Core Viewpoint - The increasing demand for care services for elderly individuals with cognitive impairments in China is addressed by the newly implemented national standard for care institutions, which aims to provide standardized operational guidance for the care of these individuals [1][3]. Group 1: Standardization and Guidelines - The "Guidelines for the Care of Elderly Individuals with Cognitive Impairments" were developed by the State Administration for Market Regulation and the Ministry of Civil Affairs, providing a comprehensive "standardized operation manual" for care institutions [3]. - The standard outlines principles for service provision, including service assurance, content, risk management, and personnel configuration, addressing the previously inconsistent understanding and operational levels among care institutions [3]. Group 2: Care System and Integration - The care system aims to extend services beyond institutional walls to communities and families, creating a comprehensive service system that includes education, assessment, early intervention, institutional care, community extension, and family support [5]. - The new standard emphasizes the need for care institutions to focus not only on basic living needs but also on psychological, social, and spiritual needs, promoting independence and participation among the elderly [6]. Group 3: Care Principles - Key principles highlighted in the standard include respect and understanding, integrated care, support for independence, environmental friendliness, and safety protection, with "support for independence" and "integrated care" being the two core highlights [8]. - The principle of "support for independence" encourages the recognition and utilization of the existing abilities of elderly individuals, allowing them to perform tasks within a safe range, thereby maintaining their dignity and autonomy [10]. Group 4: Non-Pharmacological Interventions - The standard introduces "intervention for psychological and behavioral symptoms" as a core service content, prioritizing non-pharmacological interventions to address the emotional needs of elderly individuals [13]. - By employing non-pharmacological interventions, care providers can effectively soothe the emotions of elderly individuals, reduce suffering and oppositional behaviors, and significantly lower the use of psychotropic medications, ultimately enhancing their quality of life [13].

Core Viewpoint - The article highlights the alarming rise of "self-reliance support" institutions in Japan that, under the guise of helping "hikikomori" (social recluses), engage in illegal confinement and human rights violations, raising serious ethical concerns about their practices [1][8]. Group 1: Social Context - The term "hikikomori" refers to individuals, particularly aged 15 to 39, who isolate themselves from society, with approximately 1.46 million in this age group and an additional 613,000 aged 40 to 64, indicating a growing societal issue [2][4]. - Factors contributing to this phenomenon include mental health issues, academic pressure, workplace bullying, and a narrow societal definition of success, which creates immense pressure on young people [6][7]. - The traditional family structure in Japan often leads to a disconnect between parents' expectations and children's desires for self-fulfillment, resulting in parents supporting adult children financially, contributing to the "8050 problem" [4][7]. Group 2: The Role of "Pull-Out Houses" - "Pull-out houses" exploit parental anxiety about their children's future by promising to help them reintegrate into society, often through coercive means, including forced removal from homes [8][15]. - These institutions often charge exorbitant fees, with one center claiming a 95% success rate in employment within six months, which appeals to desperate parents [15][16]. - The methods employed by these institutions include confinement, restriction of communication, and even threats of institutionalization, raising serious ethical concerns about their operations [10][11][17]. Group 3: Consequences and Public Response - The negative outcomes of forced removal can exacerbate psychological trauma and family conflicts, counteracting any potential benefits of the so-called support [17][18]. - High-profile cases, such as the tragic death of a young man in a facility, have sparked public outrage and legal actions against these institutions, leading to increased scrutiny of their practices [13][14]. - The article suggests that genuine support for "hikikomori" should focus on understanding and gradual reintegration rather than coercive measures, emphasizing the need for compassion and patience from families [18].