John W. Traphagan

Multidimensional Measurement of Religiousness/Spirituality for Use in Health Research in Cross-Cultural Perspective

This article explores difficulties that arise when culture is factored into the attempt to develop methods for both describing and measuring religiousness or spirituality as variables in health research. The author uses a report titled Multidimensional Measurement of Religiousness/Spirituality for Use in Health Research published by the John E. Fetzer Institute to raise questions about the extent to which basic ideas associated with the study of Judeo-Christian religions are meaningful in contexts such as Japan, India, or China. Using a combination of ethnographic data from his own fieldwork in Japan and ethnographic literature focused on other cultures, the author argues that as an analytic category “religion” is problematic because basic elements of that category, such as faith or the notion of the transcendent, have been developed in terms of a predominately Christian or Western theological framework that is not necessarily appropriate for research in non-Western cultural contexts.

Localizing senility: Illness and agency among older Japanese

For many Japanese, fear about senility is not primarily expressed in relation to pathological conditions like Alzheimers Disease (AD). Instead, as people grow older, their concern focuses on a widely recognized category of decline in old age which, although symptomatically and conceptually overlapping with AD and other forms of senile dementia, is distinguished from unambiguously pathological conditions. This article examines the meaning and experience of this condition, known as boke, and shows that senility in Japan is culturally constructed in a way distinct from the clinical biomedical construction of senility-as-pathology which has become increasingly the norm in North America. Rather than being a disease, boke is viewed as an illness over which people are believed to have some degree of agency in relation to its onset – through activity, particularly within the context of groups, it may be prevented or at least delayed. The data discussed also suggest the importance of culture in defining the meanings of normal or abnormal aging. While from a clinical perspective it may be clear where the line is to be drawn between what is normal and what is pathological aging, from the perspective of older people, the basis of what is considered normal or abnormal aging may not have a direct link to disease.

Cultural factors in dementia : Perspectives from the anthropology of aging

Abstract:The plasticity of cultural constructs of dementia is shown in two societies: Japan, and an American Indian nation. By demedicalizing the analysis of dementia, the social and cultural factors that influence recognition of symptoms, help-seeking strategies, caregiving behaviors, and adherence to biomedical and sociocultural coping advice become more obvious. Notably in the Japanese example, motivation toward primary prevention behavior is clear in the context of boke since it is an undesirable condition of frailty and cognitive decline considered to be preventable by remaining active. In the American Indian example, the hallucinatory symptoms are positively valued communications with the “other side” rather than pathologically defined. The findings show the need to extend dementia models beyond the biomedical in order to optimize prevention and management of this complex, chronic condition.

Senility as disintegrated person in Japan

This article focuses upon the intersection of Japanese concepts ofperson, mind and body and ideas about senile dementia. Questions exploredinclude: How do Japanese ideas about person, in terms of the relationship between mind and body, differ from those generally accepted in the Euro-American world? And how do these ideas influence Japanese conceptualizations ofsenility? I argue that gerontologists and others concerned with the treatmentand understanding of senility from a cross-cultural perspective need topay close attention to how the person, as an ontological concept of being,is perceived and constructed in different contexts. The manner in which people indifferent cultures conceptualize the nature of human being will inevitably have asignificant influence on how they perceive and experience senility. The datafor this article were collected during more than two years of ethnographicfieldwork in northern Japan.

Power, family, and filial responsibility related to elder care in rural Japan.

This article explores the discourse on filial responsibility as it intersects with familial roles and power relationships as represented by women living in rural Japan. Using case studies, I consider some of the intergenerational and intragenerational issues that arise as Japanese women contemplate or attempt to cope with care of elder parents and consider the manner in which the concept of filial piety, or filial responsibility, is expressed and conceptualized in relation to these issues. I argue that many continue to think about elder care in ways that emphasize the responsibility of children to care for their parents, but that the discourse on filial piety is continually constructed and reconstructed as people provide and contest roles associated with elder care, both from the perspective of the child and from that of the parents. To explore these issues, I consider the cases of two women who were facing issues related to provision of care to elder parents and who structured these in terms of notions about filial responsibility. The cases were obtained during extended fieldwork in an agricultural community in northern Japan.

Culture and long-term care: the bath as social service in Japan.

A central feature of Japan’s approach to community-based care of the elderly, including long-term home health care, is the emphasis on providing bath facilities. For mobile elders, senior centers typically provide a public bathing facility in which people can enjoy a relaxing soak along with friends who also visit the centers. In terms of in-home long-term care, visiting bath services are provided to assist family care providers with the difficult task of bathing a frail or disabled elder—a task made more problematic as a result of the Japanese style of bathing. I argue that the bath, as social service, is a culturally shaped solution to a specific problem of elder care that arises in the Japanese context as a result of the importance of the bath in everyday life for Japanese. While the services may be considered specific to Japan, some aspects of bathing services, particularly the mobile bath service, may also have applicability in the United States.

Intergenerational Ambivalence, Power, and Perceptions of Elder Suicide in Rural Japan

This article explores perceptions of elder suicide by older Japanese and contextualizes these perceptions within the theoretical framework of intergenerational ambivalence theory. The examples discussed show how people can use perceptions related to intergenerational relationships and changing social structures and values to create explanatory models for suicidal behavior. In the cases discussed here, high elder suicide rates are seen as a product of conflicting family values and conflicting expectations about how power should be allocated within families. Suicide is one means by which actors negotiate contradictions in the surrounding social environment, contradictions that for many Japanese appear to be consistently evident in the context of multigenerational families where communication and interaction between younger and older generations is perceived as being difficult.

Constraint, Power, and Intergenerational Discontinuity in Japan

ABSTRACT This article uses ethnographic data to explore intergenerational relationships as they are both constructed and contested within the confines of the discourse of filial piety in Japan. I argue that the current state of intergenerational relationships in Japan can neither be characterized in terms of an abandonment of traditional values of filial obligation nor in terms of a tacit acceptance of those values. Instead, contemporary Japanese experience intergenerational relationships in a social matrix that includes co-existing, and in some respects contradictory, discourses and associated matrices of power that at once encourage a lifestyle centered around the nuclear family and are characterized by independent decision-making while also emphasizing expectations of co-residence and commitment to filial obligations.

From socially weak to potential consumer: changing discourses on elder status in South Korea.

This article explores social and political dimensions associated with providing care for elders in South Korea. We look at changes in welfare policy since the 1980s and discuss the emergence of a long-term care insurance program in Korea similar to the program promulgated in Japan in 2000. We argue that while the status of South Korean elderly is undergoing change as new policies provide opportunities for elders to move from positions of dependency to increased independence as consumers of health care services, there are some reasons for concern. The capacity of elders to function as consumers remains tied to the fact family members or elders themselves must pay supplements to their health insurance premiums as well as significant co-payments for services rendered, and government policies retain a strong bias toward requiring in-home, family-centered care of frail and bedfast elders.

Group Homes for Elders with Dementia in Japan

In this article we explore the development of group homes for elders with dementia in Japan since the inception of the long-term care insurance program in 2000. We suggest that the combination of demographic and policy trends in recent years have created a context in which entrepreneurial activities related to elder care have increased significantly. By focusing on one of the new institutions that has emerged, we show one way in which social policy has had a significant influence on the lives of elders suffering from dementia and their families. Finally, we point out some of the problems that have arisen along with the growth of these new forms of care, such as a lack of involvement by family members in visiting and caring for elders.