Home care provider Chen Yifang (standing at rear) visits Mr. Guo three days a week to prepare meals and tidy up. Mr. Guo's atrophied legs prevent him from leaving his home, so he is eligible for home visits by a doctor from a program run by the Taipei City Government. (photo by Jimmy Lin)

Growing old in one's own home is how we all hope to spend our golden years. Taiwan's social welfare policies, moreover, are crafted to enable the infirm to stay in the home. In addition, in order to reduce unemployment, efforts are being made to get more locals involved in long-term home care and curb burgeoning employment of foreigners for this purpose. But the effectiveness of any system, however well conceived, depends on the contributions of individuals. This is especially true in the case of home care, where the care provider and the care receiver need to work out a modus vivendi and treat each other with respect. Unfortunately, home care providers trained by the government are reluctant to actually take home care jobs.

Home care providers, nine in 10 of whom are women, have to deal unassisted with their incapacitated charges, and also to face the many unreasonable requests that family members put upon them. They have many a tale to tell, and the stories deserve our attention.

It is Monday, and the noon hour is approaching as a doctor and nurse from the family medicine division of the Yangming Branch of Taipei City Hospital make their way to an old, no-elevator, third-floor apartment just off Yanping North Road Section 6 to pay a home visit. They find themselves in a tiny 10-square-meter living room strewn with bric-a-brac that leaves no space for walking around.

They are at the home of an octogenarian named Mr. Guo, who is sitting on a plastic stool. A closer look reveals that the stool is nailed at the base to a wooden dolly. Mr. Guo's legs atrophied after he suffered a stroke, and since then he has lost the ability to stand. Instead of walking, he uses his arms to push and pull his way around the apartment.

His married daughter lives a few kilometers away in Dazhi, and only makes it back to see him on weekends. Otherwise, Mr. Guo lives alone and is cared for the rest of the time by a Ms. Chen Yifang, a home care provider from the Chinese Home Education Association (CHEA). The Taipei City Department of Social Affairs contracts out home services to the CHEA and 14 other non-profits, including the Eden Social Welfare Foundation, which employ a total of 400 care providers. All told, these organizations served 3,072 people in 2009.

Regulations require that after a person applies for home care service, long-term care specialists must do a home visit to assess the applicant's needs, and within 14 working days thereafter a long-term care provider will start coming to the home. However, "special" requests are sometimes made. The applicant may require that the provider be physically strong enough for the job, that they be able to speak Minnan, or that they always have lunch ready before noon, for example. One applicant even required that the care provider wash clothes only by hand in order to save water. Where special requests are made, it may take longer to find an appropriate person for the job.