Licensing and training requirements for direct care workers in Japan: what can the United States and Japan learn from each other?

Shortages of direct care workers have been of concern both in the United States and in Japan. This article compares issues surrounding long-term care provisions in the two countries and introduces Japan's unique licensure and certificate system for direct care workers. Japan has established three levels of direct care worker certificates and a direct care licensure, which can be potentially used as a career ladder. Studies show that this system has resulted in different work conditions and benefits between different certificate and licensure levels but had a limited impact on hourly wage and task differentiation. Implications for the United States are also discussed.