Dignity and Independence of Older People: The Foundation of Kaigo Care

Human dignity & independence（人間の尊厳と自立）· Material

人間の尊厳と自立 · Updated 30 October 2026

The 人間の尊厳と自立 field is the foundation of all kaigo practice: every person has worth just as they are, has the right to decide their own way of life, and has the right to an ordinary life in the community. Questions in this field test whether the care worker understands concepts such as ノーマライゼーション and the ICF, and the legal systems that protect users' rights, such as the 成年後見制度 and abuse prevention.

Dignity and an ordinary life

Human dignity （人間の尊厳） means a person's worth does not depend on their abilities, age, or disability. In kaigo this means the care worker does not treat the user as an object of care, but as the subject leading their own life, and the user's own decisions （自己決定） are respected as long as they are not dangerous.

The concept of ノーマライゼーション (normalisation), born in Denmark from the ideas of Bank-Mikkelsen and developed by Nirje, holds that people with disabilities have the right to a daily pattern of life as close as possible to that of the general community — daily rhythms, housing, and ordinary activities. Its offshoot is インクルージョン， a society that excludes no one.

• 自己決定： the user's decisions are the starting point of support
• ノーマライゼーション： an ordinary life like the general community
• インクルージョン： no one is excluded from society

Independence and the ICF model

Independence （自立） does not mean doing everything alone; it means being able to live according to one's own wishes while using just enough help. Independence support （自立支援） must therefore be careful not to become 過剰介護 — excessive care that actually kills off the abilities that remain （残存機能）.

The framework is the ICF （国際生活機能分類， the WHO's International Classification of Functioning), which views a person's condition from three sides: body functions and structures （心身機能・構造）, activities （活動）, and social participation （参加）, all influenced by environmental factors （環境因子） and personal factors. Unlike the older ICIDH model, which ran in one direction, the ICF components influence each other in both directions.

• 自立支援： use 残存機能， avoid excessive help
• ICF: body functions — activities — participation, influenced by 環境因子
• The ICF is two-way, not a one-line cause-and-effect chain

Protecting rights: guardianship and consent

For people whose decision-making capacity has declined, the 成年後見制度 protects their rights and property through a guardian appointed by the family court. There are three levels according to remaining capacity: 後見 (the most extensive), 保佐， and 補助 (the lightest), in addition to voluntary guardianship （任意後見）, which a person arranges for themselves while still capable.

The care worker acts as an advocacy supporter （アドボカシー）: conveying the wishes of users who find it hard to express their opinions, making sure services are provided only after explanation and consent (informed consent), and protecting the confidentiality of users' personal information as a professional duty.

• 成年後見制度： 後見・保佐・補助 according to remaining capacity to judge
• アドボカシー： voicing the user's wishes
• Services begin with explanation （説明） and the user's consent （同意）

Preventing elder abuse

The elder abuse prevention law （高齢者虐待防止法） recognises five forms of abuse: physical （身体的虐待）, psychological （心理的虐待）, sexual （性的虐待）, financial （経済的虐待， for example using an older person's money without permission), and neglect of care （介護の放棄・放任， or ネグレクト).

Anyone who finds an older person suspected of being abused must report it （通報） to the local municipal government, and the reporter's identity is protected. A frequent risk factor is exhaustion and heavy burden on family carers, so supporting family carers is also part of prevention.

• Five forms: physical, psychological, sexual, financial, neglect
• Suspected abuse → mandatory 通報 to the local authority
• Support family carers to prevent abuse

Key terms

Frequently tested points

• ノーマライゼーション was born in Denmark (Bank-Mikkelsen) and developed by Nirje in Sweden.
• The ICF assesses participation and environmental factors, not only body-function impairments.
• Excessive care （過剰介護） contradicts 自立支援 because it extinguishes 残存機能.
• Using an older person's money without permission counts as 経済的虐待， and suspected abuse must be reported.

Independent study material for the Japanese national Certified Care Worker exam (介護福祉士国家試験). Official terms and rules may change — always cross-check with the latest official sources.