With the rapid aging of Japanese society and increasing concerns over the welfare of people with psychiatric disorders, intellectual disability, and dementia, a renewed adult guardianship system based on the notion of respect for self-determination, the practical use of one’s remaining abilities, and re-socialization, has now been in place for 20 years. Japanese adult guardianship practices are understudied in English language literature; thus, this article presents an overview of recent developments in Japan’s adult guardianship system and geriatric social work initiatives adopted in Japan’s adult guardianship practice. The authors found that the guardianship system not only helped the elderly live better with dementia but also contributed to the realization of “ageing in place” in the community-based integrated care system.

Abstract

Background

This study investigated the effects of authoritarian filial piety (AFP) and caregiver self-efficacy on the caregiving experience of adult children of physically impaired older adults. Socio-cultural stress and coping model was applied to test the influence of AFP on caregiver gains.

Methods

A total of 601 Chinese adult children caregivers and care-recipient dyads participated in this cross-sectional study in 2021. Four instruments were used to collect data: the 4-item Zarit Burden Interview, Positive Aspects of Caregiving Scale, Caregiver Task Inventory Scale, and Authoritarian Filial Piety Scale. All mediation and moderated mediation effects were estimated using SPSS 26.0.

Results

Caregiver self-efficacy was found to not only mediate but also help family caregivers convert their burden into positive gains. AFP moderates the association between caregiver burden and self-efficacy, as well as between caregiver burden and caregiver gains.

Conclusions

This study provides valuable insights into filial piety, elucidating AFP’s comprehensive impact on cognitive appraisals of caregiving. Culturally sensitive psychoeducational therapy, addressing AFP expectations and boosting caregiver self-efficacy, is recommended to enhance positive caregiving outcomes.

In lieu of a comprehensive adult guardianship law, voluntary guardianship notarization has become the main route to support the self-determination, autonomy, and decision-making of incapacitated older adults in China. This article is a first attempt to provide an overview of recent developments and current forms of voluntary guardianship notarization initiatives in mainland China. Besides highlighting the difficulties and challenges faced by the country, this article also outlines the types of guardians under the current legal framework, identifies the social functions of the notary office in adult guardianship socialization, and sets out the emerging initiatives to support decision making for incapacitated older adults.

Abstract

As the most aging society in East Asia, a renewed adult guardianship system for the idea of respect for self-determination, practical use of remaining abilities, and re-socialization have been practiced in Japan for 20 years. While, compared with Japan, in lieu of a comprehensive adult guardianship regime, not until 2017, voluntary guardianship notarization has become the main alternative for supported decision-making and self-determination for incapacitated adults and a tool for mitigating the social risks of the frail elderly in China. Based on secondary data and semi-structured interviews, this study is the first attempt that demonstrates a comprehensive comparison of the recent developments and current forms of adult guardianship initiatives in mainland China and Japan. Besides highlighting the difficulties and challenges faced by these two countries, this article also outlined the types of guardians under their current legal framework, identified the social functions of guardians, the notary office in adult guardianship socialization, and the emerging geriatric social work initiatives adopted. The geriatric social work practices in China and Japan’s adult guardianship point in particular toward the potential provocativeness: adult guardianship in the eastern context—a context marked by a strict family system that emphasizes the virtues of filial piety and discourages outside intervention in family matters. As the number of people with dementia is projected to reach 82 million in 2030, China and Japan’s experience potentially holds wide significance for countries that lack substantial policies and programs for caring for the frail elderly.