A public long-term care insurance program has been introduced to Japan in April of the year 2000. Now Japan is the third country of establishing public long-term care insurance system after the Netherlands and Germany. However, the Japanese program has not been well prepared, and several fundamental issues are remained. These include funding problem, inadequate benefits, insufficient quality and quantity of services provided, unclear eligibility criteria, and so on. This paper describes an outline of the public long-term care insurance program and discusses issues concering the determination of eligibility.

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This research is a comparative study of the living conditions of mentally handicapped people living in group homes of urban in Japan and Sweden. We specified and examined not only the facilities of such group homes, but also the daily and social activities of the mentally handicapped, their relationships with their families and the community, what they expect of the future and so on. Our subjects were 22 mentally handicapped adults in Nishinomiya, Japan and 23 mentally handicapped adults in Linkoping, Sweden. We found results which make clear the current situation of group homes both in Japan and Sweden. It was revealed that Japan is still comparatively underdeveloped with regard to the standard of facilities of group homes. Japan also has problems with respecting privacy and in the ways in which leisure time of patients is spent. In many ways, group homes in Sweden have better conditions than those in Japan. But, Swedish homes, too, have problems concerning integration. For example, most leisure activities in Sweden are organized mainly by the handicapped themselves, and there are very few activities in which non-handicapped people participate. Until the mentally handicapped earn true citizenship and are able to live inclusive lives within the community, action to enlighten non-handicapped citizens is strongly needed both in Japan and in Sweden. Differences between the Japan-type and the Sweden-type community service structure are made clear through this survey.

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This article examines the psychosocial issues of the elderly which social workers may deal with in direct practice. In the first section, the author discusses reasons why Erikson's theory of human growth is important to understand the elderly's need properly. The second section clearifies, on the one hand, what life review/reminiscence method is, and shows, on the other, how the practice of this method meets the elderly's needs. In the final section, the author suggests that there are gender differences in focusing developmental stage (s) in life review/reminiscence processes especially when we take into account the particularity of women's psychology.

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If you have seen the movie "Titanic" then you have probably already noticed that "everyone is self-centered to some extent. On the other hand, people can also be altruistic. When we have reached the limits of our mental endurance, one of these two qualities will surface, revealing our true nature." During the Great Hanshin Earthquake in January of 1995, which also destroyed my home, most people acted in their own best interests. There were a few remarkable people, however, who frequently placed themselves in danger to help rescue others. When people try to ensure the survival of their own interests, they tend to ignore and exclude weaker members of society such as the mentally and physically disabled. At the same time, they also wonder when the time will come where others will want to exclude them as well. "I have to eliminate things that are of no use to me." "If I don't try to help these people, then I too will one day be the subject of exclusion." How are we to subjugate and unify these contradictory opinions? Education, training, practice, and creating functional systems are the essential issures behind "forming a welfare community".

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This study examined how healthy people perceive their mentally retarded siblings and what they see to be their future relationship with them. Healthy siblings of mentally retarded persons were given a questionnaire regarding their relationships with their parents and mentally retarded siblings during childhood and how they introduced their mentally retarded siblings to their fiancees. In most cases, they had good relationships with their mentally retarded siblings during childhood. Most of them also intended to take care of their mentally retarded siblings after their parents passed away. However, some seemed to have ambivalent feelings about their mentally retarded siblings in connection with marriage and starting their own families. Half of the married healthy siblings had informed their partners about their mentally retarded siblings before they married. Some of the married healthy siblings were worried that they might have a mentally retarded child.

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We are facing two serious crises: the environmental problem and the welfare problem. The former began when Westerners conquered and controlled nature. Although man used nature to establish our modern socio-economic system, an excessive pursuit of wealth and goods occurred resulting in the exhaustion of natural resources and the destruction of the environment. We are now compelled to transform this system. In addition, the first victims of pollution in Japan were the socially weak, that is to say, children, the poor, the disabled and the elderly. In this sense, the environmental problem caused the welfare problem and the two are closely interrelated. Therefore, when we consider the latter we must return to the former and approach both crises from a global perspective. In legal terms, we must consider both environmental law, which protects nature, and welfare law, which protects the weak, not only as a domestic problem but also as an international problem. Based on these considerations, we will come to the conclusion that we must transform the welfare state into an "international welfare society".

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The objectives of this study were to clarify the present state and problems of families with developmental disabilities by comparing the feeling of stigma experienced by the families in Japan, Denmark, and the United States, and to pursue methods to achieve normalization in Japan. The surveys were performed using the same questionnaire, which was distributed and recovered in October, 1996 in Japan, in June, 1997 in Denmark, and in August, 1998 in the United States. In Japan, a total of 3,000 copies of the questionnaire were distributed, 1,841 were recovered with a recovery rate of 61.4%, and 1,837 responses were valid. In Denmark, 135 copies were distributed, 56 were recovered with a recovery rate of 41.5%, and the number of valid responses was 56. In the United States, 100 copies were distributed, 46 were recovered with a recovery rate of 46%, and the number of valid responses was 46. The following are primary results of the questionnaire. The percentage of the respondents who felt "inadequate" for having persons with developmental disabilities in their families were 68.6% in Japan, 5.3% in Denmark, and 41.3% in the United States. The percentage of those who felt that "the society is cold to people with developmental disabilities" were 66.7%, 3.6%, and 67.4%, respectively. The percentage of those who felt that the society has prejudice against developmental disabilities were 81.4%, 7.0%, and 80.4%, respectively. Also, the percentage of those who felt "anxiety over the future" were 93.6%, 16.3%, and 71.8%, respectively. These results suggest that, despite differences in the cultural background and social systems, the feeling of stigma experienced by the families of individuals with developmental disabilities is strong in Japan and the United States but weak in Denmark. Also, the results of this survey reveal the following problems in Japan. 1) The families are informed of their children's developmental disabilities too late. 2) Social support systems for families having members with developmental disabilities are inadequate, therefore longer time is needed for them to accept the disabilities after notification. 3) The manner of notification of developmental disabilities to the families (when, who, and how) must be evaluated. 4) Prejudice and discrimination of the society against developmental disabilities intensify the feeling of stigma of the disabled and their families. Measures to resolve prejudice and discrimination against developmental disabilities and to relieve the feeling of stigma are needed. From these observations, the authors conclude that education toward normalization is necessary for all people and that social support systems for individuals with developmental disabilities and their families should be improved in the fields of medicine, health care, welfare, education, and employment.

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In this study, first, a brief description of Independent Living (IL) movement in Japan, founding of Independent Living Centers (ILCs), and forming the Japan Council on Independent Living Centers (JIL) were presented. Second, the research results on characteristics of the consumers at 31 centers out of 81 are presented. California Gains Scale (Hiehle, 1982) was employed to measure the impact of ILPs on the participants of 31 centers. Qualitative study based on semistructured interviews were also conducted on 17 voluntary participants who used ILC services in Tokyo metropolitan area and the results are presented. Participating in ILPs, and utilizing their services, the consumers of 31 centers reported that they had developed skills of hiring and using own attendants. The results of the qualitative study revealed that the ILCs were a driving force for homebound individuals with disabilities to start in- dependent living.

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The purposes of this research are to analyze the Osaka home help service model project and problems connected with it. We carried out an interview survey on 19 examples of objectives and home-helpers. Results listed below were found. 1. Effectiveness of Home Help Service A direct effect was that, due to visits by a home-helper, homes where families were living together in an uneasy situation were able to lead more orderly lives, Especially in single person homes, besides becoming able to get the housework done, and in the case of great loneliness, it was effective to have a companion. An indirect effect was that family relationships were improved in the homes. In single person homes, life satisfaction and the quality of life were improved, and regular visits by a home-helper played an important role in much faster reporting when illness grew worse. 2. Problems of Home Help Service One problem was that mental illnesses remained unstable causing difficulties in personal relationships. Therefore, it can be thought that it is necessary to emphasize maintenance of personal relationships to a certain extent in the home help service. In cases where there are numerous problems, it is important to take the entire family, including persons with mental disorders, into consideration. In such cases, rather than introduce home help service immediately, priority should be given to solving problems. A very effective method for care management is to place priority on problme solving, and in cases with numerous problems, it is necessary to introduce home help service.

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