Beyond Dyadic Care: Ethnographic Insights into Community-Based Care Practices in Japan

This study transcends the traditional caregiver–care receiver dyad by examining how care unfolds within complex relationships in Japanese communities. Utilizing ethnographic methodologies, we explore how the meaning of care is shaped and transformed across multiple local contexts, revealing how care practices adapt to different social and cultural settings.

Japan illustrates these dynamics, particularly its increasing focus on community-based care systems amid an aging population. A notable example is the Toyama-style daycare service in Toyama Prefecture—a unique model that welcomes all community members, including the elderly, disabled, and children. For instance, one center supported a resident with mental health challenges who frequently engaged in confrontations. Rather than exclusion, the center established a space where various participants—not just care workers—could come and go, instilling a sense of community and shared responsibility. This inclusive environment allowed community members to interact organically, fostering relationships where even conflicts between staff and residents became part of an evolving dialogue, transforming the meaning of care. Remarkably, this approach extends beyond a single facility; multiple centers collaborate to share responsibility and knowledge, offering cohesive care across the region.

Ethnography was essential in capturing these complex dynamics, allowing us to observe interactions not just from the perspectives of individuals or caregivers, but within the larger communal 'space' where relationships evolve among diverse participants. This immersive approach uncovered nuanced, context-specific meanings of care that conventional sociological methodologies might overlook. Our findings highlight the limitations of current institutional care models, particularly their rigidity and lack of adaptability to individual needs. This study suggests that embracing community-based relational approaches can inform more effective health policies by shedding light on these overlooked realities. Our study contributes to a deeper understanding of care practices in health sociology and emphasizes the critical role of qualitative methodologies in uncovering such insights.