From November 21st to 23rd, 2024,Support for sustainable decision-making and arrangements that preserve dignity for everyone during and after life" project, we conducted a survey in Taiwan. We interviewed Professor Kodama and Researcher Sawamura, who conducted the survey, and will share their learnings and realizations that they gained from the survey in three parts.
The first part of the interviewHere, the middle part isHerePlease see the article.
Taiwan's characteristics are "data preparation" and "mutual assistance"
-So far, you have told us about the contents of your three-day survey and what you learned at each of your visits. From here, I would like to ask you about the survey as a whole. First of all, please tell us about the differences between Japan and Taiwan that you have seen through your survey.
(Kodama) Compared to Japan, Taiwan is more advanced in terms of healthcare, with laws such as the Patient Autonomy Act and a system for sharing medical data, including end-of-life wishes, in place. By publicly sharing data, it could be used for research as well as decision-making support. I heard that Taiwan's palliative care wards were modeled after Japan's palliative care wards when building hospitals. I think Japan needs to proactively learn from the good things about other countries, including Taiwan.
(Sawamura) Data digitization is not done at all in Japan. In Japan, there is no common format, and sometimes it is stored only in the hospital. Also, I heard that in Taiwan, two staff members are assigned to consult for one hour. In Japan, the hospital may be involved in planning, but I heard that in some cases, the documents are simply given to fill out. It seemed that the degree of support for decision-making was also different.
(Kodama) In Taiwan, the format is standardized, used, and shared properly, so it's easy to do. I was shown the screen of a smartphone app to see how the information is actually stored. It seems that people feel more comfortable if they make a decision in advance, and there seems to be a movement where people who write the information recommend it to others.
(Sawamura) I felt that Taiwan has a large number of non-professionals, such as volunteers and local people, who support elderly people in a mutual assistance manner. In particular, I felt that the presence of neighborhood association presidents was very different from Japan. I have heard that in Japan, there are areas where the head of a community center is appointed to help elderly people in the area with paperwork, but this is a rather informal form of support. In Taiwan, neighborhood association presidents are elected and paid a salary, so I got the impression that they are rather formal. They also work closely with hospital staff, and it seemed like they were able to deal with the situation well because they know each other's faces.
Future challenges: Understanding the current and future of Taiwan's support systems
Is there anything you would like to investigate further in the future?
(Kodama) I would also like to interview government offices and financial institutions. This is not about Taiwan, but a Singaporean researcher I spoke to during my research mentioned the keyword "legacy planning." In Singapore, passing on assets and values to the next generation is called legacy planning, and financial institutions sometimes provide support for this. Financial institutions may also have a role to play in Taiwan.
I also learned that mutual aid mechanisms such as volunteering play a major role in Taiwan. I would like to hear about the types of people who actually volunteer, their age group, and how they work. Volunteering can also strengthen ties with the local community.
(Sawamura) Yes, that's right. I would like to talk to someone who is actually a neighborhood association president. It seems that they are active in a formal role rather than a volunteer spirit, but I would like to delve deeper into the differences in awareness of social participation between Japan and Taiwan.
When I asked about the current situation of elderly people in Taiwan, I learned that medical and nursing care services are available to vets, while non-vets are also supported by the local community. On the other hand, it seems that many of the caregivers in Taiwan are from overseas, and it does not seem to be a country with abundant domestic resources. Like Japan, Taiwan is also seeing a trend of smaller families and more people being unmarried, so there may be issues in the future. I would like to keep an eye on future developments in Taiwanese society.
