Changes in Families and Care in Depopulated Areas from the Perspective of Community Medicine Providers

A Case Study of Tome City, Miyagi Prefecture

Abstract

This paper reveals changes among rural families in depopulated areas of the Tohoku region by focusing on their attitudes toward in-home care. The characteristics of present-day families living in depopulated areas and the ways in which they differ from families in the past can be ascertained by looking at both patients and families from the perspective of doctors and nurses providing medical care and living in the same area. Previous research has established Tome City as a classic example of an area where there is a strong tendency for families to live together, and where several multigenerational stem families are present. An interview survey conducted, however, revealed signs of changes in the local community and rural families that can be seen in home medical care settings in Tome City. When the burden of care increases, families actively choose to employ the services of nursing homes. Social resources and home medical care providers are both available in this region, and care provided by medical and welfare professionals lightens the burden of care placed on families. Due to these factors, the normative expectation on the part of cohabitating family members to provide care has reduced. Furthermore, patients and families are supported by a network of various relatives and family members. It has also been demonstrated that family members live near one another and show a great deal of consideration for members of other generations. Long-term care systems and policies in Japan today are still predicated on care from cohabitating family members. However, even in an area that has exemplified multigenerational families because it has so many, people are still discovering ways of providing care and creating family structures that do not rely on this assumption.