Kanoko Matsuyama
By Kanoko Matsuyama
Itoko Uchida, 82, was counting on the nephew she raised to support her in old age. He refused, forcing her to pay for a sponsor to join the 420,000-long queue of Japanese waiting for a nursing home bed.
With no relatives willing to help, the Tokyo widow had to spend 710,000 yen ($7,600) on a professional service to be her guarantor and assist with an application to a nursing home, she said. An erosion of traditional Confucian values in Japan means fewer elderly are being cared for at home by relatives — a fact neither Uchida nor Japan’s government were fully prepared for.
Japan, with the world’s highest proportion of retirees, can’t build nursing homes fast enough. By 2025, one in three citizens will be 65 or older from 12 percent of the population in 1990, the Organisation for Economic Cooperation and Development estimates. A lack of long-term care facilities means seniors risk living alone in ill-equipped homes or suffering abuse from resentful relatives.
“The system is designed for the 1970s, when multiple generations lived together and family caregiving was thought to continue forever,” said Hiroshi Takahashi, a professor of health sciences at the International University of Health and Welfare in Otawara City. “But that’s not the
reality now.”
By 2030, the number of seniors living alone, like Uchida, will increase 54 percent to 7.2 million household units from 2010 levels, according to the National Institute of Population and Social Security Research in Tokyo. Elderly-care costs will more than double to 19.8 trillion yen ($212bn) a year by 2026, the health ministry estimates. That threatens to overload the world’s second-most indebted nation.
From now through 2030, about 470,000 seniors will die in Japan unless more investment is made in caring for them, Takahashi said. “Society and the system will blow up around 2025 without a drastic change,” he said.
“The family is already under increasing stress from the forces of modernisation,” the Washington-based Centre for Strategic International Studies said. “Over the next few decades, massive age waves are due to engulf the region, slowing economic growth, driving up old-age dependency costs, and heaping large new burdens on governments and families alike.”
China has already sought to protect these values, passing a law last year allowing parents to sue children for failing to visit them. In South Korea, the number of suicides among people aged 65 years and older more than tripled in a decade to 4,406 in 2011, according to the latest available data from Statistics Korea. The increase was spurred by an economic slowdown and the erosion of traditional family support, the OECD said.
Worldwide, the proportion of people older than 60 years in populations is increasing more than three times faster than the overall growth rate. Within five years, adults 65 years and older will outnumber children younger than five for the first time.
The growing demands of the elderly may be stoking violence toward them. In 2011, 21 seniors in Japan were murdered or died from neglect, and the number of elderly people abused by family members jumped 32 percent to 16,599 from 2005 levels, according to health ministry statistics.
After Uchida’s husband died, her 60-year-old nephew stepped in to assist with her application and sponsor her long-term care. The help stopped when his wife intervened, said Uchida, who is 22nd in line for a bed in a home.
“I stressed his marriage,” she said. “He’s also getting old and fearing he may not get help from his son, who lives far away, closer to his wife’s parents.”
Uchida paid for support from the Four-leaf Clover Association, a non-profit group that helps about 200 people in Tokyo and Kobe complete applications and attain the requisite sponsorship for a place in a nursing home.
The number of seniors seeking sponsorship for nursing homes is increasing about 10 percent a year, said Hideyuki Ogasawara, senior director at Kizunanokai, which provides a similar service.
In 1980, 53 percent of people above 65 lived with their children, according to health ministry data. In 2010, that proportion was down to 18 percent.
Japanese are increasingly eschewing tradition and opting to live independently, according to a 2008 government study. Thirty-six percent of respondents envisaged preferring to live with, or close to, relatives in old age, down from 70 percent in 1983.
That preference though has a downside. Almost 15 percent of Japanese rarely or never interact socially with others — making Japan the least social of societies in the developed world, according to the OECD.
Social networks are breaking down as family members live further apart and can’t afford to socialise, said Katsuyoshi Kawai, professor of social welfare at Meiji Gakuin University and the author of the book Seniors Living Alone in Urban Cities and Social Isolation.
Authorities are responding. In Tokyo, officials in Adachi ward are conducting a district-wide audit of people older than 70 who live alone and any shared households whose residents are all over 75. A bylaw was recently passed enabling the information to be shared with volunteer social workers, police and residents’ groups to circumvent the isolation that has led to deaths that have gone undiscovered sometimes for months.
In 2006, Japan’s government introduced a law to protect the elderly from abuse and provide support to caregivers. It is also paying subsidies to convert hospitals into nursing homes, building residential care facilities, hiring more caregivers and urging hospitals to allow medical staff to make house calls.
Businesses, charities and local governments are also innovating to help meet the needs of the elderly. Food delivery services for seniors are expected to double in 10 years to 106 billion yen, while the market for food that doesn’t require much chewing will climb 61 percent to 158 billion yen, according to Fuji-Keizai Co, a marketing research firm in Tokyo.
Utilities are also chiming in with products to detect signs of life: Tokyo Gas Co offers a service to alert relatives to a sudden drop in usage; KDDI Corp sells mobile phones with pedometers to detect mobility; and Secom Co markets a GPS system to track movement.
The initiatives are promoting more independent living.
“Our generation has lived separately from our parents, and so wives have enjoyed freedom from their in-laws,” said Toshie Kurita, 69, whose mother-in-law volunteered to move into a nursing home eight years ago.
Kurita, whose husband died two years ago, visits her mother-in-law in Chiba, west of Tokyo, every second week and says she will be happy to hire professional help if necessary. “No one wants to beg their daughter-in-law to care for them when they’re nearing the end of their life.”
WP-BLOOMBERG
By Kanoko Matsuyama
Itoko Uchida, 82, was counting on the nephew she raised to support her in old age. He refused, forcing her to pay for a sponsor to join the 420,000-long queue of Japanese waiting for a nursing home bed.
With no relatives willing to help, the Tokyo widow had to spend 710,000 yen ($7,600) on a professional service to be her guarantor and assist with an application to a nursing home, she said. An erosion of traditional Confucian values in Japan means fewer elderly are being cared for at home by relatives — a fact neither Uchida nor Japan’s government were fully prepared for.
Japan, with the world’s highest proportion of retirees, can’t build nursing homes fast enough. By 2025, one in three citizens will be 65 or older from 12 percent of the population in 1990, the Organisation for Economic Cooperation and Development estimates. A lack of long-term care facilities means seniors risk living alone in ill-equipped homes or suffering abuse from resentful relatives.
“The system is designed for the 1970s, when multiple generations lived together and family caregiving was thought to continue forever,” said Hiroshi Takahashi, a professor of health sciences at the International University of Health and Welfare in Otawara City. “But that’s not the
reality now.”
By 2030, the number of seniors living alone, like Uchida, will increase 54 percent to 7.2 million household units from 2010 levels, according to the National Institute of Population and Social Security Research in Tokyo. Elderly-care costs will more than double to 19.8 trillion yen ($212bn) a year by 2026, the health ministry estimates. That threatens to overload the world’s second-most indebted nation.
From now through 2030, about 470,000 seniors will die in Japan unless more investment is made in caring for them, Takahashi said. “Society and the system will blow up around 2025 without a drastic change,” he said.
“The family is already under increasing stress from the forces of modernisation,” the Washington-based Centre for Strategic International Studies said. “Over the next few decades, massive age waves are due to engulf the region, slowing economic growth, driving up old-age dependency costs, and heaping large new burdens on governments and families alike.”
China has already sought to protect these values, passing a law last year allowing parents to sue children for failing to visit them. In South Korea, the number of suicides among people aged 65 years and older more than tripled in a decade to 4,406 in 2011, according to the latest available data from Statistics Korea. The increase was spurred by an economic slowdown and the erosion of traditional family support, the OECD said.
Worldwide, the proportion of people older than 60 years in populations is increasing more than three times faster than the overall growth rate. Within five years, adults 65 years and older will outnumber children younger than five for the first time.
The growing demands of the elderly may be stoking violence toward them. In 2011, 21 seniors in Japan were murdered or died from neglect, and the number of elderly people abused by family members jumped 32 percent to 16,599 from 2005 levels, according to health ministry statistics.
After Uchida’s husband died, her 60-year-old nephew stepped in to assist with her application and sponsor her long-term care. The help stopped when his wife intervened, said Uchida, who is 22nd in line for a bed in a home.
“I stressed his marriage,” she said. “He’s also getting old and fearing he may not get help from his son, who lives far away, closer to his wife’s parents.”
Uchida paid for support from the Four-leaf Clover Association, a non-profit group that helps about 200 people in Tokyo and Kobe complete applications and attain the requisite sponsorship for a place in a nursing home.
The number of seniors seeking sponsorship for nursing homes is increasing about 10 percent a year, said Hideyuki Ogasawara, senior director at Kizunanokai, which provides a similar service.
In 1980, 53 percent of people above 65 lived with their children, according to health ministry data. In 2010, that proportion was down to 18 percent.
Japanese are increasingly eschewing tradition and opting to live independently, according to a 2008 government study. Thirty-six percent of respondents envisaged preferring to live with, or close to, relatives in old age, down from 70 percent in 1983.
That preference though has a downside. Almost 15 percent of Japanese rarely or never interact socially with others — making Japan the least social of societies in the developed world, according to the OECD.
Social networks are breaking down as family members live further apart and can’t afford to socialise, said Katsuyoshi Kawai, professor of social welfare at Meiji Gakuin University and the author of the book Seniors Living Alone in Urban Cities and Social Isolation.
Authorities are responding. In Tokyo, officials in Adachi ward are conducting a district-wide audit of people older than 70 who live alone and any shared households whose residents are all over 75. A bylaw was recently passed enabling the information to be shared with volunteer social workers, police and residents’ groups to circumvent the isolation that has led to deaths that have gone undiscovered sometimes for months.
In 2006, Japan’s government introduced a law to protect the elderly from abuse and provide support to caregivers. It is also paying subsidies to convert hospitals into nursing homes, building residential care facilities, hiring more caregivers and urging hospitals to allow medical staff to make house calls.
Businesses, charities and local governments are also innovating to help meet the needs of the elderly. Food delivery services for seniors are expected to double in 10 years to 106 billion yen, while the market for food that doesn’t require much chewing will climb 61 percent to 158 billion yen, according to Fuji-Keizai Co, a marketing research firm in Tokyo.
Utilities are also chiming in with products to detect signs of life: Tokyo Gas Co offers a service to alert relatives to a sudden drop in usage; KDDI Corp sells mobile phones with pedometers to detect mobility; and Secom Co markets a GPS system to track movement.
The initiatives are promoting more independent living.
“Our generation has lived separately from our parents, and so wives have enjoyed freedom from their in-laws,” said Toshie Kurita, 69, whose mother-in-law volunteered to move into a nursing home eight years ago.
Kurita, whose husband died two years ago, visits her mother-in-law in Chiba, west of Tokyo, every second week and says she will be happy to hire professional help if necessary. “No one wants to beg their daughter-in-law to care for them when they’re nearing the end of their life.”
WP-BLOOMBERG
