Navigating the Strain of Family and Business Obligations in Middle Age
His 78-year-old mother is diagnosed with cancer. Seeing her physical and mental decline, she suggests that her mother use long-term care insurance services.
The number of business caregivers who provide care for their parents while working is increasing. One might think, “My parents are still healthy, so it’s okay,” but suddenly one day, they may be forced to choose between work and caregiving.
To achieve caregiving while maintaining employment, what should business caregivers do?
We’ll explore the experience of Aina Nishizaki (pseudonym, 49 years old), who decided to leave her job due to the inability to balance both, as one case study. We’ll discuss this over two parts, consulting with Jun Kawauchi, representative of the non-profit organization “Tonarino Kaigo,” which provides corporate caregiving support.
My mother’s dissatisfaction with the caregiving services explodes because the essential things aren’t being done.
“I’ve been a homemaker for decades. Even now, I’m better at cooking than you, and I’ve always had a housekeeper for cleaning. Is there anything you all can actually do for me?”
During the “care plan meeting,” where they discussed the caregiving plan after receiving a certification of needing care level 1, Aina Nishizaki’s (pseudonym, 49 years old) mother (then 79 years old) blurted out these words to the care manager, helper, and visiting nurse.
Having lived alone for a long time, her mother took pride in her cooking skills, considering herself professional-grade, and even approaching 80, she never cut corners. She diligently did daily stretches, maintained her social life with friends, and was proactive about end-of-life planning, hiring a housekeeper for cleaning once she realized her physical strength was declining and even visiting nearby senior living facilities for future planning. Seeing her mother this way, both Aina, who lived nearby, and her sister, who lived far away, felt reassured that they wouldn’t have trouble caring for their mother in the future.
However, at 78, cancer was discovered. Seeing her mother’s physical and mental decline, Aina suggested using caregiving insurance services for the future. Her mother, feeling positive about utilizing the service since they had paid caregiving insurance premiums for so long, agreed. However, after receiving certification for requiring support level 1 and having a weekly 30-minute housekeeping assistance, her dissatisfaction exploded.
“If that’s the level of cleaning, the housekeeper is more than enough. The time is short, and we can’t even have a decent conversation. Plus, having a different helper every week doesn’t allow for building trust. It’s just exhausting to have people coming in and out.”
Seeing her mother still capable of doing household chores alone, Aina decided to postpone using the service for now.
Later, as her illness progressed, they arranged for twice-weekly visiting nurse visits. Despite her daughter’s concerns, at the care plan meeting, her mother’s initial remark was what brought Aina to a wry smile.
“In response to my mother’s words, the care manager asked, ‘What are the real issues you’re facing? If you tell us, we can assist.’ My mother replied, ‘What I really need right now is to have the buttons replaced on my pants that I’ve suddenly become too thin to wear. Can you handle that?’
Everyone fell silent, and I, who was listening to the meeting’s progress from the next room, froze in disbelief (laughs). After a while, the helper started to say, ‘We can’t guarantee the quality, but if it’s just sewing on buttons.’ But my mother cut her off, saying, ‘I only mentioned what I’m struggling with. Is there any point to a service that can’t even handle what’s truly necessary?
My mother is someone who speaks her mind clearly, regardless of who she’s speaking to. She once upset a doctor before, so I became afraid that she might cause trouble for everyone from now on.”
Regret for not being there for her mother’s pain and not treating her kindly
What my mother sought from the caregiving service was thorough assistance with household chores in place of what she could no longer do due to illness. Additionally, she insisted, “Since helpers come in and out of the homes of elderly people living alone, there should be a fixed helper to build trust.”
“She was always critical of what the government did (laughs), so she quickly realized when things didn’t go her way and said, ‘If that’s the case, I’ll just hire a housekeeper at my own expense.’ In fact, she negotiated to increase the visits from a housekeeper who had experience as a helper, and she even asked friends and relatives to help out and offered to pay them.
Initially, she tried to relieve the burden on me, who was still recovering from illness, by repeatedly asking my eldest sister to come home, but she couldn’t find a suitable replacement as she hoped. She concluded that I was the only one who could provide the care she needed.”
Aina Nishizaki initially wanted to use caregiving insurance services while keeping her job, but after this meeting, she informed the care manager that she would give up on using the services and decided to resign.
For the next year until her mother’s passing, she continued to commute between her home and her parents’ house, doing shopping, laundry, assisting with cooking and cleaning, and accompanying her mother to medical appointments several times a month. Her mother managed toileting and dressing by herself, but she began to ask Aina for assistance with bathing when she felt anxious about bathing alone.
“I explained that she should ask the nurse for assistance because she’s afraid of falling, but she said, ‘Just lend me a little support, why can’t my daughter do it?’ (laughs).
Since she always bathed before bedtime, if she asked the nurse for assistance, she could only bathe during the visit time. I think she felt frustrated that she couldn’t maintain her lifestyle and couldn’t move as freely as she wanted. Gradually, her dissatisfaction with me increased. I also became truly exhausted. I regret that I couldn’t sympathize with my mother’s suffering, that I couldn’t approach her with kindness, but instead, I rebelled against her idealistic arguments about medical and caregiving practices and felt resentful about why I was the only one sacrificing.”
Safety and security are more important to children than parental pride. Hence the great discrepancy that arises.
According to Jun Kawauchi, representative director of the NPO “Tonarino Kaigo” (Care Next Door), there are many care recipients like Nishizaki’s mother who refuse helpers and day services.
“When someone who has been independent for a long time suddenly has others deeply involved in their lives, it’s natural for care recipients to feel anxious. They’re expressing a need for understanding of these anxieties, rather than outright refusal of helpers. And even if they refuse, they may not fully understand their own feelings.
If they say they’re still good at cooking compared to helpers, then their pride should be respected. However, family members tend to prioritize the safety and security of care recipients, creating a significant gap in perspectives.”
As Nishizaki’s mother’s illness progressed, she worried about potential accidents such as burns while cooking, despite her culinary skills. However, her daughter’s concerns might have seemed unnecessary to a mother who took pride in her cooking abilities.
“Such differences in values with parents are often unavoidable but difficult to navigate. Therefore, ‘creating distance from parents’ becomes a strategy. In Nishizaki’s case, it might have been better to leave the meeting to avoid hearing the discussions and leave it to the professionals. This might have prevented her from giving up on using caregiving services.
Also, Nishizaki was concerned about her mother’s statements that troubled the caregiving professionals during the care plan meeting, but the statements themselves weren’t necessarily negative, and the helpers didn’t seem troubled. Well, they might have been a little troubled (laughs), but there are cases where caregivers suddenly take out a knife and say, ‘I’ll stab you, get out.’ In fact, this case was likely a very important statement for the professional development of caregivers.”
The impact of a parent’s words on a child can indeed be significant, and they may be easily influenced. However, to balance work and caregiving, it’s crucial for children not to shut down their thinking in response to their parents’ words but to make autonomous judgments, as Kawauchi emphasizes.
Furthermore, Kawauchi strengthens his stance,
“Many Japanese people equate caregiving with being by their parents’ side and being filial. However, I believe resetting this mindset is the biggest challenge in the business caregiver issue.”
While it’s natural for many to want to support their aging parents, Kawauchi questions whether this mindset is necessarily correct.
In the second part of this article , we will discuss why it is a mistake to think that “caregiving = filial piety” and delve a little deeper into how caregiving can be balanced with work.
Jun Kawauchi, Representative Director of the NPO “Tonarino Kaigo” (Care Next Door). Born in 1980. Graduated from the Department of Social Welfare, Faculty of Letters, Sophia University. After working in a nursing home referral business, a foreign consulting company, and as a caregiver in both home care and facility settings, he founded the citizen group “Tonarino Kaigo” in 2008, which became an NPO in 2014.
Interview and text by： Keiko Tsuji
