This paper expands upon the Presidential Address delivered at the 51st Annual Meeting of the Japan Society of Health and Medical Sociology by incorporating additional data to compare the current situation and challenges related to the retention of foreign care workers in Nagasaki and Saga Prefectures. In Nagasaki, where there has been no prior acceptance of foreign care workers under the Economic Partnership Agreement (EPA), the recruitment of technical intern trainees marked the beginning of foreign labor intake in the long-term care sector. In contrast, Saga Prefecture initiated the recruitment of foreign care workers through the so-called “Saga Model,” aside from EPA framework. A challenge common to both prefectures is the outflow of foreign care workers to major metropolitan areas after the completion of their initial employment contracts——or in some cases even before the contracts expire. Such cases often involve the new employment facility assuming responsibility for the contract violation penalty.

Vietnam is experiencing one of the fastest rates of population ageing in the world, creating both opportunities and challenges for its health and social care systems. The growing number of elderly people, coupled with an increasing prevalence of chronic and functional impairments, has generated urgent demand for long-term care. However, Vietnam’s caregiver workforce remains insufficient and largely informal, with limited legal recognition and training standards. This lecture outlines the demographic and social characteristics of older persons in Vietnam, analyzes the gaps and potentials in elderly care provision, and introduces the Association of Vietnam Nurses initiative to develop a standardized training program for elderly caregivers. The program focuses on essential competencies——such as physical assistance, hygiene, communication, and safety——and aims to establish a framework for professionalization that is consistent with national and international qualification standards.

This translator’s note is based on the educational lecture “Opportunities and Challenges of Implementing the Elderly Caregiver Training Program in Vietnam” presented by Pham Duc Muc, President of the Association of Vietnam Nurses (AVN), at the 51st Annual Meeting of the Japanese Society of Health and Medical Sociology. It is translated and annotated from a newly written manuscript prepared by the author. First, the note highlights that the new manuscript reflects the outcome of over a decade of academic collaboration between President Muc and Professor Yuko Hirano, which has deepened mutual understanding of Japanese approaches to caregiving. Second, it situates the manuscript within the shared Asian context of “population ageing and the securing of care workforce,” introducing Vietnam’s emerging framework for caregiver training. Finally, it analyzes the relationship between nursing and caregiving in Vietnam and discusses the significance of President Muc’s proposal for the professionalization of care workers (nhân viên chăm sóc).

Japan is an advanced country with an aging population. As demographic aging is now a global trend, the construction of care economy and cross-border care workforce are being sought along with it. Can KAIGO, which means Japan’s long-term care, contribute to the smooth cross-border activities of care workers in Asia? Before the introduction of the Bilateral Economic Partnership Agreement (EPA), I visited several times in Asian Countries and regions with officials of long-term care facilities and researchers. I considered a holistic framework reached through dialogue and experience with many informants in visited communities. In conclusion, the current situation of cross-border long-term care labor in Japan cannot be a common model in Asia. For achieving a common model in Asia, it is necessary to start international harmonizations to appropriately position each care vocational training program and workplace duties and treatment within the international vocational qualification framework, based on mutual understanding and collaborative efforts in line with the development status of each country.

Through this case study, we have examined the ageing of ethnic minorities in Japan and the inherent challenges within the community-based integrated care system. In this instance, a disconnect emerged between the fragmented living spheres envisaged by the state in its institutional design and the actual living spheres of elderly Koreans residing in Japan. Furthermore, within the framework of objective assessment, the specific care needs of elderly foreign nationals and the advantages of their cultural resources were not sufficiently evaluated. Consequently, despite strong user demand for its continuation, the facility ultimately faced closure. Moving forward, policies must incorporate a perspective that respects and supports cultural backgrounds, rather than relying solely on single-criterion assessments for groups with culturally specific needs.

This study examines a support model aimed at promoting autonomous living for older people aged 75 and over who require in-home support. The model focuses on older people’s experiences of dealing with life difficulties and sharing them with support staff. Semi-structured interviews with five older people were conducted to explore these experiences and identify key elements for an autonomous living support model. Participants developed a positive awareness through recognition from support staff, which helped build their confidence. However, they also experienced support that threatened their dignity, and felt they were responding in relationships where they couldn’t understand the staff’s intentions. Nevertheless, they became aware of the importance of building relationships led by older people and actively supported the staff in improving the assistance they receivedd. The model highlights two essential factors: “promoting the sharing of experiences” and “hindrance to sharing of experiences,” both crucial for supporting autonomous living for older people.