Japanese Studies presented an overview of the elderly care situation in Japan, with particular reference to the use of technology. Due to financial policies related to healthcare and aging dating back to the 1970s, a vast number of hospitals in Japan function as elderly homes. Despite research changes in the healthcare system, institutional care continues to play the key role in Japan, while efforts are currently being made to allow elderly to remain at home, living independently, as long as possible. Contrary to the popular perceptions abroad, the Japanese healthcare system was quite late in adapting ICT solutions. The Japanese government is currently investing heavily in this sector.

Case studies

Dr. Suzanne Brucksch and Junko Sakurai from the German Institute for Japanese Studies introduced three case studies that will stand central in the research that will be conducted within the framework of the Aging Japan project. They belong to three categories of technologies 1) robotic care and/or AI 2) ICT and telemedicine and 3) patient monitoring and rehabilitation devices. They explained that despite this image created by the Dutch media, technologies such as monitoring, transfer and mobility aids tend to be used more often in Japan than communication robots. For example, the second case study presented by Dr. Brucksch concerns the Fukui Medical Net. Care is provided through ICT of integrated systems which allows the provision of the same level of care with a lower number of staff. Junko Sakurai presented the case study of a walking aid, which has been recently introduced on the Japanese market. The high costs and big size of technological solutions introduced in the past primarily for the use by institutional care are not easily adaptable to the home situation. Assistive Walker is an example of new technological solutions being developed with the domestic care, rather than the institutional one, in mind.

After the presentation of the German Institute for Japanese Studies, Dr. Michiel Bleijlevens gave a presentation on his research titled ‘an overview of innovation in long-term care for older people’. Maastricht University works together with care providers, investigating tailored variety of approaches to challenges that nursing homes in the Netherlands encounter at the moment – the number of nursing staff is decreasing while more elderly people expect to age at home. The goal of the research is to deliver knowledge on caregiver burden and quality of life. Dr. Bleijlevens emphasized that research into the effectiveness of technological innovations in elderly care are rarely conducted, while stressing that it is important to keep evaluating whether technology has any added value.

Feedback from societal partners

Feedback from societal partners was one of the key objectives of this mid-term symposium. It was noted that there seems to be a shift in opinion in the Netherlands, recognizing that things cannot be done as they were in the past. Instead of looking at the image portrayed by the media and politics we should look at the user perspective, that is often more positive about care technologies. Furthermore,  the focus of the Dutch government is more on the quality of life and patient centric care. It might also be necessary to include users’ experience when investigating elderly care. An example was given of the fear of stigmatization as one of the impediments in the introduction of new technologies into elderly care. They often do not want to admit that they need help from either humans or technology as they are afraid to lose their independence. This kind of issues present a challenge to the introduction of technological solutions into elderly care. All participants agreed that technology must be need driven and contribute to the wellbeing of the elderly, rather than follow political agendas. This is relevant to both the Dutch and Japanese contexts. A suggestion was made to include case studies on the Dutch technologies into the project for a comparative perspective. It was also pointed out that the analysis of Japanese case studies can have an added value when thinking about the Dutch solutions, as well as for the more general debate of the use of technology in elderly care. It would be interesting to include some case studies on Dutch technologies. It was noted that there are a lot of similarities in terms of technology but that the sense of urgency is different in Japan and the Netherlands, with the Japanese government pushing harder for technological solutions. In the future, the focus will be on prevention and this market is very likely to be privatized by bottom-up projects (partly) financed by the government.

[1] It is important to note that the definition of healthcare robot in Japan is different from the Dutch definition. In the Netherlands ‘robot’ often means a social or humanoid device. In Japan the definition of ‘robot’ is more broad. For example it also includes lifting devices and sensor technologies.