In 1997 and 1998 the then Ministry of Health and Welfare issued guidelines concerning the appropriate use of katakana. However, the vocabulary employed in the Long-term Care Insurance System adopted in 2000 is still noticeably rich in katakana expressions. Using questionnaires and interviews directed at both the elderly and at long-term care service workers, I have attempted to assess to what extent katakana expressions are used toward the elderly and to what extent they are understood. The following findings were made: I) When long-term care service workers are talking to their clients, regular katakana expressions are indiscriminately mixed with katakana abbreviations, lexical explanations of katakana, and improvised paraphrases based on the particular circumstances of each case. II) Though long-term care service workers for the elderly seem to try to be careful in their use of katakana, there remains a strong possibility that katakana will continue to be used despite its not being understood. III) The paraphrases recommended under the Ministry of Health and Welfare guidelines are not much used by long-term care service workers to their clients. IV) A considerable number of the elderly feel an instinctive dislike for katakana.