Independence, Security, and the intergenerational social contract: home-helper services and elder care in rural Japan

For several years, demographic trends and changing ideas about responsibilities for elder care in Japan have contributed to the desire, or need, for families to seek out new care approaches. This article focuses on one alternative to traditional approaches to caring for elder family members--the home-helper program that is available through the Japanese long-term care insurance program. Using ethnographic data collected in northern Japan, it will be argued that the home-helper program forms a compensatory elder care system that is intended to augment family-provided care and social support, rather than to promote independent living. This compensatory approach to elder care is based upon an intergenerational social contract in which it is assumed that some degree of dependence on family members is both an expected and preferred outcome of growing old.