[Shadow of Care Work] "Each Is Each Other's Perpetrator"... To Break the Vicious Cycle of Abuse

Experts point out that the relationship in which the elderly and care workers violate each other's human rights was a foreseeable problem. In a situation where the demand for care workers is expected to surge, the government has been negligent in establishing legal systems for care workers.

The lack of professionalism among care workers leads to elder abuse, and these workers themselves continue to leave the care industry due to the harm they suffer from the elderly. To break the vicious cycle of abuse, a comprehensive reform of the care labor system at the government level is urgently needed.

[Image source=Yonhap News]

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Within the care industry, voices are calling for significantly strengthening the qualification requirements for care workers beyond the current level.

Japan, which entered a super-aged society over 20 years ago, requires care workers to complete more than five times the education hours compared to Korea. To qualify as a 'Kaigo Fukushishi' (care welfare worker) working in elder care in Japan, one must either complete more than two years (1,800 hours) of education at a vocational school after high school or graduate from a welfare-focused high school.

The practical training hours are also noticeably longer compared to Korea. The mandatory practical training hours for care workers regulated by Japan's Ministry of Health, Labour and Welfare total 450 hours, which is 5.6 times that of Korea's 80 hours. The professionalism of care workers is determined by how many diverse patients they have encountered during practical training. The more cases they experience, the better they can flexibly respond to the unexpected behaviors of elderly patients in the field.

On the other hand, in Korea, care worker training facilities are heavily focused on theory education aimed at obtaining certification. Kwon Tae-yeop, president of the Central Association of Elderly Welfare, stated, "Care workers learn to handle various symptoms of dementia during practical training, such as patients shouting loudly or just hugging dolls, and they learn response scenarios for these cases," emphasizing, "Strengthening dementia education and focusing on practice-based training rather than just passing certification exams will help care workers adapt well to the field without confusion."

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Measures to enhance the professionalism of existing personnel must also be established. In Japan, care workers are classified by their level of professionalism, with different work authorities assigned accordingly. For example, 'home helpers,' who are home care workers, at the entry-level (Level 2 home helper) who have completed 130 hours of training can only perform general caregiving tasks. To be promoted to a practical worker level who can supervise the field, they must complete 450 hours of care training.

Successful promotion results in a significant wage increase. As of 2022, the average annual salary for practical workers was 3.97 million yen, approximately 35.49 million KRW, which is 10.2% higher than the entry-level salary of 3.6 million yen. This is a government incentive encouraging care workers to develop their professionalism.

The Ministry of Health and Welfare also recognizes the need to cultivate professional personnel and plans to introduce a care worker promotion system starting this October. Care workers who have worked for more than five years at facilities with 50 or more employees will be assigned senior roles and take on additional tasks such as beneficiary case support and trainee education. These workers will receive an additional monthly allowance of 150,000 KRW.

Working conditions are also cited as essential requirements that the government must improve to prevent elder abuse.

Experts suggest that introducing a two-person team work system for high-risk patients could be a solution. The Ministry of Health and Welfare established safety guidelines for care workers in 2021, recommending the deployment of two care workers for high-risk patients, but private care facilities do not follow this manual due to financial issues.

Seok Jae-eun, professor of social welfare at Hallym University, advised, "It is possible to consider dispatching care workers in pairs for high-risk elderly patients," adding, "In this process, the managing organization, the Corporation, should observe and classify high-risk patients and mediate between facilities and users."

There are also calls to increase the number of personnel deployed on-site. To reduce care workers' fatigue and guarantee break times, it is argued that the staffing ratio should be raised from one care worker per 2.5 beneficiaries to a long-term goal of one per 2 beneficiaries.

The government strengthened the staffing ratio from one per 2.5 beneficiaries to one per 2.3 beneficiaries in 2021, but industry experts say they have not felt the shortage of manpower improve. President Kwon pointed out, "Since 2021, the number of statutory holidays has increased. In fact, the shortage has only been filled to match the increase in workers' holidays," adding, "When a small number of workers care for the elderly, it inevitably leads to a decline in service quality."

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However, the supply of care workers is also severely insufficient to realize these alternatives. As of last year, about 2.52 million people obtained care worker certification, but due to poor working conditions, many have left their jobs. During the same period, only about 600,000 care workers were active in the field, accounting for just 24.1% of the total.

Experts emphasize that improving working conditions must be concurrently addressed to solve the manpower supply problem. Improving the working environment for care workers is ultimately linked to wage issues.

Choi Hye-ji, professor of social welfare at Seoul Women's University, said, "The imbalance in care worker supply and the lack of quality service mostly stem from low wages," expressing concern, "If left to the market as it is, it will be difficult for care workers' wages to rise above the minimum wage." She stressed, "A standard wage system for care workers should be introduced to establish a kind of wage table for them."

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