Even though ageing is the common challenge in many countries of Asia, many developed countries recruit foreign workers at home and institutions. 700,000 domestic workers are employed in small islands of Taiwan, Hong Kong and Singapore, half of whom engage in either elderly care or care for the disabled. However, challenge is not merely limited to the number of workers towards the future but level of care to be provided corresponding to the increasing number of chronic diseases, dementia or cancer patients. Probably current trend of hiring domestic workers without any proper training will not meet this demand in the future. However, this under-qualification of care skill problem is not easy to change unless establishing human resource development program in both sending and receiving countries. Thirdly, many nursing homes recruit overseas nurses as care workers to meet the demand for higher care skills, which results in over-qualification or deskilling of nurses. The over-qualification may cause further shortage of nurses in Asian region. This under-qualification and over-qualification show absence of equivalent care concepts in sending countries. This may put question on future sustainability to care not only quantity of care workers but also quality of care. Considering sending countries rapidly age, this project takes the issue as common regional challenges and the project considers the possibility of harmonization of care skills within multilateral framework with collaboration with multi-stakeholders from Japan, Taiwan, Singapore, Philippines, Indonesia and Vietnam. 

The followings are the main findings of the program. In the process of international mobility of elderly care, conceptual difference of care and skills gap of migrant care workers between sending and receiving countries are evident. Skills gaps are in the form of under-qualification with more than 700,000 domestic workers and of over-qualification with nurses recruited as care workers, which shows absence of care concepts of elderly care. Considering declining labor force among the region, optimal allocation of human resources is prerequisite through institutional harmonization. However, due to religious, ethnic, disease transitional, institutional diversity in the region, harmonization of care concept is not easy. Furthermore, care has multifaceted phases including medical, physical, household work, spiritual, rehabilitation, end of life and so forth. Therefore, Kaigo in Japanese referred within Long Term Care Insurance is one of the phases. Therefore, diversity of Asia and multi-faceted nature of care are constraints of the conceptualization and harmonization. However, Japan can learn from the experience of other Asian countries from the diversity. Considering increasing mobility, harmonization is indispensable and becomes policy agenda in the region.