The central government’s “long-term care services program 2.0” began trial operations on Tuesday last week in four cities and nine counties.
While President Tsai Ing-wen (蔡英文) has said that nothing but success is acceptable, a major problem remains: The healthcare workforce is not only short by about 10,000 people, it is also relatively old. The government must begin recruiting more healthcare professionals.
How can the government encourage more young people to choose a career in long-term care? Japan might serve as a useful reference.
While Taiwan has several hundred thousand nursing assistants, Japan has more than 1 million; and while 75 percent of these personnel in Taiwan are more than 45 years old, in Japan 75 percent of nursing assistants are 40 years old or younger.
In Taiwan, there is a preconceived notion that working as a nursing assistant is for mothers who have gone back to work after childbirth. However, in Japan, nursing assistants are considered highly professional, just like doctors and nurses.
The Japanese manga series Help Man tells of how young people in Japan have developed a passion for long-term care. In the series, a young man who does not like studying chooses to study long-term care at a vocational high school rather than trying to enter a famous school.
After graduation, he becomes a care worker for an older person with dementia, who refuses to shower and smears his feces around. Although the young man is unfamiliar with care theory, he uses his creativity to overcome many problems. He not only takes good care of the older person, but also helps their family by giving them time to rest.
In Japan, more than 100 high schools have a long-term care department, but in Taiwan, there are only a handful, which means that the support of educational authorities is necessary.
President Tsai Ing-wen is encouraging high-school graduates to join the workforce for a few years before continuing their studies, and announced a monthly subsidy of NT$10,000 to students returning to school after having gained a few years of work experience.
Long-term care could be a focal point of the subsidy plan to encourage high-school graduates to enter the long-term care profession and gain the understanding that caring for older people is both a joyful and meaningful occupation that is worth considering as a career choice.
In addition, nursing assistant salaries must be able to provide security. In Japan, nursing assistant salaries are 75 percent of a nurse’s salary. Converted to New Taiwan dollars, nursing assistant salaries should be about NT$33,000. The figure is the same if the conversion is based on national income.
A certification system could raise the status of the nursing profession, and Taiwan’s Long-Term Care Services Act (長期照顧服務法) clearly requires continued education among nursing staff. To improve the image of care services, this requirement must be enforced.
There is a Physicians Act (醫師法) and a Nursing Personnel Act (護理人員法), so why is there no nursing assistant act? With a law in place, it would not only be possible to guarantee the welfare of nursing assistants, it would also improve the quality of the care they provide.
Similarly, there is Doctors’ Day and Nurses’ Day, so why is there no “nursing assistants’ day”?
Japan’s example shows that the need for nursing assistants will catch up to the need for physicians and nurses. Taiwan must treat care services just as importantly and provide the sector with resources equal to those of other sectors if the nation is to attract more young people to the profession.