8
Management and Residents: Communication Failure

In earlier chapters, we have shown the process of social and demographic change affecting the elderly. We have followed the complex and often confusing path of the development of institutional living for senior citizens. Against this background, we are almost ready to move to our main task: the description and explanation of social life at Fuji-no-Sato. First, however, we must deal with one more aspect of the wider social context within which our subjects' lives unfold, an aspect of the new phenomenon of Japanese retirement housing that has not yet been well understood by the Japanese themselves: cultural beliefs and expectations about "welfare" as it applies to the care of the aged. A lack of clear concepts that can guide expectations—specifically, the expectations that management and residents have of one another—has caused serious friction.

Fuji-no-Sato is an example of what we earlier defined as a "life-care" retirement community—a facility that provides, through a type of entrance contract, both living units specifically designed for the needs of the elderly and skilled nursing care for the duration of the resident's life. The relationship between Fuji-no-Sato and its residents is determined to a large extent by the terms of this contract. We have pointed out that the meaning of the word "welfare" (fukushi ) is changing for the Japanese, and it is understood differently by different sets of users. The fact that the builders of this community advocate something called "new welfare" for middle-income people on the face of it does not clarify the situation, nor does the use of a new piece of industry jargon, keiyaku fukushi , which means "contract welfare."

"Contract welfare" really has no exact standard meaning. Its important connotations are poorly understood by the Japanese in general and the residents of Fuji-no-Sato in particular. The words "contract" and "welfare" have specific social meanings of their own

for the Japanese, but when they are combined to make a new phrase, that phrase at first lacks a clear and widely held set of associations of its own. It is ambiguous and subject to a wide range of interpretations. This terminology problem turns out to be far from superficial.

Soon after he began fieldwork, Kinoshita was surprised to hear strong criticism, sometimes even openly hostile remarks, from many residents about the community's management—those in the head office in Tokyo and the local director of the community. He was told with a sense of anger, disappointment, and betrayal about avoidable problems and inconveniences residents had experienced in the community. The management was at first bewildered by this criticism. Certain senior staff in Tokyo and some local management people, including the director, looked on the more outspoken residents as too demanding. The management felt that their own good intentions and strenuous efforts were not understood or credited.

To some extent, this problem set the stage for much of the social life we shall soon be describing. We must begin, however, by analyzing the negative images held by the management and the residents of each other and the residents' uncooperative attitude, stemming from conflicting interpretations of "contract welfare."

The Residents' Perspective

In their relations with the management, the residents perceived four chronic problems having to do with the building design, the physicians, the director, and the "money-making management policy." These were seen as major problems by almost all the residents, although reactions varied from open agitation to silent resignation. Their collective perceptions that emerged around these problems reveal a good deal about what the residents had expected and what they emphatically had not expected from Fuji-no-Sato.

Building Design

There were two problems with the building structure: the noise of flushing toilets and the heat in the second floor units in summer. The drain pipes from the upstairs toilets run directly through the toilet room in the downstairs units. The pipes are visible, and when

the upstairs residents flush the toilet, the noise is very obvious to the residents in the lower units when they are using their own bathrooms.

There appeared to be three reasons why the residents perceived the noise as a major problem. First, the level and type of noise was unfamiliar to most of them. Japanese are used to other intrusive sounds, such as traffic noise, but not to this kind of sound. Although some other types of congregate housing in Japan have this architectural feature, most of the residents came from more traditional-style private houses. Drain pipes are usually hidden in the walls in such traditional housing. Second, the residents disliked the noise because it offended their sense of cleanliness—it was the auditory analog of visible human waste. Third, the problem occurred frequently. The elderly tend to use the toilet often, even late at night, when one most expects quiet and when, indeed, there are no other human sounds.

There was virtually nothing that the management could do to reduce this noise, because remodeling would have been too expensive. After much complaint, the director finally asked the residents not to flush the toilets during the night, with the result that meetings were held in several buildings and decisions made not to flush between about 10 P.M. and 6 A.M. But this was not completely satisfactory.

As for the heat problem, the buildings were constructed without air spaces between the roofs and the ceilings, so the sun raised indoor temperatures very noticeably in summer, and rooms did not cool off even during the night. Of course, this was desirable in winter, but the combined heat and high humidity in summer was, for many upstairs residents, difficult to cope with. Some said that on the worst days, the temperature would stay in the mid-eighties (Fahrenheit) all night. As a result, most of the upstairs residents had air conditioners installed at their own expense.

The management acknowledged the heat problem as a serious one and began at once searching for a solution. In May 1983, after a year of study, the management tried having special equipment installed on the roofs. According to tests, this should have lowered the temperature several degrees, but the residents' reactions to the renovation during the following summer were mixed. Some said there had been a marked improvement; others saw little difference.

The one thing they all agreed on was that it was good to see management finally respond positively to their problem. In their opinion, the problem had been management's responsibility in the first place.

In fairness to the management, recall that the planner had tried to make this community cheap enough for the middle-income elderly, setting guidelines aimed at an entrance fee within the range of the typical retirement bonuses of middle-income workers. Although the entrance fee was raised three times in four years beginning in 1982, the initial entrance fee still roughly meets this guideline. Better quality construction probably would have made this impossible.

This background reason was not well understood by the residents, partly because management had not made much effort to explain it to them and partly because the inconvenience of the outcome was more personal, concrete, and persistent than the abstract notion of equity that led to it.

Problems in the Clinic

Resident complaints related to the clinic were also of two kinds: the unavailability of the physician on Sundays and the general quality of medical help.

The residents saw a serious problem in the fact that no physician was on duty on Sundays. They expected that any medical emergency should be promptly handled, an expectation promoted by the sales brochure, which says, "A physician is always on duty in the community." A full-time physician was actually living in Fuji-no-Sato from Monday through Friday; and on Saturdays, either a cardiovascular specialist from a nearby hospital or a family physician from the neighborhood came. However, from Saturday afternoon to Sunday evening, there was no physician in the community. Starting in the spring of 1983, the neighborhood doctor agreed to be on call throughout the week, including Sunday, and there are also both community-based and city ambulance services for emergency transport to any of several hospitals within a thirty-minute drive. But because Fuji-no-Sato is relatively far from the center of the city, many residents were worried about the emergency response system.

The residents claimed false advertising. Their criticism on this issue stemmed from their perception that the claims of the sales

brochure were not being honored. The entrance contract does not state anything about the availability of the physician, only that the management undertakes to provide sufficient health care for the residents. But many residents made up their minds to come to Fuji-no-Sato largely on the basis of the brochure. Only a minority actually examined the contract before making the decision, and many are unaware of its terms, even after they have signed it and moved in. The residents admitted that the brochure is not a contract, but they felt betrayed, partly because they saw no reason to question its details and partly for other reasons to be discussed shortly. It did not help matters when, early one Sunday morning, a resident had a heart attack and died before a doctor could get there—an incident that reinforced for them the importance of the discrepancy.

The problem of physician quality arose from the difficulty of hiring a reliable doctor. The first full-time doctor quit after only seven months, and the one on duty during this study was the fourth in less than four years. The first doctor was seventy-five years old and apparently could not stand the work load. The second was sixty-three years old when she was hired, but she resigned after a year when she learned of the harsh criticism that some residents had made of her work. The third physician died at sixty-four after having served for seven months. The fourth physician came to Fuji-no-Sato in September 1981 and was still serving, aged seventy-two, at the time of this study.

Gender and age appear to be the main reasons why many residents did not think the clinic's physicians were reliable. In Japan, women physicians, except perhaps for obstetricians, are still viewed as less reliable than men, and this view appears to be held more strongly by the elderly than by young people. Dr. Miura, the current doctor, was not only a woman, but she was over seventy, having been hired by Fuji-no-Sato after she retired from her private practice as a family doctor in a large city. Dr. Miki, the part-time physician, was also old (seventy-four at the time of the study) and also a retiree who was persuaded by the director, Mr. Baba, to work for Fuji-no-Sato. Dr. Miki had been the director of a large general hospital in northern Japan, and he and his wife had come to the Izu Peninsula to spend their retirement years in a mild climate.

Generally speaking, the residents of Fuji-no-Sato had received better than average medical care before they moved to the community, and they undoubtedly expected at least a similar level of care

at the clinic. How they viewed the abilities of Drs. Miura and Miki could be seen in their reaction to Dr. Shimoda, a cardiovascular specialist. Dr. Shimoda would come to the clinic on the first and third Saturday of each month. In his mid-fifties, he was an authority in his field and the medical director of a large hospital. When Dr. Shimoda was on duty for three hours on Saturday mornings, an unmanageable number of residents would clamor for appointments. On average, the full-time Dr. Miura saw twenty-three outpatients a day, and the number dropped slightly when the part-time Dr. Miki came (second and fourth Saturdays). In contrast, at least fifty people were seen by Dr. Shimoda during each of his three-hour visits.

The competition to see Dr. Shimoda took place as follows: The order of appointments is determined on a first come, first served basis. Like any medical institution in Japan, the clinic issues a name card to each regular outpatient. This must be put into a box at the reception desk on each visit. Appointments follow the order in which the cards are deposited. This outpatient service is open between 9 A.M. and noon, and when Drs. Miura and Miki were on duty, residents came around 9 A.M. Dr. Shimoda was so popular, though, that residents began to come earlier and earlier, leaving their cards and going home until opening time. Finally, some were coming as early as 6 A.M.

According to some residents, the management was simply incompetent in hiring doctors, but this seemed to us unfair for two reasons. First, Fuji-no-Sato could not afford to pay more than an average doctor's salary, let alone enough to attract someone the residents would admire. It is nearly impossible to have a clinic of this size and type sustain itself economically, and the Fuji-no-Sato facility continuously operates at a loss. The second reason will be familiar to rural people throughout the world: The community is located in a remote resort area where few young doctors want to live and practice.

Meanwhile, many residents appeared to expect a level of care that is unrealistically high for a retirement community. The residents association demanded that the management get a physician in on Sundays and even that they build a kind of geriatric hospital—the kind that must have at least three full-time physicians and more than twenty beds. That the latter is totally unrealistic for Fuji-no-Sato was something nearly all the residents knew—including, of

course, the officers of the association. The association, however, stuck to its demand.

Several explanations seem likely for this unrealistic attitude. One is the better than average medical care most residents seemed to have been accustomed to on entrance. Another is the high priority given health care among the many attractions of Fuji-no-Sato and the encouraging information on this point contained in the sales brochure. Still another explanation is that the move to the community had the unexpected and upsetting effect of making it more difficult for some to get certain types of medical care. For example, Drs. Miura and Miki practiced only internal medicine, and the residents had to commute to outside clinics and hospitals for other specialties such as ophthalmology and orthopedics (although there are two dental clinics in the immediate neighborhood). Commuting is laborious for such residents because public transportation in the area is not well developed; in the summer, they have to take very early trains to avoid the tourism congestion. This last seems to be the chief reason behind the demand for a geriatric hospital. Lastly, the residents were not fully aware that acute medical care and long-term care are different, and they tended to misplace their concerns about future care in their demand for a better and larger acute care facility. This misperception is an easy one to have in Japan because the shortage of nursing home beds there has resulted in the use of acute hospitals for long illnesses. The average length of stay of elderly patients in Japanese hospitals in 1983 was eighty-eight days, as compared with eleven days in America.

In addition to hiring Dr. Miki, the management eventually responded to the residents' demands by building a new thirty-bed long-term care facility of its own.

Problems Concerning the Director

The director and the physicians are the most important staff people at Fuji-no-Sato, and it is not surprising that the continuity and competence of the directorship was also a major issue between the residents and the management.

The directorship had lacked continuity since the opening of Fuji-no-Sato. The first director was incompetent and was fired after only

six months. For about the next two years, there was no real on-site director, an executive board member in the Tokyo head office holding the title in absentia . During this period, a section chief from the central administration acted in the directorial capacity. This person, Mr. Baba, was eventually promoted to the permanent post.

Residents interpreted the absence of a director as a lack of interest in them on the part of the management, not only because of the position's importance but, more to the point, because this hiatus coincided with the period when the residents were pressing for solution of the other three problems.

The residents' evaluations of Mr. Baba as the director were mixed. He was forty-one years old during the study and had no previous experience in serving the elderly. In fact, he had worked as a salesman for the construction company that built Fuji-no-Sato before being hired by the management of the community.

Mr. Baba was an energetic person and enthusiastic about his work. "He's so energetic," residents often said. "He doesn't sit in the office all day. He leads the staff in their work. He is so versatile. He and the maintenance staff can fix all sorts of problems. They even built a nice barbecue grill in the yard." In addition, Mr. Baba was an excellent supervisor, particularly of the younger staff. He would spend a good deal of informal time with them, which in turn made it possible for him to mobilize manpower outside of regular tasks. When one task group had too much work, staff from another section would help, so that, for example, maintenance staff usually helped when unscheduled drivers or ambulance assistants were needed.

On the negative side, people said, "He is too young to be the director. He has no family and no university degree. He is too impatient to listen to us. He isn't making enough effort to understand our feelings. We would like to talk with him more. He's only concerned with making money from us, and he can't understand what 'welfare' is."

At forty-one years of age, Mr. Baba was divorced and had only a high school diploma. Although these attributes would not be serious drawbacks for an American director, they were important to the residents. Age and education are markers of both technical and moral ability in the Japanese worldview. The ideal image of a direc-

tor is a male in his mid-fifties or early sixties, a family man with at least a bachelor's degree. These criteria, lacking in Mr. Baba, would have indicated a mature man able to understand the residents' thoughts and feelings.

Maturity in this context means the ability to perceive nuances, to understand both what is said and what is left unsaid. The expression rojinno kimochi no wakaru hito —a person who can understand what old people feel—was repeatedly raised by residents when they talked about Mr. Baba. Kimochi , usually translated "feeling," is a difficult word to render accurately in English; it generally means both thinking and feeling in a much broader sense than either English word. To understand kimochi means to grasp the whole spirit, to understand a person in his or her totality. Their use of this phrase indicates that the residents wanted their director to be not only sympathetic, not only attentive to their feelings and problems, but also able to interpret and carry out their unspoken wishes. This is the essence of an ideal dependent relationship in Japanese culture (see Doi, 1973).

It was impossible for Mr. Baba to understand and respond to the huge array of spoken and unspoken wishes of the residents, many of which were mutually contradictory; to try such a thing would leave the entire management in disarray. He was very capable as a personnel manager and fiscal manager, areas wherein he had training, but he did not have the interactional skills needed to deal effectively with the residents. Because he was trying to be as sensitive as possible, he simply did not know how to respond to the criticism of insensitivity. It was not that he did anything particularly wrong, but he was seen as doing too little, if anything, to show understanding of the residents' kimochi .

The "Money-Making" Policy

A major criticism that the residents had of Mr. Baba and the management in general was what they perceived as a profit-making policy, which seemed to contradict the "welfare service" policy. For instance, the residents believed that Mr. Baba demanded a profit from the store in the community center, whereas it should have operated as a break-even service. The barber would tell the residents

that he had to give 10 percent of his fee to the administration, adding that he would prefer to give a 10 percent discount to his customers instead. And there were other accusations.

The perception of profit motive was an unfounded one, based on a serious misunderstanding about the principle of service charges. Although Mr. Baba tried to generate income from the shop, the barber, and other merchants who did business in the community, this income went into the operating budget of Fuji-no-Sato, helping to keep the monthly fee from being raised for four years. The misunderstanding was due to a lack of clarity about policy: whether the residents who use paid services should in so doing help subsidize the community or whether costs should come out of everyone's monthly fees. Fuji-no-Sato management had adopted the former policy without consulting the residents (a mistake, it seems) but later made efforts, largely unsuccessful, to explain its choice. Consequently, as other problems developed, the residents added their suspicion of this policy to what they thought of as evidence of profit-centered management.

The "telephone fee incident," as it is known by the residents, typifies the problem of misunderstanding and its consequences. It was an incident with major unfortunate effects on the thinking of both management and residents. Management perceived that their good intentions were totally misunderstood, and the incident more or less permanently cemented a negative image of the management in the residents' eyes.

As mentioned, Fuji-no-Sato has only one telephone trunk line connecting it with the outside, and all the phones in the community are extensions of this line—a system that has some advantages for the residents. The management initially charged the residents 30 percent more for phone service than the telephone company charged. No explanation of this rate was given the residents. After about two years of this, a resident who had worked for the phone company happened to discover the rate difference and brought the issue to the residents association. The association studied the issue, made inquiries to the phone company, and concluded that the additional charge was illegal. The association asked the management to stop this practice and to refund the extra that the residents had already paid.

Several mass meetings between the residents and the top staff of the Tokyo office were held, and the latter tried to explain the surcharge, which was paid into a fund to maintain the community phone system. Otherwise the residents would have to be charged a substantial fee for breakdowns. The attempted explanation failed because the residents were so convinced of management's wrongdoing—an interpretation that was supported by the phone company. In the end, the management gave in, dropped the surcharge, and refunded back payments. The residents rejoiced, thinking they had won justice. The refund was perceived as an admission by the management of its wrongdoing, and its image suffered accordingly.

Communication Problems Within the Management

Some of the these problems were caused by inexperienced administration. However, the management appeared to have good intentions toward the residents, and their response to such problems was positive and forward looking. Some problems, particularly in building design, have been avoided in the construction of their newer communities; and vigorous efforts have been made to explain the management system to the residents at these new communities to avoid similar misunderstandings.

It was perhaps inevitable that Fuji-no-Sato would have some of these problems, being a pioneer in the industry and something of an experiment. The managing organization itself was in a formative stage and experiencing communication problems among the staff. The head office in Tokyo was responsible for overall management, while the director was responsible for day-to-day community operation. Within the head office, there were communication problems between the Planning Department and the Administrative Department. Planning (1) proposed the "new welfare" philosophy for middle-income elderly, (2) formulated the sophisticated long-term management plan, and (3) supervised the actual architectural design and construction. But when Fuji-no-Sato opened, administration took on responsibility for running it while the Planning Department turned its attention to developing new sites. Administration staff apparently had not been properly included in the de-

velopment process and did not thoroughly comprehend the philosophy or the highly mathematical long-term fiscal plan. These administration staff were unable to explain the system to the residents' satisfaction. The residents saw this as evidence of incompetence in the head office.

Two policies conceived by the head of administration, although rational enough in themselves, had major negative consequences. First, he thought it was essential for Fuji-no-Sato to achieve full occupancy promptly if the community were to survive financially, and he therefore emphasized an aggressive advertising strategy. Promotional brochures that contained some slightly exaggerated claims were approved, a factor that contributed to a climate of mistrust. His second problematic policy was to focus on the "safe" financial management of the community and, without consulting the residents, to have the director generate as much extra revenue as possible. Intended to protect the residents' investment, this policy ended up being seen as evidence of greed.

Problems and Consequences of "Contract Welfare"

Given that some major problems at Fuji-no-Sato appear to have been caused by well-intentioned but inexperienced management, the residents' reactions may seem somewhat uncompromising, rigid, and unrealistic. A sense of betrayal, disappointment, and distrust of the management prevailed among them. They were highly intellectual people and generally aware of what the management could and could not do in a realistic sense. Why, then, did they continue to make unrealistic demands?

Meanwhile, the management was bewildered that its good intentions could not be seen by the residents. The staff admitted their mistakes and took action to correct them. But the senior staff complained privately that the more they did for the residents, the more strongly they were criticized. The director and others sometimes tried to discredit the residents association and some of its outspoken residents, portraying them as too demanding. Mr. Baba and the staff did not seem to realize that this made further communication with the residents difficult.

During the early years of operation, the relationship between the management and the residents was deadlocked, each side interpreting events so as to reinforce its negative image of the other. For both sides, the issue was one of good faith—of sincerity—unfortunately, something that was nearly impossible to measure. The residents saw their attitude toward the management as one of self-defense, having come to the conclusion that the management was not sincere. The management, too, saw a lack of good faith in the residents' harsh criticisms and demands. In order to understand what sincerity meant for both sides, we must first understand what each expected of the other; these expectations grew partly out of the Japanese meanings of the words "contract," "welfare," and "contract welfare." Clear explication of this linguistic problem will help reveal some of the culturally based problems of retirement communities and other forms of contract welfare in Japan.

Japanese Meanings of "Contract"

"Contract" means something quite different for Japanese and for Americans. Wagatsuma and Rosett (1983:2) summarize this difference as follows: "While in the American mind the function of a contract is to predetermine strife and trouble in the future, pre-define dispute, and enunciate rights, a contract in the Japanese mind is a symbolic expression or reflection of mutual trust that is expected never to break down and that will work favorably for both parties in case of future trouble. . . . [The] 'confer-in-good-faith' and 'harmonious-settlement' clauses reveal the basic nature of the Japanese contract." Thus, for the Japanese, a contract means far more than what is stated on paper. It is a ritual, establishing a new relationship and a mutual commitment to that relationship on the basis of mutual trust. Mutual trust is not possible unless both parties take the relationship seriously—that is, unless they are "sincere." Put another way, the American style of contract may be excessively cut and dried and "cold" for the Japanese because, although it may be based primarily on the mutual trust of two parties, it also takes into account their possible distrust in the future.

The contract offered by Fuji-no-Sato is no exception to the Japanese style. For instance, it has only one short item each on such

crucial issues as the management of the residents' health and their medical care:

Item 8: Health Management

The organization constantly monitors the health condition of the resident and provides professional consultations on health, and professional health checkups.

Item 9: Care

When the resident requires care due to illness, injury, or other reasons, and when the physician determines that care is necessary, the organization provides the necessary care at Fuji-no-Sato.

Although the contract is not specific, "care" in item 9 is taken to refer to both acute and long-term care and "the physician" to mean a physician on contract at Fuji-no-Sato, not other physicians. These items simply state goals and do not anticipate problem situations concerning the health management and medical care of the residents, There is no need for further specification because, like any contract in Japan, the Fuji-no-Sato contract includes the good faith and harmonious settlement clause at the end:

Item 35: Others

For issues not specified in this contract, and for interpretations of each item in this contract, both the organization and the resident, in accordance with relevant laws, will mutually confer and deal in sincerity.

Thus, both parties expect that the definition of health management and medical care, as well as whatever problems may arise in the future, are to be dealt with on an ad hoc basis and with mutual trust and sincerity.

Americans may be surprised that not one of the well-educated residents at Fuji-no-Sato was familiar with the terms of his or her contract. Many did not even bother to look at it. The residents felt there was no need to be familiar with its terms; they assumed they would be able to live at Fuji-no-Sato throughout their lives and would be taken care of in the community when they needed skilled nursing care as long as they were paying the monthly fee. The contract means to them the organization's commitment to these as-

sumptions in exchange for their payment of the entrance fee and the monthly rate.

Japanese Meanings of "Welfare"

On the one hand, welfare for the Japanese still means public support for the needy. On the other hand, it is coming to include public well-being—the welfare of a "welfare state." Both meanings are reflected in social policies, but the term has an underlying cultural dimension that distinguishes the Japanese and Western meanings. The Japanese use the expression fukushi no kokoro , "the welfare spirit," a phrase that denotes an altruistic devotion of welfare workers to their clients. This is a highly emphasized cultural value among the Japanese, particularly when the clients are destitute. For instance, if a welfare worker is a young woman, she is often referred to as an "angel," serving the needy out of true devotion, usually working under inferior conditions and pay. Her self-sacrifice for others has strong cultural support, being one of the core values of the Japanese. If the worker is a middle-aged man, the Japanese expect him to be a highly moral person because they assume that anyone who devotes his life to the well-being of others does so out of desire and must have superior qualities as well.

These images may reflect an earlier reality, but today they are often stereotypes and mythifications. Still, images are important. Because of them, the working conditions of many welfare workers continue to be poor. After all, such outstanding people should be able to endure hardship!

The residents of Fuji-no-Sato like the phrase fukushi no kokoro very much. They perceive themselves as the beneficiaries of the welfare spirit. Fuji-no-Sato is a "welfare community," and the sponsoring corporation has the word "welfare" in its name.

But the builders of Fuji-no-Sato advocate something called "new welfare," which they take to be different from the traditional welfare and which does not entail the "welfare spirit." For the management, the new welfare defines the relationship between the service provider and the recipient in terms of a contract. It is an equal relationship in which the recipient is expected to be an independent individual. In short, a wide gap separates the residents' and the management's understandings of the word "welfare."

Intrinsic Problems of Contract Welfare

The lack of consensus on interpretations of contract welfare was an important reason for the poor relationship between residents and management. This issue is part of a larger cultural and historical problem for Japanese society. Using Western, individualistic suppositions rather than traditional Japanese ones, the management assumed that its relationship with the residents was ultimately determined by the terms of the contract that the residents had freely signed. Residents were taken to be intelligent people who comprehended the nature of their relationship with the management and were independent enough to take responsibility for their part in it. Management's responsibility was taken to be finite and based on reciprocity.

But the management was at first not successful in communicating this new notion, and the traditional meanings continued to dominate the residents' thinking. This communication failure can be seen in the language of the contract used by Fuji-no-Sato. It is a typical Japanese contract that simply states the commitment of the management to certain goals, with the assumption that they and the residents will negotiate, with sincerity and mutual trust, the best possible solutions of unforeseen problems. It can be read in the traditional way, and there is no wording to clarify nontraditional intentions.

The strength of the residents' position vis-à-vis management derived from their straightforward use of the traditional meanings of the terms. They viewed the contract as a symbol of the management's commitment to their comfort, health, and long-term care. They expected that because the management would respond to future problems with sincerity, it could not do anything contrary to their wishes. This expectation was amplified by their view that the contract is not merely a guarantee of good faith, but a welfare contract: namely, a contract that guarantees the "welfare spirit" on the part of the management. In other words, they did not perceive their relationship with the management as an equal one at all, but thought of themselves as the recipients of altruistic services, the traditional dependent position vis-à-vis the service providers. They thereby gained a moral upper hand, emphasizing their weak posi-

tion and mobilizing moral rather than legal pressure. The residents' strength was further consolidated by their strong moral position as old people in Japanese society.

The residents, then, did not need to care too much about the terms of the written contract. Any information about Fuji-no-Sato, even the promotional brochure or a verbal explanation given by some staff member, was taken to be as legitimate as the contract itself, given the traditional "sincerity" interpretation. When they discovered that the management did not adhere to this assumed spirit behind what they had heard or read, the residents felt betrayed and became suspicious of all the management's motives. This suspicion grew through neglect and was seemingly confirmed when the management failed to respond satisfactorily to developing problems. The fatal blow to their trust was the imputed "money-making policy" because money making is exactly the opposite of the welfare spirit.

Once either side is convinced that sincerity has been lost in a relationship, its foundation has disintegrated, and it is extremely difficult to restore good faith. We believe this was the background of the residents' behavior, which had grown wary and demanding even to the point of irrationality.

This dilemma was just as much a hardship for the residents as for the management. The residents sought to exchange money for a kind of traditional, paternalistic goodwill. But can money buy the welfare spirit? Traditionally, devoted service by welfare workers was valued because its recipients were socially disadvantaged people; the welfare spirit was an altruistic spirit, directed toward the needy. The residents of Fuji-no-Sato are neither poor nor socially disadvantaged, but from a better than average social stratum. The question has a definite answer in Japanese culture: Money cannot buy the welfare spirit; it is an ethical value contradictory to the pursuit of money. The residents, who sensed this at some level, therefore felt uneasy in their self-righteous claims. They were not sure to what extent they could legitimately demand self-sacrifice in return for cash.

The very strength of the residents' logic on contract welfare, nonetheless, produced a kind of double-bind. The management felt they could not satisfy demands based on the traditional meanings of "contract" and "welfare" because such demands have no clear

limits and could result in bankruptcy. But their sincerity would always be questioned if they rejected these meanings. As part of their effort to explain their operating policies and restore good relations with the residents, the management proposed the idea that the residents should send a representative to the board of directors during these negotiations. The residents declined the offer.

The difficulty for the management can be seen when one realizes that culturally rooted meanings are very difficult to change and that such changes take a long time. Unless and until a new generally accepted meaning of "contract welfare" emerges, problems like this will persist, and the management of Fuji-no-Sato will continue to bear not only its legal responsibility under the contract, but also its social responsibility as a welfare facility in the traditional sense.