The harm caused by abuse cases in which caregivers at nursing care centers and other facilities suffer abusive language, physical violence and sexual harassment by care-receivers and their families is becoming more serious.
To cope with the acute rise in nursing care needs in a super-aging society, it is imperative to create an environment in which caregivers are able to work with peace of mind. Countermeasures must be formulated urgently.
According to a survey by the Nippon Careservice Craft Union, a labor union of workers involved in nursing care, three-quarters of its members have suffered some sort of abuse.
Of those members, 70 percent have suffered abuse of power through such acts as "shouting offensively" and "poking strongly." Thirty percent complained about sexual harassment through such acts as "unnecessary physical contact" and "repeating sexual jokes."
Measures against the abuse of care-receivers have made progress given the heightening of social interest in the matter. But the opposite pattern of abuse has been overlooked, with no effective preventive measures yet worked out.
Nursing care centers and other facilities are highly closed environments, providing many chances for caregivers to be alone with a care-receiver or one of their family members. Close contact with care-receivers for assistance in such acts as taking baths and changing clothes happen every day. Caregivers also have to listen empathetically to users' requests. It can be said that nursing-care centers and other facilities have an environment in which abuse tends to occur.
The abuse of power and sexual harassment by care-receivers threatens to undermine the safety and ease of the nursing-care profession. It is pointed out that such abuse is a major factor behind caregivers' mental and physical disorders, their suspension and separation from employment.
Amid the ongoing manpower shortage at nursing-care centers and other facilities, this is a problem that cannot be overlooked.
Central, local govt efforts key
In anticipation of an increase in the need for nursing care, the government is pushing a transfer of nursing care from facilities to individual homes. Home-visit care services, which will serve that purpose, are generally provided singlehandedly at the home of a care-receiver, with most of the care providers being women. Unless the employment environment is improved, it is doubtful that nursing care at home will expand.
There are some operators that cope with the issue by doing such things as having multiple caregivers provide home-visit care service. But they face many difficult cases due to a labor shortage and the care-receivers' refusal to accept more than one caregiver at a time.
The Health, Labor and Welfare Ministry will launch a fact-finding survey to assess problems associated with home-visit care service. Based on survey results, the ministry plans to produce a manual for use by home-visit care operators. The ministry is called on to use the survey results to work out practical measures.
The Hyogo prefectural government has established a consultation service on the harm caused by the abuse of home-visit caregivers, among others. The prefecture also provides subsidies to help pay for the dispatch of multiple caregivers to households with the risk of abuse.
Strong voices among those engaged in nursing care call for compiling guidelines on the cancellation of contracts and other matters.
There are cases in which abuse is attributed to dementia and other disorders. In response to such abuse, there also is a deep-seated trend among caregivers to consider that it is "natural for them to endure" and they "have to engage in tactful evasion as a professional." Along with bolstering seminars on nursing skills that would not provoke abuse, it is also imperative to reform awareness among the people engaged in nursing care.
Also of note are acts that are committed due to a lack of understanding of the nursing-care insurance system, including demanding care service not mentioned in contracts. The central and local governments need to make greater efforts to educate the people about the care insurance system.
(From The Yomiuri Shimbun, Aug. 18, 2018)
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