Supervisor of a Private Day Service Center
I would like to begin my report by expressing my gratitude to everyone who worked together to make this program a success. The experiences I gained have helped me greatly to mature as a working woman, and I now have a very strong desire to devote my life to furthering international friendship and understanding between Sweden and Japan.
Moreover, I am very thankful for the opportunity to end my trip with a kind of bonus trip to Stockholm. While walking the streets of Stockholm, I recalled the many people I had met and the things I had experienced while doing my GSE research. It was both a nostalgic time and a happy time as I realized how blessed I was to be able to participate in this program.
Almost every day of our time in D-2400 was spent in homestay situations, and altogether I was able to stay with ten families. At times, I wished I could slow down just a bit more and not have to move from home to home, but having the opportunity to catch a glimpse of how ten different Swedish families live was very beneficial. As expected, the best way to get to know the Swedish welfare system is to get to know how those living within the system live. I would like to write now about the things which impressed me the most during my homestay situations.
The first thing that caught my attention about Swedish homes was the beauty of the windows and yards. The window sills are decorated with lamps and beautiful potted plants, and the yards contain a neatly cut lawn and flowers of all kinds and colors. The Swedish people do all this work themselves, from hanging the lamps to cutting the grass and planting the flowers.
The Swedish people work hard, both at the company and at home. Sweden is famous for its midnight sun, but we could not see the midnight sun in the region where we stayed (southern Sweden). It finally got dark after 9:00 pm. It appeared to me that most people work from 8:00 in the morning to 4:00 in the afternoon, but after getting home from work, they work in the yard, do some simple carpentry work around the house, etc. During our program, we even went hiking from 4:00 in the afternoon and had a barbecue afterwards. We also went out driving around 8:30 in the evening sometimes to look for wild deer.
When I say the Swedish people work hard, I want to emphasize the word hard. It does not mean that they work long hours. In Sweden, to work hard means to work with intense concentration and high efficiency. Or to put it another way, it means to concentrate hard and work efficiently during the time allotted for work. It never means to faithfully and diligently spend long hours slaving away at ones company. The only time they work long hours is when they cannot finish their work during regular working hours. This intense concentration and high efficiency work ethic is a fundamental labor requirement in Sweden. I will leave the more detailed explanation of this theme to another team member.
Sweden is famous for its high percentage of working women, and almost every woman I met while I was in Sweden had a job. I would say the ratio of full-time and part-time workers is about 50/50.
It seemed to me that the household work was clearly defined with the women being in charge of the meals and the men being in charge of the carpentry and repair work around the house. Some of the husbands in the homes I stayed at prepared very delicious meals, but on the whole, the wife bears the burden of taking care of the home and earning a living. It seems like most housewives would like their husbands to help them with the housework a little bit more, which is basically the same situation faced by working wives in Japan.
Among the actively working Swedish women I talked to, I often heard the following comment: Social advancement has given us a high social standing and economic independence, but along with these things have come some things we dont need. What they are talking about is stress and child-rearing problems. In particular, there are many who claim that delinquency is rising because mothers cannot spend enough time with their children and show them the love they need. Without fail, these women said to me, Japanese women must never follow in our footsteps! To be honest, when I heard them say this, I had mixed feelings. The reason for this is that the social advancement of Japanese women is clearly something yet to be achieved in the future. We, too, need to discover the road to independence, don't we?
In all ten of the homes I stayed at, there were no university-age children living at home. Instead, I often heard the comment, "They are living alone now since they are university students." To be sure, there are cases where the university is very far away from the students home, but it seemed like many students lived close enough to home that they could come home for the weekend by train or car. However, most students do not return home every weekend. For example, in order to persuade their children to come home for a meal, some of my homestay parents took the opportunity of saying that there was a visitor from Japan staying at their home.
Also, there were no homes where the husband or wife's parents were living with them. Like university students, the children do not live with their parents. They prefer to have their parents live close by (about half of the families said their parents lived in the same town) and visit them often. In such cases, many of these elderly people were living in old-age homes called "service houses" which are unlike anything which exists here in Japan. I will discuss these homes in more detail later.
Sweden is known as an advanced welfare state. It is one country I really wanted to visit so I could see its welfare programs for the elderly. The vocational study I was able to carry out in this GSE program were extremely valuable. Since there are space limitations, I would like to just introduce, for the most part, the things I learned about which exist in Sweden but not in Japan.
"Normalization." In welfare circles, you could say that everyone knows what normalization means, but in Japan, there are still many who do not understand this concept. Normalization is the way of thinking by which a government strives to create a country in which "a normal society is one in which the disabled and elderly have social service facilities readily available to them which will help them to live normal daily lives." In Sweden, this way of thinking has completely permeated their society to the point where they unconsciously think this way.
When I deplaned at Stockholm Airport, I went to the ladies' room. It was there that I received the first great shock of my trip, and the source of this shock was the toilet paper holder. In Japan, when toilet paper holders are set up for use by right handed people, you hold the upper stainless steel cover with your left hand and tear the paper with your right hand. In other words, you need to use both hands. In Sweden, however, the toilet paper holders have simple springs attached to the upper stainless steel cover. These springs allow the cover to apply enough pressure to the toilet paper roll so that you can tear it off smoothly with just one hand, but not so much pressure that it is impossible to pull the paper out. These holders are easy for those who have lost the use of one side of their body as a result of a stroke to use, and they were truly amazing to me because I pay so much attention to details. After this occurrence, when I went into a ladies room, I made sure to look not at the toilet, but at the toilet paper holders and railings, and I took many photos in Swedish restrooms. No matter where I went, every single public restroom had toilet paper holders which could be used with just one hand. It is easy to see how such easy-to-use toilet paper holders would be convenient even for those who are not physically impaired in one hand.
Also, in Sweden, the light switches in new buildings are placed about one meter above the floor. In Japan, the average is about 1.2 meters. The switches are lower in Sweden than in Japan even though the Swedish are considerably taller than the Japanese. Again, the reason for this lower switch is to make it easy for those who cannot raise their arms easily. I have expended a lot of energy trying to persuade construction workers, electricians and architects in Japan to put light switches lower when constructing facilities for the elderly. It seems like a trivial thing, but again, I was struck by the thoughtfulness of Swedish design.
In Sweden, it is impossible to get a building permit for any public building which is not designed in such a way as to make it easy for those in wheelchairs to use the building, and even older buildings have had ramps built to accommodate the wheelchair bound. Even restaurants and places of business must be designed for wheelchair access or they cannot get a business permit.
The aforementioned examples are small things, but they show how effective Sweden has been in their efforts to make Sweden an easy place to live for both the able bodied and the disabled. They did this by rethinking the common practice of designing and building things with just the able-bodied in mind, and their efforts have been very fruitful.
I noticed several things in practice in relation to Swedens day service centers which we do not have in Japan, although people would like to seem them adopted here. The first was the effectiveness of their transport service. They have specially equipped vans provided to transport those who are wheelchair-bound to the hospital, rehabilitation center or shopping center. With just a phone call, someone will drive the van to their door, help the person into the van and take them wherever they want to go whenever they want to go there. In Japan, we have taxis which are labeled for use as transportation for the disabled, but you need to call ahead and reserve such a van, and it is very expensive to reserve one. While in Sweden, these vans are much easier for people to use.
These service houses are like apartments for the elderly which come with nursing care included. These houses will even accept the bedridden and senile. Many of the service houses I visited were from five to eight stories high (medium height buildings) and on each floor there was a common, multipurpose room which served as a sunroom, social hall and employee lounge. At small-scale facilities, there were dining rooms on each floor where everyone ate lunch together. At larger facilities, there was usually a large cafeteria where both those living at the service houses and the general public were free to eat. Many elderly people who are not living at these service houses go there to eat everyday.
It is possible for both single people and married couples to live in these service houses. Most of the units had a kitchen, bath, toilet and two rooms, although there were single-room units and three-room units as well. The rent for each type varies, but the average person pays about 70% of his social security income for room and board. A number of people allowed me to see their rooms, and each room was furnished and decorated with their own personal furniture and memorabilia. These units were absolutely the same as private apartments. Those who are worried about their health or the health of their mate, or those who are feeling lonely living alone are usually the ones who choose to live at these service houses.
Also, in these service houses there is space for what they call "day centers" -- places where people can come for both rehabilitation and enjoying recreational free time. At these day centers, the service house residents and outsiders are free to meet with their friends whenever they wish to talk and do arts and crafts. Those who are unable to walk are brought to these day centers by the special vans I mentioned previously.
The elderly are not able to use these service facilities for free. They pay rent to live at the service house, meals are separate and if they take a bath, they must pay extra for that as well. These service fees, however, are set at just the right level, so it is easy to live a completely normal life on ones social security check.
In Japan, we also have old-age homes where people must pay to live, but they are extremely expensive, and recently, many of them have gone bankrupt or are not providing the kinds of services they promised in their contracts. Also, most of Japans day centers can only be used once a week on a fixed day at a fixed time, and there is still a long way to go before people will be able to use them whenever and however they wish.
This service is different from Japans home helper service. Most of those working in this program are occupational therapists. There are some elderly or disabled people who prefer to continue living at home, so Swedens home help occupational therapists visit these peoples homes by car and help in whatever way they are needed. For example, they look over a variety of things in order to ascertain the persons needs and then supply them with those things so they are able to continue living at home. Some of the things they check on are just how much and what kind of help the person needs, what kinds of renovations will need to be made to the house, or what type of wheelchair or ambulatory device the person needs. I always feel like we arent able to provide effective services at the place where I work in Japan, and as I saw what is being done in Sweden, I felt that they have truly made progress in this area.
Sweden is a country with superior social welfare programs and high social welfare costs. After I returned to Japan, I was often asked, "Will Japan model its social welfare system after Sweden's?"
I dont think it is possible to answer that question with a simple "yes" or "no" because here in Japan, those who live in urban areas and those who do not have different living requirements and values. All I can say is that Japanese women have begun to achieve a higher degree of education, social success and financial independence, and I think we have reached the limit of our ability to nurse our elderly parents at home. With Sweden's "home health care," society is helping to support the elderly's desire to continue living at home, and the resulting security and stability which society provides the elderly gives them real peace of mind.
Also, Sweden's population density is much less than that of Japan. Even though Sweden is 20% larger than Japan, its total population of 8,700,000 is just about the same as that of Osaka Prefecture. This difference in population density makes the situation in Japan fundamentally different than that in Sweden in many ways.
I learned many things while I was in Sweden. We in Japan have many political and financial problems which need to be debated. However, if I were to sum it all up in regard to these small day centers I visited, I would say it all boils down to the various degrees or levels of "normalization" found in our society.
And by normalization, I'm talking about the objections that are raised by those who are healthy and strong against various basic standards. For example, everyone should have the freedom to live his or her life the way they want, regardless of whether or not they are ill or disabled. This way of thinking was clearly reflected in Sweden where they have provided an environment where the elderly are each considered important and are well cared for. As the proverb says, "To reach the top, you must take one step at a time."
I do not wish to merely lament the situation in Japan. Instead, I will continue to work toward the day when I will see abundant fruit from my efforts.
