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Paper short abstract

Japanese older adults’ reluctance to “cause trouble” and their self‑perceived burden reflect both concern for others and negative self‑evaluation. This presentation analyzes literature to clarify the diverse meanings behind these sentiments.

Paper long abstract

In Japan, it has frequently been observed that older adults and patients express a desire not to “cause trouble” or “be a burden” to their family members or caregivers. Such feelings are often conceptualized as self‑perceived burden (SPB). Previous studies have pointed out that these sentiments are associated with existential distress and psychological strain, and may negatively influence communication, help‑seeking behavior, and acceptance of necessary care. However, the feelings expressed by Japanese older adults and patients when they say they “do not want to cause trouble” or that it is “painful to burden others” are not uniform; rather, they encompass a wide range of meanings shaped by cultural, relational, and personal contexts.

　In some cases, this desire not to cause trouble reflects genuine concern or consideration for the physical, financial, social, or emotional burden they believe they impose on others. Individuals may worry that their illness, disability, or need for assistance creates hardship for family members or caregivers, and this concern may motivate them to restrain their requests for help. In other cases, however, the sentiment carries a more self‑directed, negative evaluative meaning. This includes issues related to independence and dependence, autonomy and heteronomy, perceived social roles, self‑worth, shame, indebtedness, and a sense of inequity or imbalance in relationships. For some individuals, the feeling of “being a burden” is closely tied to their identity and their understanding of what it means to maintain reciprocity within family relationships.

　Clarifying the diverse meanings embedded in the desire not to cause trouble is essential for determining how best to support older adults and patients who hold such concerns. Without understanding the underlying significance of these expressions, responses from caregivers or family members may fail to address the individual’s true needs or sources of distress. This presentation aims to elucidate the characteristics of these meanings by conducting a literature‑based examination of how Japanese older adults and patients understand and articulate the feeling not to be a burden, as well as how SPB has been conceptualized in existing research.