Social Workers from Osaka Talk about Social Welfare in Japan
Delegates from Osaka City pose for a commemorative photo after the 2024 Social Services Conference hosted by Chicago Sister Cities International
A group of five social workers from Osaka City, which has a sister-city affiliation with the City of Chicago, visited Chicago to see social welfare facilities in the city. On the last day of the visit, June 22, the 2024 Social Services Conference hosted by Chicago Sister Cities International was held at the Epiphany Arts Center on Chicago's North Side, where social workers from nine sister cities, including Osaka, gave presentations on their social welfare situations, activities, and exchanged opinions.
The agenda of the conference was “Innovations in Social Services: Fostering Global Connections through New Ideas and Strategies,” and the topics were as follows:
Participants of the 2024 Social Services Conference from Chicago's nine sister cities, Birmingham (UK), Casablanca (Morocco), Durban (South Africa), Galway (Ireland), Hamburg (Germany), Kyiv (Ukraine), Osaka (Japan), Paris (France), and Shanghai (China)
- Issues Faced by Older Adults: Addressing challenges and fostering healthy aging
- Revitalizing Workforce: Accelerating opportunities for professionals to enter and thrive in social services career
- Inclusive Communities: Combating systemic inequalities and embracing diverse identities
- Trauma-informed Care: Empowering survivors of war, natural disasters, gender-based violence, refugees and immigrants
- Expanding Mental Health Support: Utilizing creative approaches and community support
After the Conference, the Chicago Shimpo interviewed three social workers from Osaka; Tomohide Kitano, Facility Director from Special Nursing Home for the Elderly “Kounotori”; Daigo Kobayashi, Director General of the Kamagasaki Shien Kiko (The organization to support the homeless in Kamagasaki); and Toshio Furumoto, Leader of the Osaka Jikyokan Efforl (Facilities for Persons with Disability).
Interviews with Social Workers from Osaka
Yushinkai Social Welfare Corporation
Special nursing home for the elderly Kounotori
Facility Director Tomohide Kitano
Yushinkai, Special nursing home for the elderly Kounotori
Facility Director
Tomohide Kitano
Director Tomohide Kitano has many qualifications in the social welfare field such as a certified care worker, social welfare counselor, care manager, and dementia care counselor certified by Osaka City. The Yushinkai, located in Hirano-ku, Osaka City, also operates day service center, care plan center, and holds exchange events between the nursing home residents and the people in the local community.
Q: Who are the residents in the special nursing home for the elderly Kounotori? (Kounotori is a stork in English. The bird represents fertility, springtime, and good luck.)
Kitano: Currently, 70 to 80% of the residents have dementia.
Q: I had an acquaintance who suddenly forgot his past, was put in a nursing home with locked doors, and said, “I want to go home, I want to go home.” I was very sorry to hear that.
Kitano: As I mentioned earlier in the panel, most facilities in Japan lock elevators and entrances.
When I started Yushinkai, I tried to create an open environment with unlocked elevators and entrances. The building has six floors, and residents are free to use the elevators to get around. To date, no injuries or accidents have occurred as a result of this.
Five years after it opened, a male resident sitting alone in the elevator on a hot summer day. A staff member, concerned about his heat stroke and dehydration, let him get out of the elevator and locked the elevator for the first time. At that time, there was a resident who kept pushing the button in front of the elevator and waiting. Another resident pressed the emergency bell and went out through the automatically opening door and down the stairs.
The staff member, who witnessed the situation, changed his mind and decided that they should not lock the doors after all.
Our residents can move freely throughout the building and are unlikely to want to go home. It means that the residents do not feel safe in an environment where the staff members are watching them. The more you stop their free movements, the more they will ask, “Why not?” If they feel that the staff is “on my side,” they can live in peace.
Q: If the front door is open, resident go out?
Kitano: Yes, it happens. Our job at such times is to stop our work, walk with them, and listen to their feelings. Then they would say, “It's hot. Let's go back.”
If you take away his or her driver's license while they are not convinced, or if you restrict where they are going by saying, “Dangerous”, it will be even more confusing to them. It is important to talk patiently with them until they are convinced, and once they are convinced, they are not to go out alone at all.
Q: Have you visited similar nursing homes in Chicago?
Kitano: Even in Chicago, all elevators and doors are locked. I think the priority is to avoid the risk of physical injury, and the risk of damaging the person's ability to spend a mentally rich life is being put on the back burner.
By creating a totally liberating environment, residents can move around freely, which improves their physical abilities. They are less likely to fall, and they feel safer because they are not confined, so they don't try to go outside. The big challenge is how to expand this idea.
I believe that it is important for the residents to be able to see their families and friends freely. Most nursing homes in Japan are restricting visitation due to the COVID-19 pandemic, but Yushinkai allows residents to meet visitors freely. This makes both the residents and their families feel at ease. Family members are inclined to complain because they cannot see what is going on inside. By meeting with them and letting them see how we are caring for and supporting the residents, the family members' concerns will be alleviated.
Q: I think it is really important to understand people with dementia, is there a movement to educate people about dementia?
Kitano: That's right. That's why we use part of the Yushinkai to hold a monthly community gathering called “Kounotori no Tamago,” or “Kounotori's egg,” which involves local people from children to adults.
There are people, who are isolated in the community, people who have trouble eating on any given day, people who stay at home, and people in elderly households who have little connection with neighbors. That is why I think it is important to have a cozy place in the community.
On those event days, parents bring their babies and small children, and many elderly people also come. We have created a place where children can play freely and interact with multiple generations, creating a safe, cozy place where people who want to connect but do not know how to do that with neighbors.
I believe that caregivers and professionals should not be the only ones supporting people with dementia, but everyone in the community, from children to adults, should be involved in supporting each other and helping each other.
I believe that if we work together to create such a system, the number of people in need will decrease. To enrich the lives of these people, it is important to help together to support people with disability in the community. This is what I strongly felt when I came to the United States. I think it is very important to expand the circle of people who are willing to help others because they have helped others, rather than asking for something in return.
Don't label them as dementia. Don’t think people with dementia do not understand anything. Help them to do what they can do by themselves; otherwise, they will become more and more incapable of doing so. I believe that enriching the lives of people with dementia depends on how much we develop their abilities.
Q: Why did you choose to work in social work?
Kitano: I majored in liberal arts in college, so most of my employment opportunities were in the sales field. Although it is my own image, I had to kick people down to get ahead, and I thought it would not suit me, so I applied for a volunteer position at a hospital or nursing home welfare office that was looking for volunteers.
I volunteered during summer and winter breaks to assist with defecation and bathing, and I thought this might be a job I was suited for. After graduating from college, I went to a vocational school, became a certified care worker, and worked at a nursing home.
I am now 42 years old and have been working hard to realize my ideals which are the major driving force in my work. I have been looking for a way to create an environment where people can deepen their understanding of dementia and the elderly, and where everyone and people with dementia can help each other. I believe that if there is love and consideration for each other, my ideals will be conveyed to everyone. I have a strong desire not to give up. People with dementia all care about each other and have built social relationships with each other. I would be happy if such understanding expands among the people in the public.
Q: Thank you very much.
Yushinkai’s website is https://yuushinkai.or.jp/. (Japanese language only)
Corporate Non-Profit Organization
Kamagasaki Shien Kiko
Director General Daigo Kobayashi
Kamagasaki Shien Kiko
Director General
Daigo Kobayashi
Q: Kamagasaki is known for its day laborers. My late husband also worked as a day laborer in Kamagasaki during his summer breaks when he was a college student, and he often boasted that he had dug all the trenches around the Toyonaka Ball. What kind of support do you provide, Mr. Kobayashi?
Kobayashi: Kamagasaki Shien Kiko (Support Organization) is located in Haginochaya, Nishinari-ward, Osaka City, and provides support for the homeless in the area generally known as Kamagasaki.
For example, homeless, we run shelters for people without homes, introduce jobs, create jobs for homeless people, and provide support for those who were able to get a home in their subsequent lives.
In Japan, the government provides support for housing and living expenses, but people with alcoholism or gambling addictions tend to spend that money quickly. Therefore, we also work to find and provide alternatives to alcohol and gambling that are interesting and enjoyable. In that way, the addicts don't spend all their money on alcohol and gambling, and they can take better care of their lives.
Q: Such as making crafts?
Kobayashi: Yes, we support them by providing such opportunities.
Q: How do they find a job?
Kobayashi: Employers start to recruit day laborers at 5 a.m. in Kamagasaki, and many people come to get a job. Almost all the jobs are physical labor.
Q: What happens to those who can't find work?
Kobayashi: People, who are living just barely by the day, no longer have a place to sleep or food to eat.
Until around 2000, they were living on the streets, but then shelters were built, and they can sleep there. We have a soup kitchen in the shelter almost every day, so they have something to eat.
Q: Does somebody appear to be like a boss in the shelter?
Kobayashi: The shelter is run by our organization, and we are thoroughly careful to make sure that such trouble does not happen. We have about 120 people using the shelter every day, but those relationship problems are decreasing and different problems are occurring.
In Japan’s aging society, shelter dwellers are also getting older, and problems related to dementia are occurring. For example, some people forget where they are supposed to go to the bathroom and end up doing it on the floor, or they forget where they are supposed to sleep or their belongings in the shelter, and these problems have increased considerably.
Q: Are individual beds assigned to each person in the shelter?
Kobayashi: Before the COVID-19 pandemic began, anyone could enter and we would give them a piece of paper to indicate which beds they use, but after the pandemic, the entering risk of strangers became higher, so we changed to a registration system.
For those who want to sleep in the shelter, they have to submit individual names, even names are fake, and then they are issued a card with their name on it, when they hold that card up at the entrance, it shows them where they will be sleeping.
Q: Is there any age limit? Can a 90-year-old man stay in the shelter?
Kobayashi: You can enter even if you are 90 years old. However, Nishinari-ward has the shortest average life expectancy in Japan. People, who are homeless or worked as day laborers in construction, tend to die early because they inhale a lot of bad things, live in poor health, and have poor nutrition. In Kamagasaki, people die more than 10 years earlier than the average age in Japan. That is why there are no 90-year-olds.
Most of them are doing physical labor, so many of them cannot do hard physical labor anymore. Thus, we are making efforts to create jobs to reduce burdens on their bodies.
One such job is removing fluff from used clothing offered by secondhand clothing businesses. It is very difficult to find such jobs due to the industrial technologies.
Q: How many people are you helping?
Kobayashi: I can't tell you the exact numbers, but we probably support between 1,500 and 2,000 people a year at the Kamagasaki Shien Kiko.
Q: What percentage of the homeless population do you cover?
Kobayashi: Here is a pretty accurate figure. Currently, there are 2,800 homeless people in Japan, and we support about 300 of them.
Q: Where do you get funds?
Kobayashi: We receive funds from Nishinari-ward, Osaka City, Osaka Prefectural government, and the government of Japan.
Q: Why did you choose this job?
Kobayashi: I felt discrimination due to poverty when I was a child, and when I was 10 years old, my mother became depressed and continued to be a social recluse for a long time. She is still a hermit today. There were also people around me, who had a hard time expressing themselves and who could not connect well with the people in the community.
I love children and happened to have an opportunity to volunteer at an organization that provides child-care support for children in Kamagasaki. I felt that Nishinari was a very fun town, and from there I got more and more involved, and here I am today.
Q: I'm glad to hear that you had good experiences when you were young, although you had a hard time.
Kobayashi: I think so. Without hardship, there would be no growth. That experience created empathy with various people, which led to a deeper connection, and I finally came to understand it at the age of 37.
Q: Thank you very much.
The Kamagasaki Shien Kiko’s website is https://www.npokama.org/index_e.htm.
Social Welfare-Corporation
Osaka Jikyokan
Group Leader Toshio Furumoto
Q: What kind of work do you do at the Osaka Jikyokan?
Osaka JikyokanGroup
Leader Toshio Furumoto
Furumoto: I work in a wide variety of jobs, from direct support for people with disabilities to care planning, clerical work, and everything in the facility.
Jikyokan is a support facility for persons with disabilities. Originally, it was a nursing care home for the physically handicapped, but in 2013 the Japanese government's Services and Supports for Persons with Disabilities Act came into effect and the name was changed to a support facility for persons with disabilities. There are three pillars of disability: physical, intellectual, and mental, so Jikyokan accepts not only people with physical disabilities, but also people with intellectual and mental disabilities, and they can live in the facility.
The Services and Supports for Persons with Disabilities System is divided into daytime support and nighttime support, and those who stay in the facility fall under nighttime institutional support.
On the other hand, there are various types of daytime support, and Jikyokan offers a program called Lifestyle Care. Those who want to take day service, which offers job training to help people lead independent lives, can join another daytime service.
Because services are different for daytime and nighttime support, it is necessary to create both daytime and nighttime care plans, which can be difficult administratively.
Daytime and nighttime supports are different, so we need to make multiple plans for both time supports. This task is pretty hard for us.
Q: How many people are living in the facility?
Furumoto: Our facility has 50 residents and 10 short-stay residents.
We also have short-stay programs. People come for two days and one night stay or special long stay for seven nights and eight days. Their families use the program according to their needs.
Q: Do they come for a short stay when their families go to travel?
Furumoto: I think that is also true. But basically, people with disabilities live at home, and they have helpers. It is very difficult to make daily lives. The number of hours for helpers is fixed in a month, and if they have helpers every day from Monday to Friday, in the morning and at night, they would not have enough helpers’ hours. To compensate for this, they use short-stay services.
They also use the short-stay program without helpers, some use it on weekends to reduce the burden on their families, and it is used for a truly diverse range of purposes.
Q: Did you visit similar facilities in Chicago?
Furumoto: There was no facility involved in short stays, but I went to the Anixter Center in Chicago, which provides support similar to daycare services for daily living.
I heard that the users of the Anixter Center come to the facility by themselves, but Jikyokan basically provides transportation. Sometimes family members provide transportation, but no one can come by themselves.
There are many different programs for daytime support, and some people spend their daytime taking a bath, some have lecture-like days or leisure-like activities, and some come early to have lunch and go home.
Q: Why did you choose to work in social welfare?
Furumoto: It's a long story, but after graduating from college I had a sales job. It was a job that required me to travel quite a bit, including going to a semiconductor plant in a rural area and not returning home for three months.
I got married when I was 25 and had a child when I was 29. At that time, my wife told me that we couldn't make it as a family with a job that required so much travel, so I switched to a welfare job at 29. I am now 49 years old.
I have never learned so much as I have this time in Chicago. If I could take it back to Japan and put it into practice, I think it would be difficult. But I am very happy that I was able to learn about the welfare services in Chicago.
In the U.S., each state is different, and as far as disability alone is concerned, I heard a few cases of people with disabilities leaving for other states because they are not 100% supported in Illinois.
In Japan, the same support is available no matter where you live because the system is set in place in Japan. A well-defined system means that there are many things we have to do because what the supporters have to do is firmly defined.
On the other hand, during a session with companies at today's conference, I learned that facilities for the handicapped in the States receive donations from companies and the private sector. There is a lot of such financial support in the U.S., but I don’t see it very often in Japan.
Q: Thank you very much.
The Osaka Jikyokan’s website is http://www.ojk.or.jp/. (Japanese language only)