Ruth Campbell

Changing ideas about family care for the elderly in Japan

As rapid social changes occur around the world, accompanied by increasingly larger numbers of elderly in need of care, it is crucial to gain new knowledge of the relationship between changing social institutions and the impact of such changes on the context in which care is given to the elderly.In Japan, the family has tradiditnally been the context in which caregiving occurs. Although family care still remains central, 22 focus groups conducted in Tokyo in 1982 and 1990 with three different age groups (N=175) reflect the significant changes which are occurring in the traditional Japanese family system-despite important continuities-and the manner in which these changes are influencing the Japanese approach to care for the elderly.In this article, we focus on material, instrumental, and emotional reciprocity among adult generations within the Japanese family. Our data suggest that families mix traditional options with newer ones in providing care to their elders.

Enhancing Forgiveness: A Group Intervention for the Elderly

This article describes a therapeutic model of forgiveness (Enright, 2001) and discusses its applicability to social work intervention with older adults. A total of 20 men and women, aged 57–82, participated in 2 different forgiveness groups, each of which met weekly for 8 sessions with a 4-month follow-up session. Measures of forgiveness, as well as biopsychosocial functioning, were collected before and after the group intervention. Results indicated that participants experienced long-term improvement with respect to forgiveness and depression, short-term improvement of physical health, and no change in relation to anxiety or social support. Clinical issues that emerged during the forgiveness group are discussed, and suggestions for gerontological social workers are offered.

The Couples Life Story Approach: A Dyadic Intervention for Dementia

This article describes an approach for working with individuals who have dementia, along with their spouses or partners. The 5-week intervention focuses on helping couples communicate, reminisce about the story of their relationship, find photographs and mementoes from their past, and develop a book that incorporates these mementoes. This clinical approach highlights the strengths and the resilience of couples and adds to the limited repertoire of dyadic interventions for dementia care which are currently available. Preliminary findings from 24 couples are presented, including the interventions feasibility and acceptability.

Creating a duet: The Couples Life Story Approach in the United States and Japan

There is a global need for interventions that help couples who are dealing with dementia. This paper describes the way in which interventionists from the United States and Japan participated in the development of an intervention for dyads in which one person is experiencing memory loss. The 5-week intervention, the Couples Life Story Approach, helps dyads to reminisce about their life together as a couple, to work on their patterns of communication, and to develop a Life Story Book. Based on an analysis of cases conducted in the United States (n = 20 couples) and Japan (n = 9 couples), this paper highlights the cross-fertilization process that has occurred as interventionists from the two countries have shared their experiences with one another. Using case illustrations, the discussion focuses on the clinical themes that have emerged for couples in the United States and Japan.

Forms of communication: A cross-cultural comparison of older married couples in the USA and Japan

Interviews were conducted with 24 older couples in the USA and Japan. Spouses participated in a causal conversation during which they discussed their marital history. The dialogue between the spouses was examined in relation to five forms of communication: prompting, questioning, echoing, contradicting, and teasing. Results from this analysis challenge some of the stereotypes concerning Japanese and American communication patterns. Couples in both countries engaged in teasing but the purpose of these kinds of exchanges differed for the American and the Japanese spouses. Findings are discussed in relation to cultural and gender differences and similarities in forms of communication between older spouses.

Effectiveness of Writing Groups in Nursing Homes

We examine the effect of participation in an 8-week writing group in six nursing homes. Pretest and posttest assessments of cognitive and affective functional status were administered to 62 participants and 54 control subjects. We asked writing-group participants about previous writing experience and perceived ability to convey feelings, ideas, life experiences, and memories to others. Weekly assessments were conducted on eight group process measures. Findings suggest that participation in writing groups may reduce depression, particularly among residents with higher cognitive ability and greater depression. Significantly more participants than control subjects report an ability to relate feelings and ideas to other residents and staff. Improvement in group process measures is greatest for cognitively impaired participants and those with high physical function scores. There is considerable improve ment in residents for whom writing-group participation frequently is considered inappropriate: those without writing experience, the depressed, and the cognitively impaired.

Lost and Found: Memory Loss and the Resilient Caregiver Portrayed in Japanese Films

Alzheimers disease is often described as loss: loss of memory, loss of self. Four Japanese films over the last 30 years probe the depths of this loss, both to the individual and the caregiver. They dramatically represent changing images in Japan of elderly with dementia as well as the enduring values of family and caregiving. Kokotsu no Hito (“The Twilight Years,” 1973), Oriume (“Broken Plum Branch,” 2002), Ashita no Kioku (“Memories of Tomorrow,” 2006), and Mogari no Mori (“The Mourning Forest,” 2007) illuminate the challenges and loss as well as the creativity, resilience and meaning found in the process. Comparisons will be made with four recent Western films portraying Alzheimers disease.