Wednesday, December 5, 2012

Japanese Direct Support/ Privacy and Confidentiality

I am in Japan for a family medical emergency. My mother-in-law, who is Japanese, is in the hospital and we needed to come immediately to be with her.  In my experience at the hospital over the last few days I have witnessed lots of direct support "moments" in a Japanese light.  The support I have been observing is more medical than not but still it is a variation of direct support worth noting. A few reflections about confidentiality and privacy;

The Japanese are incredibly modest people.  Maybe we can take some direct support lessons from this cultural value...

In a moment of intimate care, I observed the steps and care for confidentiality and promoting physical and emotional well-being made by her direct support assistant.  This direct support professional ensured my mother-in-law was treated respectfully and privately as she shares a room with 5 other people and uses a commode next to her bed.  I happened to come back into the room well before my mother in law was completed and the DSP was clearly and adamantly not allowing me back in her bed space or near her until  all was finished.  The DSP stood "sentry" with her and also assisted with all those important details associated with cleaning up and sanitizing following the personal "event".  This person was very respectful to me but was putting her allegiance with my mother in law first. Even as a close family member, I was told that I was not welcome back until the scene was dignified, safe and respectful for everyone, mostly my mother in law who was in a very compromising and private moment in an EXTREMELY public setting.

This may sound that it is not such a unique thing....well, I have spent LOTS of time in hospitals as a social worker and family member.  At least in my experiences, privacy is often unheard of. Curtains and doors exist but seemingly in most hospital environments in America one can be sure to be seeing all sorts of intimate things happen.  Heck, why do we even have those federal HIPAA Laws??  Well, some of the rationale for HIPAA is to prevent medical personnel from blabbing about patient's private health matters in public settings i.e.; hallways, waiting rooms, shared spaces, documentation, etc.....confidentiality is precious.  We lack it big time in our culture comparatively to the Japanese. And, in situations beyond a hospital setting, whether a group home or a setting that hosts people with disabilities in some congregate way, I have time and again been confronted with situations whereby professionals disregard the privacy and confidentiality of those they are serving.  I could devote an entire blog to that theme!

This one small interaction with a Japanese Medical DSP was illuminating in regards to the culture here but more-so was a validation for me about the power and efficacy of confidentiality as an ethical obligation and a best practice. This should be the case anywhere. Thanks for that brief moment with a dedicated professional in a Tokyo hospital I was reminded of the importance of this value and ethical code.

Here is a snapshot from the hospital in Tokyo, Japan where I am spending some important time with my family. Please note my wife, mother in law and daughter.  My daughter is the budding future DSP in the lower right corner of the picture assisting her grandmother with some artwork activities.

I will be observing more Japanese "DSP stuff" and will be sure to report to you more before I leave if I get the opportunity.  But as I said before,  I am here based on some serious developments in my mother in law's health so, of course, that must come first.  Please keep us in your thoughts.   More soon!!


  1. :) (smh) There is a man true to his calling,using his own life experience as example- your family/heritage you married into, your surroundings, outside of DD and "our" culture- managing to intertwine all into this one blog article. Good luck with everything! Hopefully all goes well and we hear from you stateside soon, but you enjoy your visit while you can, of course. :)

  2. Sending healing light over land and water to your family. - Ronni