Benjamin E. Mizukawa and Dr. Leslie Williams, Asian and Near Eastern Languages
My original proposal suggested alternative medical institutions appearing in response to Japan’s swelling elderly population provide a desirable option to both the elderly and their families in a society where multi-generation households are common yet strained. Rather than being a repository for useless old people, like the “Obasute” mountain in the Japanese folk tale, such institutions provide the elderly with meaningful socialization and activity while easing tension between them and the family that tends them at home. Accomplishing this simultaneously with regular supervision of health and chronic pain demonstrates an intact value towards respecting and caring for the elderly. Accordingly, I pursued a course of inquiry into how those involved interpret their experiences at such an institution.
The Asagiri Mutsumi Center began in May of 1990. As recent years have met an elderly population that comprises 20% of Japan’s society, various kinds of institutions have been created to meet the concerns that arise. The Asagiri Mutsumi Center, annexed to the Asagiri Hospital in Akashi City, Japan, was born out of concern over the inundation of hospitals with elderly patients eager to find personal attention and immediate relief from the pains natural to growing old. Their primary focus rests on assisting elderly patients from the time their medical status is stabilized and cleared for release from the hospital until they can regain the confidence and self-reliance necessary to live at home. Two floors house temporary residents from the time they leave the hospital until they can return home a few months later. The first floor consists of a day care service center that maintains regular contact with patrons to monitor health, provide helpful services such as rehabilitation and recreation, and foster social interaction among other elderly persons. As one of the earliest institutions of its kind in the region, the Asagiri Mutsumi Center often hosts students, interns, and visitors studying its operation. For five weeks between late June and the end of July, the Asagiri Mutsumi Center also hosted me.
My volunteer work as a full-time church missionary two years earlier first introduced me to the Asagiri Mutsumi Center. I arranged this return visit with the help of Mrs. Nagakura, the head occupational therapist at the center, who remembered me from my previous experience. I performed my study while working as a full-time volunteer 3-4 days during each week. The first 6 visits were primarily devoted to observation and informal interviews with both patrons and staff. The remainder of my study continued participant observation while incorporating formal interviews with two key informants selected from among the elderly and three staff members. Additionally, I collected surveys completed by 80 of the patrons. Due to limited contact with families of the elderly patrons, (most patrons use the center’s bus, rather than transportation from home), I was unable to interview or survey family members as well.
Preliminary analysis of the survey findings offers a sketch of the demographics at the Asagiri Mutsumi Center. Of the 80 people surveyed, 15 were male (18.8%), and 65 were female (81.2%). The average age of the elderly at the center was 82.1 years, ranging from 67 to 95 years. Only 17 of those surveyed lived alone. There were 14 living with their spouse, while the majority, 49, lived with one of their children.
I am currently involved in transcribing the interviews and translating the transcription into English. As a result, the more pertinent results of this study are pending. Review of the field notes and journal entries written during my observations and informal interviews provoke a number of questions that may be pursued in further study. Perhaps the most intriguing aspect of the Asagiri Mutsumi Center experience is the bold discrepancy between male and female patrons. Beyond the physical fact of a vast female majority that uses the center, the men and women at the center expressed different behavior and conversation. Most men at the center spoke hardly a word. Most women chattered incessantly. Most men expressed their reason for coming as an issue of health. Most women expressed their reason as an issue of social enjoyment.
This difference between how men and women interpret their experience at the Asagiri Mutsumi Center seems to correspond to views of the center itself. One key informant related how several men in her neighborhood refer to the center as a kind of obasuteyama, the mountain in Japanese folk tradition where a son would leave his aged mother to die since society deemed them useless. These men were critical of the chatting and games they deemed trifling rather than meaningful. That same informant however dissented from this opinion saying that you need a place to have fun. Furthermore, when I asked the typical subject of conversation, she explained that the women often chat and criticize the way their daughter-in-law runs the household.
Thorough discussion of the interview transcripts and my written notes, as well as further analysis of the survey data collected, will provide a more complete understanding of the social attitudes towards new health institutions like the Asagiri Mutsumi Center. This early report of findings suggests the paradox that they might be an obasuteyama and a solution to the stress and concerns of aging at the same time.