In an era of changing demographics and values, this volume provides a cross-national and interdisciplinary perspective on the question of who cares for and about the elderly. The contributors reflect on research studies, experimental programmes and personal experience in Japan and the United States to explicitly compare how policies, practices and interpretations of elder care are evolving at the turn of the century.

Japanese and American economists assess the present economic status of the elderly in the United States and Japan, and consider the impact of an aging population on the economies of the two countries. With essays on labor force participation and retirement, housing equity and the economic status of the elderly, budget implications of an aging population, and financing social security and health care in the 1990s, this volume covers a broad spectrum of issues related to the economics of aging. Among the book's findings are that workers are retiring at an increasingly earlier age in both countries and that, as the populations age, baby boomers in the United States will face diminishing financial resources as the ratio of retirees to workers sharply increases. The result of a joint venture between the National Bureau of Economic Research and the Japan Center for Economic Research, this book complements Housing Markets in the United States and Japan (1994) by integrating research on housing markets with economic issues of the aged in the United States and Japan.

In Through Japanese Eyes, based on her thirty-year research at a senior center in upstate New York, anthropologist Yohko Tsuji describes old age in America from a cross-cultural perspective. Comparing aging in America and in her native Japan, she discovers that notable differences in the panhuman experience of aging are rooted in cultural differences between these two countries, and that Americans have strongly negative attitudes toward aging because it represents the antithesis of cherished American values, especially independence. Tsuji reveals that American culture, despite its seeming lack of guidance for those aging, plays a pivotal role in elders’ lives, simultaneously assisting and constraining them. Furthermore, the author’s lengthy period of research illustrates major changes in her interlocutors’ lives, incorporating their declines and death, and significant shifts in the culture of aging in American society as Tsuji herself gets to know American culture and grows into senescence herself. Through Japanese Eyes offers an ethnography of aging in America from a cross-cultural perspective based on a lengthy period of research. It illustrates how older Americans cope with the gap between the ideal (e.g., independence) and the real (e.g., needing assistance) of growing older, and the changes the author observed over thirty years of research.

The problems of an ageing population are particularly acute in Japan. These problems include people living longer, with many needing more care, and the problems of supporting them by a diminishing working population and a diminishing tax base. This book, based on extensive fieldwork in a Japanese institution for the elderly, explores the whole issue of ageing and responses to it in Japan, and compares the Japanese approach in these matters with Western approaches. It discusses how people in Japan have changed their perceptions towards family responsibility, the institutionalization of the elderly, and rights of welfare. It also discusses how institutions for the elderly are run in Japan and how their management differs from that in the West.

Ageing population poses a set of complex policy and dilemmas for social security systems, intensifying the concerns about rising expenditures in health care and long-term care for elderly. In this context, ageing societies has many valuable lessons to learn by studying Japan's experience dealing with its hyper-aged society and particularly from its strategies to ensure the financial sustainability of the Long-Term Care Insurance (LTCI) system. Based on an exhaustive literature review, and the results from six original researches on long-term care expenditures in Japan (LTCE) conducted during a doctoral program, the book provides a comprehensive view in analyzing trends and factors associated with increasing expenditures in the Long-Term Care Insurance system in Japan. The book address relevant topics such as; the main socio-demographic changes experienced by the Japanese society during the last three decades, predictors of the LTCE, measuring efficiency in nursing homes, the impact of the LTCI 2005-reform to contain expenditures, cost-effectiveness of the in-home and community based services and institutional LTCE in the last year of life. The book end with a discussion on futures challenges and strategies oriented to contribute with the sustainability of LTCI system in Japan.

Across the globe, populations are getting older. Hayashi surveys the development of residential care in Britain and Japan from the 1920s onwards, using regional case studies, and taking into account the influence of traditions and cultural norms.

DIVA comprehensive picture of costs in Japan's effective and efficient health care system. /div