Japanese-American Attitudes on Long-Term Care Scheppersa, Dongenb, Dekkerc, (2006) defines the use of healthcare services as "the process of seeking professional health care and submitting oneself to the application of regular health services, with the purpose to prevent or treat health problems." On the other hand, the long-term healthcare is variety of services that include both medical and non-medical procedures for people with disability or chronic illness for a long period. A long-term care involves non-skilled or custodian that includes performing daily tasks for patients such as using the bathroom, dressing and toileting.

Saltman, Dubois, and Chawla, (2006) argue some categories of long-term care involves delivering a level of healthcare that requires the expertise of a skilled health practitioner to address the needs of older generation. While people of any age may require the long -- term healthcare service, however, the use of healthcare is common among older generation.

The challenges facing the healthcare providers in the United States are the strategy of providing healthcare for all people from different cultural backgrounds. The United States is a multicultural society and Japanese-Americans are among the fastest growing population of Asian descent. The data of the United States 2010 census reveals that the population of Japanese-Americans is more than 1.3 million. (Census, 2012). Despite a long history of Japan with the United States, many Japanese-Americans are still attaching to their cultural beliefs and unwilling to accept American long-term care systems.

Japanese-American has a unique culture that is very different from American culture and Japanese parents pass this culture to their descendants from one generation to the other. In essence, the Japanese-Americans have a unique culture that affects many aspects of their lives including beliefs towards a healthcare. In the United States, the use of healthcare is still low among Japanese-Americans due to their long history of cultural attachment.

Naoko, (2007) argues that Japanese traditionally rely on family members for a long-term care especially from a daughter in law or daughter. These cultural and social norms still exist among Japanese. Thus, the care of self sacrifice and endurance are part of the Japanese culture. Many Japanese-Americans still believe that sending their parents to an institutional health facility for a long-term care is considered a negative delight, which is similar to abandoning their parents. The cultural attachment to family member is still strong among the older Japanese-American because they nurture a strong cultural belief that it is the responsibility of the family member to provide them with healthcare rather than going to a formal health institution for a long-term care.

McCormick, Ohata, Uomoto, (2002) contributes to the argument by pointing out that the Japanese-Americans historically use healthcare facilities far less than other Asian-American in the United States. Factors influencing the lower attitude towards the healthcare include language barriers, difference expectations and negative attitudes towards healthcare setting in the United States. It is essential to realize that the use of the long-term health facilities increase with age and Japanese are among the long-lived ethnic group in the world.

Since older people demand for long-term healthcare than younger generation, investigating the factors influencing the Japanese-Americans attitudes towards a long-term health care facilities is very critical to provide recommendations that can assist healthcare professionals overcoming the cultural and language barriers that can hinder delivering of long-term care for Japanese-Americans.

Kolb, (2013) support the argument of previous authors by pointing out that the attachment of Japanese-Americans towards their family is still strong when issue of a long-term healthcare delivery arises. To substantiate his argument, Kolb, (2013) presents the results of survey used to investigate the attitude of the Japanese-Americans to long-term healthcare in formal health institutions. The outcomes of the survey reveal that 47% of respondents prefer a long- term care from family members rather than accepting the care from a health institution. However, 53% of Japanese-Americans admit that they will accept long-term health care from health institutions if only they have serious health problems such as hip fracture or dementia.

Difference in American and Japanese culture affects the Japanese-American attitude towards long-term healthcare. Typically, average elderly Japanese-Americans are still being influenced by the copying styles with the conception of Japanese culture. However, American culture is base on individualism. Contrarily, Japanese behaviors to long-term healthcare are influenced by the Japanese culture of collectivism. The culture of individualism centers on self-determination or self-reliance. On the other hand, the culture of collectivism stresses on interdependence among the member of family. Japanese culture emphasizes on accommodating the needs of others. In Japanese culture, when an individual is receiving care, the individual is required to suppress dissatisfaction without voicing their complaints. To voice complaints is a sign that...

The Japanese cultural orientation makes the Japanese-Americans believing that they should passively accept the health assistance from healthcare professionals rather than voicing a complaint. In the light of Japanese cultural orientation towards healthcare believe, Japanese-Americans may be unwilling to submit themselves to a long-term health care if they believe that a health institution may not satisfy their health needs.
McCormick, et al. (2002) points out that the age of Japanese-American influences their willingness to accept long-term healthcare delivery rather than home care. Large percentages of younger generations of Japanese-Americans prefer accepting long-term care from a health institution rather than home care. However, large percentages of older generations still prefer home care from the loves ones rather than being transferred to a health institution for a long-term care.

Apart from the cultural factor that can influence the acceptance of long-term care among Japanese-Americans, language barrier is another factor that can influence the acceptance of long-term care by Japanese-Americans. Scheppersa, Dongenb, Dekkerc, (2006) point out that language barrier is one of the factors making Japanese-Americans to be reluctant to accept being transferred to a health institution for a long-term care. Many older generations of Japanese-Americans still attach to their local Japanese language and many of them are reluctant to speak English because of inability to communicate effectively in American English. Some of them understand American English; however, they are unable to establish a direct communication with a Native American because of a difference in intonation. Thus, barrier in language can jeopardize an effective communication between a healthcare provider and Japanese-American patients seeking for a long-term care.

Moreover, a language barrier can hinder the Japanese-Americans to express their inner feelings especially when medical personnel decide to bypass the patient to communicate with family members. Meanwhile, language difficulties can lead to additional discomfort or emotion stress of patients. The language barriers can also hamper ability of patients to obtain a vital medical history. Thus, the cultural attachment coupled with language barriers make increasing number of Japanese-Americans to rely on informal support for a long-term care. Typically, older Japanese-Americans generally avoid nursing home because they do not want to disrupt the relationships with their relatives and families whose they consider very important for their well beings.

Implication for Medical Practice

The providers are to be aware that Japanese-Americans have unique cultural belief, perspectives and attitudes towards illness, and healthcare delivery. Providers should be supportive and show respects for Japanese-American seeking for a long-term care because Japanese culture emphasizes that a young person should respect an older person. It is essential to realize that due to the culture of collectivism in Japanese culture, a respect for older generation is very important. Moreover, healthcare providers are to apply a competent knowledge of Japanese cultural health orientation when dealing with Japanese-Americans seeking for a long-term care. (Zhao, 2011).

Summary

Japanese-Americans have a unique culture that is different from a western culture. A Japanese-American parent passes this culture to their children, which continues from one generation to the other generation. The cultural beliefs influence the attitude of Japanese-Americans towards a long-term care. An average Japanese-American believes in seeking for support from a member of the family rather than seeking for help from a totally strange person who belongs to another ethnic group. These believe make increasing number of Japanese-Americans to be unwilling being transferred to a health institution for a long-term care. Japanese-Americans still nurture a cultural believe that it is the responsibility of member of the family to take care of the family seeking for a long -term care.

Moreover, language barrier between a Japanese America and provider makes many Japanese-Americans to be unwilling accepting a long-term care from a formal health institution in the United States. Providers can overcome this barrier by having a basic understanding of Japanese culture, which will assist them providing a long-term care that can tally with the Japanese cultural perspectives.

Reference

Census (2012). The Asian Population:2010. United Census Bureau.

Kolb, J.B. (2013). Social Work Practice with Ethnically and Racially Diverse Nursing Home Residents and Their Families. New York. Columbia University Press.

Naoko, M. (2007). Culturally sensitive long-term care for Japanese Canadians

Metz, Naoko. Trinity Western University. (ProQuest, UMI Dissertations Publishing,

McCormick, W.C.1. Ohata, C.Y. Uomoto, J. (2002). Similarities and differences in attitudes toward long-term care between Japanese-Americans and Caucasian-Americans. J Am Geriatr Soc. 50(6):1149-55.

Saltman, R.B., Dubois, H.F.W. And Chawla, M. (2006). The impact of aging on long-term care in Europe and some…