Barriers of use of community-based care among elderly people with crosscultural backgrounds living in Japan

Abstract

In 2025, all 6.5 million of baby boomers will be 75 or older in Japan. It estimates 20% of Japanese population is oldest-older people and Japan will become a super-aged society. The governments were given responsible to establish 'the Community-based Integrated Care System' which comprehensively ensures the provision of health care, nursing care, prevention, housing, and livelihood support. By this, the elderly could live the rest of their lives in their own ways in environments familiar to them, even if they become heavily in need for long-term care. However, ethnic minority elderly people have difficulty to access the information and care because of low health literacy. This observational study aimed to identify the barriers of use of community-based care service among elderly people with cross-cultural backgrounds. In total, 40 participants from Korean, Vietnamese, and Chinese living in Kobe city were analysed. Mixed methods approach was used to identify the barriers of service use. More than half of the participants answered that they experienced difficulties in using care services because they 'did not know the care system' and there were 'no users from same country or backgrounds in care facilities'. Low proficiency of Japanese language was associated with barriers of service use. A qualitative data showed that 'written information' and 'culture' were typical barriers for service use among Korean, 'translation' for Vietnamese and Chinese. 'Attitudes of medical staff' was also associated with barriers of service use. To include ethnic minority elderly people into community-based care system in Japan, enormous efforts need to be made to provide multi-language care information, a place for gathering together people with same cultural and lingual background, and improve cultural competency among medical staff.