著者
矢澤 澄子 矢沢 澄子 ヤザワ スミコ
出版者
東京女子大学
雑誌
東京女子大学紀要論集 (ISSN:04934350)
巻号頁・発行日
vol.59, no.1, pp.85-116, 2008-09

Japanese society has been facing elder care crisis since the 1980's epitomized by a so-called "nursing hell" which has resulted from a care service shortage for the increasing number of elderly people. The national elder care insurance system commenced in 2000 as a response to the above situation. It was a paradigm change to the social care of elderly people, from a limited adminis-trative service by the government, to a social care insurance system with individual choice and mutual help by contract with the government.This article examines the basic idea of a care model for the elder care insurance system (a care model for 'decent life' for elderly people) and attempts to discover influences from the ideas and practice of group homes for elderly people with dementia developed in local areas since the 1980's prior to the institutionalization of the elder care insurance system. The article also analyses the gap between the idea of a care model for the elder care insurance system and the reality of care workers facing difficulties in workplaces, based on empirical research of care workers in group homes. The research was based on a questionnaire designed by our research group in 2006, and sent by mail to 1382 workers all over Japan.In conclusion, the paper proposes the necessity of re-examining and improving the design and contents of the elder care insurance system, in order to realize its original ideas and purpose as the national social care system, by strengthening public responsibility and financial support at the national as well as local level. It is the only way to maintain a high quality of elder care service in the system and respond to the sincere desires of care workers who work diligently for long hours and receive low salaries.少子高齢化と「介護の危機」(ケアの危機)が進行するなか、日本では2000年を起点としていわゆる社会福祉基礎構造改革により、高齢者介護サービスは、措置制度から介護保険制度(自由契約制度)へとパラダイム転換を行った。本論文は、日本の社会的介護(ソーシャル・ケア)の要を担う介護保険制度の理念、目標像がどのように明確化され制度化されてきたのかについて、特に制度の理念・目標像の構築に大きな影響を与えてきた、認知症高齢者グループホーム実践(認知症対応型共同生活介護)の展開過程との関連に注目して考察する。また制度の運用と改変の過程で顕在化してきた理念・目標像と運用・実践の間の矛盾や、2005年の制度改正以降とくに深刻化している理念・目標像と利用者の選択権や現場ケアワーカーの労働実態との間に広がる乖離の中身についても全国調査に基づき検証する。論文では日本の介護保険制度の形成・改変過程を見据え、制度の理念・目標像、介護保険政策の展開、介護現場の実態の3者を相互に関連づけながら、制度の成熟と「望ましいケア実践」にむけて何が問われているかを明らかにする。いま多くの認知症高齢者グループホームでは、介護保険制度の運用と改正の負の影響を受け、ケアワーカーたちが利用者と制度の狭間で苦悩し、他の介護施設と同様にホーム運営(経営)の瀬戸際で解決すべき複雑な困難に直面している。介護保険の「お年寄りをどんどん切り捨てる」「机の上だけて決められている制度」と「介護実践の場」の現状との間にある大きな乖離は早急に埋める必要がある。そのために国・地方自治体は、現場の声にしっかり耳を傾け、制度の改善・改革にむけてどのように有効な政策的対応をとりうるのかに真剣に立ち向かうことが求められている。
著者
矢澤 澄子 矢沢 澄子 ヤザワ スミコ
出版者
東京女子大学
雑誌
東京女子大学紀要論集 (ISSN:04934350)
巻号頁・発行日
vol.59, no.2, pp.111-143, 2009-03

This paper aims to investigate some of the problems encountered by group homes for the elderly with dementia in Japan. The National Care Insurance Scheme, implemented in 2000, consolidated the financial foundation and determined an overall framework for the national social care service system for the elderly in Japan. Among many care service facilities constructed under the above scheme, the group home has been recognized as the most user-friendly care home for the elderly with dementia and its construction has been widely promoted all over Japan. However, it has now been realized that group homes have their own problems, which should not be overlooked. Firstly, I shall highlight the problem of the poor working conditions of the overburdened care workers, who are mainly women. Secondly, I shall examine the problematic aspect of the ideology of gendered "homely care" provided in group homes and its impact on the care workers' working conditions. Thirdly, I shall propose my view on how to tackle the above problems.The Care Work Study Group, of which I am a member, conducted two surveys; a questionnaire survey by post on care workers working in group homes all over Japan in 2006 and an interview survey with directors and staff of group homes located in Hiroshima, Aomori and Yamaguchi prefectures from 2006 to 2008. The result of both surveys demonstrates the poor working conditions and low payment of the care workers: a workforce made up largely of women. In spite of their poor working conditions, the care workers express a pride in the quality of the service they provide to the elderly based on the ideology of "homely care," which means they aim to make the elderly feel like they were staying in their own home by providing an attentive care service meeting each individual's needs in a homely, cozy environment. This can be seen as the positive aspect of "homely care." However, such an attentive care service often imposes an endless workload on the care workers and pressure on the female workers to behave as if they are fulfilling the traditional gender role of Japanese women in the home. The more the care workers appreciate and accept the ideology, the larger their workload becomes, so that in the end they fall into the pitfall of the negative aspect of gendered "homely care."In order to provide a high quality "homely care service" in its true meaning, it is important for those working in the administration of the service to listen to the real voice of the care workers and make a greater effort to improve the caring environment.本稿の目的は、日本の社会的介護の仕組みの要となる介護保険制度の下で、高齢者介護のケアモデルとしても推奨されてきた認知症高齢者グループホーム(認知症対応型共同生活介護)における女性中心にジェンダー化されたケアワーカーの労働実態と、そこでの「家庭的なケア」の陥穽について検討することである。そのため第1に、筆者らの「ケアワーク研究会」が実施した全国のグループホームで働くケアワーカーへの郵送調査票調査 (2006. 11) や、広島・青森・山口県の複数のグループホームでの施設長、職員への聞き取り調査 (2006, 2007, 2008) に基づき、認知症高齢者グループホームにおけるケアワーカー(介護職)の低賃金・低待遇労働の実態を分析する。第2に、ケアワーカーが、グループホームの理念でもある「家庭的なケア」「生活ケア」つまり「小規模の家庭的な環境・雰囲気の下での一人ひとりを大切にした日常生活ケア」について、どのように考え、感じているかを詳細に分析し、「現場の声」が明らかにしているジェンダー化された「家庭的なケア」の陥穽について考察する。そして第3に、グループホームでの「家庭的なケア」(「生活ケア」)の理念・実践と改正介護保険制度の間に広がる乖離についても検討し、ケアワーカーたちの「声」に真摯に耳を傾けることなしには、グループホーム、また介護保険制度下での「よいケア」「生活ケア」の実現は困難なことを、本稿での実証分析を通して明らかにする。グループホームというケアの場は、家庭的で(アットホームで)、人間らしい触れ合いによる「生活ケア」の実践を目標像として構成され、それがケアワーカーたちの「働き甲斐」を生み出している。しかしグループホームは同時に、彼女/彼らの仕事上でのストレスやジレンマを生み出し続ける「家庭的なケア」装置を内包している。この意味でそこは、他の介護現場にも増してジェンダー化された「両義的なケアの場」である。ケアワーカーが、さまざまな介護現場で「ジェンダー化されたケア」の陥穽に陥ることなく、本来の「生活ケア」を実践できるように、国は大胆な発想の転換を行い、介護労働者・利用者・家族のケアの権利を保障する法制度を整備し、地方自治体の政策主体や事業主体は、ケア環境の大幅な改善に努める必要があろう。
著者
矢澤 澄子
出版者
東京女子大学
雑誌
東京女子大学紀要論集 (ISSN:04934350)
巻号頁・発行日
vol.59, no.1, pp.85-116, 2008-09

Japanese society has been facing elder care crisis since the 1980's epitomized by a so-called "nursing hell" which has resulted from a care service shortage for the increasing number of elderly people. The national elder care insurance system commenced in 2000 as a response to the above situation. It was a paradigm change to the social care of elderly people, from a limited adminis-trative service by the government, to a social care insurance system with individual choice and mutual help by contract with the government.This article examines the basic idea of a care model for the elder care insurance system (a care model for 'decent life' for elderly people) and attempts to discover influences from the ideas and practice of group homes for elderly people with dementia developed in local areas since the 1980's prior to the institutionalization of the elder care insurance system. The article also analyses the gap between the idea of a care model for the elder care insurance system and the reality of care workers facing difficulties in workplaces, based on empirical research of care workers in group homes. The research was based on a questionnaire designed by our research group in 2006, and sent by mail to 1382 workers all over Japan.In conclusion, the paper proposes the necessity of re-examining and improving the design and contents of the elder care insurance system, in order to realize its original ideas and purpose as the national social care system, by strengthening public responsibility and financial support at the national as well as local level. It is the only way to maintain a high quality of elder care service in the system and respond to the sincere desires of care workers who work diligently for long hours and receive low salaries.少子高齢化と「介護の危機」(ケアの危機)が進行するなか、日本では2000年を起点としていわゆる社会福祉基礎構造改革により、高齢者介護サービスは、措置制度から介護保険制度(自由契約制度)へとパラダイム転換を行った。本論文は、日本の社会的介護(ソーシャル・ケア)の要を担う介護保険制度の理念、目標像がどのように明確化され制度化されてきたのかについて、特に制度の理念・目標像の構築に大きな影響を与えてきた、認知症高齢者グループホーム実践(認知症対応型共同生活介護)の展開過程との関連に注目して考察する。また制度の運用と改変の過程で顕在化してきた理念・目標像と運用・実践の間の矛盾や、2005年の制度改正以降とくに深刻化している理念・目標像と利用者の選択権や現場ケアワーカーの労働実態との間に広がる乖離の中身についても全国調査に基づき検証する。論文では日本の介護保険制度の形成・改変過程を見据え、制度の理念・目標像、介護保険政策の展開、介護現場の実態の3者を相互に関連づけながら、制度の成熟と「望ましいケア実践」にむけて何が問われているかを明らかにする。いま多くの認知症高齢者グループホームでは、介護保険制度の運用と改正の負の影響を受け、ケアワーカーたちが利用者と制度の狭間で苦悩し、他の介護施設と同様にホーム運営(経営)の瀬戸際で解決すべき複雑な困難に直面している。介護保険の「お年寄りをどんどん切り捨てる」「机の上だけて決められている制度」と「介護実践の場」の現状との間にある大きな乖離は早急に埋める必要がある。そのために国・地方自治体は、現場の声にしっかり耳を傾け、制度の改善・改革にむけてどのように有効な政策的対応をとりうるのかに真剣に立ち向かうことが求められている。
著者
矢澤 澄子
出版者
東京女子大学
雑誌
東京女子大学紀要論集 (ISSN:04934350)
巻号頁・発行日
vol.59, no.2, pp.111-143, 2009-03

This paper aims to investigate some of the problems encountered by group homes for the elderly with dementia in Japan. The National Care Insurance Scheme, implemented in 2000, consolidated the financial foundation and determined an overall framework for the national social care service system for the elderly in Japan. Among many care service facilities constructed under the above scheme, the group home has been recognized as the most user-friendly care home for the elderly with dementia and its construction has been widely promoted all over Japan. However, it has now been realized that group homes have their own problems, which should not be overlooked. Firstly, I shall highlight the problem of the poor working conditions of the overburdened care workers, who are mainly women. Secondly, I shall examine the problematic aspect of the ideology of gendered "homely care" provided in group homes and its impact on the care workers' working conditions. Thirdly, I shall propose my view on how to tackle the above problems.The Care Work Study Group, of which I am a member, conducted two surveys; a questionnaire survey by post on care workers working in group homes all over Japan in 2006 and an interview survey with directors and staff of group homes located in Hiroshima, Aomori and Yamaguchi prefectures from 2006 to 2008. The result of both surveys demonstrates the poor working conditions and low payment of the care workers: a workforce made up largely of women. In spite of their poor working conditions, the care workers express a pride in the quality of the service they provide to the elderly based on the ideology of "homely care," which means they aim to make the elderly feel like they were staying in their own home by providing an attentive care service meeting each individual's needs in a homely, cozy environment. This can be seen as the positive aspect of "homely care." However, such an attentive care service often imposes an endless workload on the care workers and pressure on the female workers to behave as if they are fulfilling the traditional gender role of Japanese women in the home. The more the care workers appreciate and accept the ideology, the larger their workload becomes, so that in the end they fall into the pitfall of the negative aspect of gendered "homely care."In order to provide a high quality "homely care service" in its true meaning, it is important for those working in the administration of the service to listen to the real voice of the care workers and make a greater effort to improve the caring environment.本稿の目的は、日本の社会的介護の仕組みの要となる介護保険制度の下で、高齢者介護のケアモデルとしても推奨されてきた認知症高齢者グループホーム(認知症対応型共同生活介護)における女性中心にジェンダー化されたケアワーカーの労働実態と、そこでの「家庭的なケア」の陥穽について検討することである。そのため第1に、筆者らの「ケアワーク研究会」が実施した全国のグループホームで働くケアワーカーへの郵送調査票調査 (2006. 11) や、広島・青森・山口県の複数のグループホームでの施設長、職員への聞き取り調査 (2006, 2007, 2008) に基づき、認知症高齢者グループホームにおけるケアワーカー(介護職)の低賃金・低待遇労働の実態を分析する。第2に、ケアワーカーが、グループホームの理念でもある「家庭的なケア」「生活ケア」つまり「小規模の家庭的な環境・雰囲気の下での一人ひとりを大切にした日常生活ケア」について、どのように考え、感じているかを詳細に分析し、「現場の声」が明らかにしているジェンダー化された「家庭的なケア」の陥穽について考察する。そして第3に、グループホームでの「家庭的なケア」(「生活ケア」)の理念・実践と改正介護保険制度の間に広がる乖離についても検討し、ケアワーカーたちの「声」に真摯に耳を傾けることなしには、グループホーム、また介護保険制度下での「よいケア」「生活ケア」の実現は困難なことを、本稿での実証分析を通して明らかにする。グループホームというケアの場は、家庭的で(アットホームで)、人間らしい触れ合いによる「生活ケア」の実践を目標像として構成され、それがケアワーカーたちの「働き甲斐」を生み出している。しかしグループホームは同時に、彼女/彼らの仕事上でのストレスやジレンマを生み出し続ける「家庭的なケア」装置を内包している。この意味でそこは、他の介護現場にも増してジェンダー化された「両義的なケアの場」である。ケアワーカーが、さまざまな介護現場で「ジェンダー化されたケア」の陥穽に陥ることなく、本来の「生活ケア」を実践できるように、国は大胆な発想の転換を行い、介護労働者・利用者・家族のケアの権利を保障する法制度を整備し、地方自治体の政策主体や事業主体は、ケア環境の大幅な改善に努める必要があろう。
著者
矢澤 澄子 国広 陽子
出版者
東京女子大学
雑誌
東京女子大学紀要論集 (ISSN:04934350)
巻号頁・発行日
vol.47, no.1, pp.97-121, 1996-09-20

This study is based on research, conducted in July, 1995, on men and women involved in community activities. The target of the research was 62 members of a Midori-ku, Yokohama, branch of a political organization, the "Kanagawa Network Movement," and their husbands. The research was conducted as a follow-up of a previous study, done in 1991, on the activities and perceptions of people who were active in the Kanagawa Network Movement. The major purposes of the research were: 1) to analyze anew, from the perspective of gender, what these people have achieved, as of the mid-1990s, through their Dairinin Movement (political action through representation), a movement that was intended to further their "independence as the citizens who live gendered community life," and 2) to assess how much politically Dairinin Movement could change the lives of these of its members who depend their movements on their husbands, in urban employment divided by gender, which is one of their movement's targets for political change. This study further discusses the shifting grounds of gender roles and the political commitment of suburban wires who are mostly married to salaried employees and who often find themselves isolated by gender, with an analysis of their perceptions (attitude toward their own community, awareness as independent citizens, etc.) in comparison with those of their husbands.