Parent-carers in Taiwan and Japan: lifelong caring responsibilities within a familistic welfare system Prof Yueh-Ching Chou, Institute of Health and Welfare Policy, National Yang-Ming University, Taiwan Prof Toshiko Nakano, Faculty of Sociology and Social Work, Meiji Gakuin University, Tokyo, Japan Prof Antti Teittinen, Adjunct Professor and Research Manager, Centre for Research and Development, Finnish Association on Intellectual and Developmental Disabilities Carers and Work-Care Reconciliation International Conference University of Leeds, 13th August 2013

1. 1
Carers and Work-Care Reconciliation International Conference
University House, University of Leeds
Caring situations for a disabled child in Finland, Japan and Taiwan: Work-Care reconciliation
(Handout)
Presented by Yueh-Ching Chou, Toshiko Nakano & Antti Teittinen
Tuesday 13th August 2013, morning session, 11:00am workshop A

2. Table 1: Basic data related to disabled child care in three countries
2
Age / type of disability Taiwan Japan Finland
Number and % of total
population
All with disabilities 1,080,000; 5% 7,443,000; 6% 303.000; 6%
All with IDs 96,565; 0.4% 547,000; 0.4% 40.000; 0.7%
% living either with family or
independently
All with disabilities 93% 93% 92%
All under age 18 with
disabilities*
97%
(i) 94%
(ii) 98%
All with IDs 93% 77% 66%
% using residential services All with disabilities 7% 7% 4%
All under 18 with
disabilities*
3%
(i) 6%
(ii) 2%
(iii)
All with IDs 7% 23% 25%

3. Use of community services Less than 5% Less than 9%1
Use Personal Assistant services None2 None 4%
% employing a live-in migrant
care worker
3
All with disabilities 11% None-
All under 18 with
disabilities
1% None-
All with IDs 0.7% None-
Notes: IDs – intellectual disabilities
*For Japan, first figure is for persons under 18 with physical and intellectual disabilities; second figure is for persons under 20 with ‘mental
disorder’.
Sources: Figures for Taiwan: Chou et al, 2007, 2010; DSMI, 2007, 2011. Figures for Japan: Cabinet Office, 2010b; MHLW, 2005, 2006, 2009;
JILPT, 2011. Figures for Finland: Tossavainen, P. & Kuronen, R. (2012) Institutional Care and Housing Services in Social Care 201. THL; Social
Insurance Institution of Finland: Statistics on disability benefits 2012.
1 Includes persons using more than two service programmes.
2 In experimental stage-NGO; included in the Disability Act act since 2012.

4. Table 2: Supporting parental care for disabled child in three countries
4
Finland Japan Taiwan
Support
from
workplace
Paid job alternation leave for 90-359
days; must take as min. 90 successive
days, employees with 12 months’
service and 10 yrs experience only, 70%
of unemployment benefit rate; costs
covered by state.
Unpaid care leave, max. 6 months per
request, available at employer’s
discretion.
Like all parents, childcare leave until the
child is 3 years old, paid flat-rate
allowance, with means-tested and
possible municipal supplements.
1995: employers recommended to offer family
care leave.
Paid family care leave, max. 93 days for each
family member (self-employed not eligible).
Paid or unpaid nursing leave for 5 days per
year (10 days per year if more than one
dependant).
Legal right to request flexible working:
employers must offer carers i) shortened
working hours; ii) flexible working time; iii)
limitation of extra working hours, up to one year
per application.
Paid parental leave (60% of salary)
parents (one at a time) with children
aged 6 mths-3 yrs, parents with
labour insurance; otherwise unpaid
Paid care leave, 5 days p.a. children
<12 yrs, civil servants only.
Flexible working or unpaid
one-hour early leave, employees
with children <3 yrs, companies
with 30+ employees only
Support
available
locally
1993: Decree on Support for Informal
Carers.
1995: Job Alternation Leave Experiment
Act allowed career breaks of 90-359
days.
1995:Childcare and Family Care Leave Act
(Revised) extended to care of ‘other family
members’ in addition to childcare
1999: Childcare and Family Care Leave Act
(Revised) obliged employers to offer family
care leave.
1993: Respite care initially
introduced (in Taipei City).
2002: Gender Equality in
Employment Act: unpaid leave to
care for relatives.

5. 5
1997: Social Welfare Act (revision): 1
free day per month for recipients of
carer’s allowance.
2001: Social Welfare Act (Revised): 2
free days per month for recipients of
carer’s allowance.
2002: Job Alternation Leave Act: 90-359
days’ financially supported leave made
permanent.
2005: Support for Informal Carers Act: 3
free days per month for recipients of
carer’s allowance.
2011: Support for Informal Carers Act
(Revised): LAs may contract with a
2000: LTCI Act: (in general, for persons over
65, not for persons with disabilities includes a
family carer support programme.)3
2001: Family Care Leave extended / amended.
2002: Family Care Leave extended / amended.
2004: Family Care Leave extended / amended.
2005: Family Care Leave extended / amended.
2009: Childcare and Family Care Leave Act
(Revised) obliged employers to establish a
system of short-time work for workers having
children aged 3 or younger, to extend the
maximum lengths for childcare leave when
both father and mother take the leave, to
establish a system of short-term family care
2004: 5 days per year paid care
leave (govt. officials only).
2007: Welfare of Disabled People
Act: included Special Care
Allowance to mid- or low-income
senior citizens.
2007: Welfare of People with
Disabilities Act: LAs to co-operate
with NGOs on respite/ carers’
services.
2009: Employment Insurance Act:
unpaid care leave for carers of
family members.
2009: Welfare of Older People Act:
3 Persons with disabilities over 65 will be able to choose services based on LTCA instead of services based on the Comprehensive
Support Act for Persons with Disabilities Act.

6. 6
‘respite care’ worker to replace family
carer on ‘days off’.
2011: Employment Contracts Act
(Revised): right to request unpaid leave
to care for family member.
Health and social care:
Public universal healthcare (with
moderate user fees).
Home care and residential social care
services (with moderate user fees).
Variable, discretionary carers’ services
such as short-term respite care (with
moderate user fees).
State involvement:
Carer Allowance.
Job Alternation Leave Benefit.
Special Care Allowance (during
treatment of a child).
Disability Allowance (to parents of
leave.
Health and social care:
Healthcare system (with 30% user fees).
Early intervention support services.
Nursing care at home.
Short-term hospitalization.
Day service for disabled children.
After school care service
Specialist medical care.
State involvement:
Family Care Leave Supplement (through
unemployment insurance, for carers with prior
employment record only).
Special Child Rearing Allowance.
Welfare Allowance for Children with Severe
Disabilities.
Income tax allowance.
LAs to co-operate with NGOs on
respite/carers’ services.
Health and social care:
Variable, discretionary LA-funded
carer services (respite, training,
support groups, counselling,
information).
Universal insurance- funded
healthcare (NHI) system.
State involvement:
Income tax allowance.

7. 7
under 16-year-old disabled children to
support care at home).
families/c
ommuniti
es
involved
for
making
change
The Central Association of Carers in
Finland
 exists to improve the status of
families in care situations
 is for carers and their loved ones,
local associations and citizens
The Central Association of Carers in
Finland is an advocacy and support
association for carers and care receivers.
Japan’s 1998 Promotion of Specified
Non-profit Activities Act enabled eligible
non-profit organisations to become legal
entities. After LTCI system established in
2000, the Services and Supports for Persons
with Disabilities Act was enacted in 2006(the
Comprehensive Support Act for Persons with
Disabilities revised in 2012), many grassroots
voluntary organisations became non-profit
organisations (NPOs) and began to provide
services. Profit organisation also began to
provide services. NPOs and Profit
organisations growing rapidly. NPOs supply
employment support for employment for
persons with disabilities and day services for
children with disabilities.
NPO services share small – less than 16% –
role of private and quasi-public welfare
organizations); POs share over 57% for
In-home LTC (home help) and Home-visit care
for persons with severe disabilities (MHLW ,
1. TAFC-- Taiwan Association
of Family Caregivers established in
1996
-first voluntary group working for
the rights of carers;
-Campaigning on carers’ issues
began in 2010;
-by 2011, 10 branches;
- campaigns on 4 main issues: one
day a week respite for family
carers; paid family care leave;
inclusion of family carers in the
forthcoming LTC Services Act
(drafted in 2011); and economic
security for carers.
-TAFC and 26 other NGOs have
established a ‘LTC Coalition’ to
monitor the government’s design of
its planned LTC scheme: universal
LTC services to meet the needs of
care recipients and family carers;

8. 8
2011)
More recently, informal internet support network
groups managed by working mothers with disabled
children growing up, peer supporting or information
resources--Internet network groups will be much
more accessible than the support programmes for
carers organized by the national-wide and traditional
carers’ associations.
LTC inspection and ombudsman
systems; and family support
services; argued for domestic and
‘live-in’ migrant care workers, with
appropriate training, to be
integrated into Taiwan’s LTC
system
2. Woman groups involved
currently
future
challenge
s for
parental
carers of
disabled
children
1.Development of temporary care and
ensuring sufficient financial support for
formal and informal carers. It is also
important to develop peer support,
occupational health service for carers as
well as guidance and counseling.
2. A structural point is that it is
inexpensive to care disabled persons at
home. However, at the same time, family
carers’ situation is not so good, as they
often are displaced from labour markets
and their incomes are quite low.
3. Prolonged responsibilities of family
care when disabled children grow up.
1. To formulate new policies emphasising the
need for positive attitudes to flexibility in
the workplace and raising disabled children.
2. Policies need to support children’s
independent lives in the community, with
formal or informal resources available to
them and their families.
3. Parent-carers need the chance to choose a
working style which suits their caring
circumstances, which means providing a
special subsidy for children with disabilities
to ensure their financial security.
1. Aware of the needs and
well-being of parent-carers-- social
services available
2. Supporting parents/mothers--
paid work & reconcile paid work
and care—paid care leave available
for parents of disabled children
3. Reducing the cost of day care
4. Universal family subsidy

9. Note: All data are based on the book, Chapter 1, 2, 8 and 12: T. Kroger & S. Yeandle (Eds.) Combining paid work and family care: Policies and
experiences in international perspective. Bristol: Policy Press.
9