Squeezed between the demands of their jobs and the demands of taking care of aging parents, many middle-aged Taiwanese workers are desperate for a sound long-term care system that has yet to materialize.
The arrival of an aging society will soon put many Taiwanese workers between the ages of 40 and 60 in a bind, if they aren't feeling the squeeze already.
At a time when this segment of the population should be starring in the workplace and, with their children grown, no longer having to face changing diapers at all times of the day, a formidable challenge looms: figuring out how to care for parents who may be sick, incapacitated or suffering from dementia.
"Everybody I know is in the same situation, older family members having problems one after the other. We often see people get pulled out of the workforce," Shu-Lan Chen, secretary-general of the Social Enterprise Development Association, says somberly.
Whenever Chen gets together with her friends, the first question they ask each other is, "How are your parents doing?" Over the past two years, she says, she has run into many outstanding professionals in their 30s and 40s who gave up good jobs in the private sector to work for nonprofit organizations, almost invariably so they could take care of their parents.
The responsibility for elderly care in Taiwan is increasingly falling on the shoulders of individuals and families, creating heavy demands from both work and family that are squeezing the vitality out of middle-aged salaried workers and leaving them in a perpetual state of anxiety.
Chen-fen Chen, president of the Taiwan Association of Family Caregivers and an assistant professor in Chinese Culture University's Department of Social Welfare, had just returned from an overseas trip the night before her interview with CommonWealth Magazine. On the day of the interview, she got up early to take her father, who has worked in China for many years, to the hospital for a check-up.
Chen's 67-year-old mother, who lives alone in central Taiwan, is healthy and can take care of herself, but Chen, who lives in Taipei in northern Taiwan, heads to Taichung to see her mom every weekend and calls her every day just to see how she's doing.
Want to Trade Caregiving Duties?
"In Taiwan, people like me who have had to leave their hometowns to work but can't stop worrying about their moms back home are probably not in the minority. Would you be willing to trade caregiving duties with me?" Chen wrote in her blog, highlighting the importance of a support network.
She is planning to work with a large-scale dating website this summer to study how to build a mutual support website similar to "Share the Care" in the United States that connects people with caregiving needs in different locations.
Caregiving duties are no longer solely limited to women. Taiwan's plunging birth rate has meant that men have no choice but to assume some of the responsibility.
One such example is 45-year-old Liu Heng-an, who waved goodbye to a nearly 20-year professional career in Taipei to return to Jiayi to take care of his octogenarian parents. He now lives in the same apartment building they do.
Liu's mother has advanced dementia, and half of her body is paralyzed. Because of major changes in her condition, the family has already been through three foreign caregivers. Liu's father, though healthier, has a degenerative knee condition that makes it hard for him to get around, and he still needs to be looked after from time to time.
"In the year before I returned, I was really conflicted," recalls Liu, who is not married. After returning to Jiayi and being with his parents, he was shocked to find that the situation was far worse than he had realized from his short visits home previously.
Still able to clearly remember snuggling up to his mother and playing by her side when he was young, Liu has had a hard time reconciling the fact that his mother no longer recognizes him and cannot speak, her entire being totally different from the past.
"How did my mother change into a completely different person? There was a time when I was depressed and I had to overcome the psychological impact," Liu says, choking up as he speaks of his mother.
In making his transition, Liu has also come under heavy financial pressure. After earning NT$70,000 a month in a steady supervisory position in Taipei, he now drafts advertising copy for real estate developers, earning only one-third to one-quarter of what he used to. When Liu first got started, he was depleting his savings because of the lack of steady jobs, putting him under a lot of pressure.
"I had real doubts in my mind because I didn't know how long I'd be able to (write advertising copy)," Liu says.
Though his workload has since picked up, Liu says he now just goes with the flow and leaves things to fate, a far cry from his attitude of the past, when he strove for precision and efficiency in his job, and expected to get out of his work whatever he put into it.
Cases like Liu's, where men are forced to shoulder the burden of care, are becoming increasingly common. According to figures from the Taiwan Association of Family Caregivers, men now account for 30 percent of all caregivers, up from 20 percent in the past.
An aging society and declining birth rate are nudging Taiwan's population structure closer to a dangerous precipice, threatening its economy and productivity. Saving the workforce has become an urgent concern.
To counter the threat, Taiwan most urgently needs to establish a viable long-term care system that allows working-age members of society to be productive.
"Long-term care and elderly care have to be dealt with. Otherwise, it will drag down the next generation," Shu-Lan Chen insists. Though no statistics are available to document the depth of the problem, private social welfare groups estimate that there are at least 900,000 family caregivers in Taiwan, many of whom have quit their jobs to live at home as full-time caregivers.
At present, many families rely on foreign caregivers, mostly from Southeast Asia, to look after their elderly loved ones. But as emerging countries in the region become more prosperous, the flow of migrant workers they have provided is already starting to dry up.
"The number of foreign workers has begun to decline, and the waiting time to get a new caregiver has gotten longer," says Hsin-Ning Tu, president of the Taiwan Home Service Strategic Alliance. In the past, Tu says, a foreign caregiver could be found in two weeks but now the wait is generally five to eight months.
Europe and the United States have begun to take notice of the adverse effects caused by productive members of the workforce leaving or changing their jobs to take care of elderly family members.
A report for Public Health England released in early May by the Centre for Economics and Business Research found that dementia caring obligations cost English businesses 1.6 billion pounds (about NT$83 billion) a year, with 50,000 people in England expected to quit their jobs in 2014 to care for relatives with dementia and another 66,000 expected to make significant adjustments at work.
Care Issues and Productivity
Companies overseas are also introducing flexible work hours, allowing employees to work from home, offering paid family care leave, and hiring psychological consultants to help employees deal with the stress of caregiving responsibilities and enable them to find a balance between doing their jobs and caring for their parents.
Not so in Taiwan, where only a small minority of Taiwanese companies have gotten into the act and policies are urgently needed to encourage businesses to foster friendly workplace environments.
When CommonWealth Magazine contacted several large local and foreign companies operating in Taiwan and asked them if they have introduced measures similar to those promoted by companies abroad, the response was overwhelmingly negative.
"It would be a win-win system," says Chiu Yi-chia, the head of National Chengchi University's Graduate Institute of Technology, Innovation & Intellectual Property Management. He believes that if companies help employees in their time of need, the employees will repay the investment many times over.
What is clear is that the public and private sectors are not adequately prepared to cope with the onset of an aging society. Caring for the elderly until they die is more than just the responsibility of their children; it's a national obligation.
Finding solutions to help middle-age workers maintain peace of mind and remain productive in the face of caregiving responsibilities can only be addressed by a coordinated effort by the government, society and the private sector, preferably sooner rather than later.
Translated from the Chinese by Luke Sabatier