Abstract
In this paper, I explore one of the roots of the devaluation of care work in Japan, focusing on the administration of the program of Tsukisoi for the care of the elderly in hospitals between the 1970‘s and 1990’s. Tsukisoi were care attendants hired directly by the patient, not by the hospital, but stayed all day in the hospital to give around the clock care to the patient. Tsukisoi had provided the bulk of hands-on care for the elderly in hospitals. A program of Tsukisoi was promoted by health care policy in the 1970's to 1980's to cope with the social issue of care for the bed-bound elderly, but was problematized and put to an end in 1990's. Though the program of Tsukisoi in itself is over and front line care workers hired by the hospital have substituted them, the history of the program still greatly contributes to the devaluation of front line care work. While a certain part of today's care attendants in medical settings are semi-professionalized with nationally legislated certification, they have not yet been revalued and continue to be regarded as having ‘low skill’ or being of ‘low social status’ and their income is accordingly low.
This paper points out that one reason for the de v a luation of care workers is rooted in and perpetuated through the historical use of the term “ Tsukisoi” in Japanese health care policy. The framework has not been changed toward revaluing care work even with the professionalization of front line of care work, but rather been established for the devaluation of those care workers.
