{"id":596791,"date":"2023-01-11T18:00:00","date_gmt":"2023-01-12T00:00:00","guid":{"rendered":"https:\/\/news.sellorbuyhomefast.com\/index.php\/2023\/01\/11\/japan-confronts-a-stark-reality-a-nation-of-old-people\/"},"modified":"2023-01-11T18:00:00","modified_gmt":"2023-01-12T00:00:00","slug":"japan-confronts-a-stark-reality-a-nation-of-old-people","status":"publish","type":"post","link":"https:\/\/newsycanuse.com\/index.php\/2023\/01\/11\/japan-confronts-a-stark-reality-a-nation-of-old-people\/","title":{"rendered":"Japan confronts a stark reality: a nation of old people"},"content":{"rendered":"
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Published January 12, 2023<\/p>\n

30 min read<\/p>\n<\/div>\n<\/header>\n<\/div>\n

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On an overcast Saturday<\/b> morning in Iwase, a sleepy port district on the lip of Toyama Bay on Japan\u2019s largest island, the streets are deserted until the appointed hour approaches.<\/p>\n

An elderly woman pokes her head out of her doorway and peers down the main thoroughfare lined with traditional low-slung wooden buildings. Another advances gingerly along a narrow side lane. A few minutes later, two tiny trucks trundle up and roll to a stop.<\/p>\n

The area suddenly springs to life. Five orange-vested workers emerge and bustle about, setting up traffic cones, handing out shopping baskets, and apologizing profusely for shifting the Tokushimaru mobile grocery a few feet from its usual spot. They ferry groceries from the first truck to the second, which efficiently morphs into a miniaturized shop with fold-out shelves and red awnings. The left side is refrigerated and stocked with individual portions of fish and meat, yogurt, eggs, and other perishables. Produce is on the right; snacks and crackers, at the back. Half a dozen shoppers, all older women, move haltingly around the truck.<\/p>\n

Miwako Kawakami, a stooped 87-year-old with bobbed hair, hands her cane to a worker and takes a small basket. She buys leeks, carrots, three onions, and a carton of milk. Kawakami lives alone behind a nearby temple. \u201cThere used to be a lot of stores here, but they\u2019re all gone,\u201d she says. \u201cThe vegetable stand, the fish stand\u2014they all closed about five years ago.\u201d She totters across the street to meet her 86-year-old neighbor, who has come to help carry her groceries.<\/p>\n

Iwase has emptied out. Its young have left, and those still here grow older. This dynamic is happening all over Japan as the birth rate continues its decades-long decline. The country\u2019s population peaked in 2010, at 128 million. Now it\u2019s less than 125 million and projected to keep shrinking over the next four decades. At the same time, Japanese people are living longer\u201487.6 years for women and 81.5 years for men, on average. Except for the tiny principality of Monaco, Japan\u2019s population is now the oldest in the world<\/a>.<\/p>\n

The numbers, though stark, don\u2019t convey how profoundly this demographic shift is playing out day to day. The increasingly disproportionate mix of more and more seniors and fewer and fewer young people is already altering every aspect of life in Japan, from its physical appearance to its social policies, from business strategy to the labor market, from public spaces to private homes. Japan is becoming a country designed for and dominated by the old.<\/p>\n

Watch the nightly news, and you\u2019ll hear reports on Japan\u2019s \u201caging society\u201d as regularly as the weather. Young people caring for family members need greater support. 100-year-old driver steers car onto sidewalk, hits pedestrian. Majority of yakuza in Japan now over age 50.\u00a0<\/i>Aging is everywhere. On some train station platforms, there\u2019s a notch in the base of each seat: It\u2019s a place to park your cane. Abandoned \u201cghost houses\u201d<\/a> strangled in vines are a common sight in hollowed-out communities like Iwase but also in big-city neighborhoods.<\/p>\n

Japan\u2019s path<\/a> foreshadows what\u2019s coming in many areas of the world. China, South Korea, Italy, and Germany are on a similar trajectory; so too is the United States, although at a slower pace. Five years ago, the world reached an ominous milestone<\/a>: For the first time in history, adults 65 and older outnumbered children under five years old.<\/p>\n

If Japan is any guide, aging will change the fabric of society in ways both obvious and subtle. It will run up a huge tab that governments will struggle to pay. Meeting the challenge won\u2019t be easy, but the future isn\u2019t necessarily all downhill. Japan\u2019s experience, with its characteristic attention to detail and design, suggests extreme aging\u2014a world in which an increasing share of the population is old\u2014may inspire an era of innovation.<\/p>\n

(Can aging be cured? Scientists are giving it a try.<\/a>)<\/i><\/p>\n

In 2020, Japan\u2019s health ministry launched eight \u201cliving labs\u201d dedicated to developing nursing-care robots. Yet in a way, the entire country is one big living lab grappling with the repercussions of a rapidly aging society. In business, academia, and communities around Japan, countless experiments are under way, all aiming to keep the old healthy for as long as possible while easing the burden of caring for society\u2019s frailest.<\/p>\n

Osamu Yamanaka is on a mission<\/b> to prevent lonely deaths. Several times a week, the 67-year-old doctor leaves his Yokohama clinic to make the rounds of pensioners who live alone in ramshackle single-room-occupancy units in Kotobukicho<\/a>. The hardscrabble neighborhood sprang up during the postwar building boom to house day laborers and is now home to aging welfare recipients and \u201cpeople fleeing social obligations for one reason or another,\u201d Yamanaka says\u2014alcoholics, the mentally ill, ex-convicts.<\/p>\n

On one of Yamanaka\u2019s stops, he visits Seiji Yamazaki, 83, a former construction worker. As is his habit, Yamanaka forgoes the elevator and walks determinedly up seven flights of stairs without stopping, carrying the scuffed black bag that belonged to his physician father. His patient lies on a hospital cot, one fist permanently clenched. Aside from the bed, the narrow room holds a mini-fridge, a microwave, a collection of stuffed Winnie the Poohs, and little else.<\/p>\n

\u201cI\u2019m dizzy,\u201d he tells the doctor. \u201cHow\u2019s my blood pressure?\u201d Yamanaka takes the bedridden man\u2019s vitals, assures him he will check his medication, and reviews the visitors log; health aides also come by daily to bring food, administer medicine, and change diapers.<\/p>\n

Japan\u2019s long-term care insurance system<\/a> is among the most generous in the world, and Yamazaki\u2019s needs are well covered. Compared with people in other industrialized countries, the Japanese receive far more benefits than they pay for in taxes and premiums. The program subsidizes between 70 and 100 percent of elder care, depending on income. Before the system began in 2000, the ailing old would go to hospitals and stay until death. Now they tend to die at home. \u201cIn some ways,\u201d Yamanaka says, \u201cwe\u2019re the most advanced socialist country in terms of medical welfare.\u201d<\/p>\n

But the system is strained. There\u2019s already a shortage of care workers; the government estimates the country will need 700,000 more by 2040. Proposed fixes include raising their pay, recruiting retirees and volunteers, promoting nursing as a career, relying on robotics, and\u2014last and likely to stay last\u2014allowing more foreign workers. Immigrants from countries such as Vietnam and the Philippines are working in nursing homes, but there\u2019s a tight cap on the number of visas for skilled workers. Japanese insularity combined with the difficulty of learning the language makes it hard to fill the gap in care workers from abroad.<\/p>\n

Meanwhile, the cost of benefits is escalating. Social security expenses, which include public health care, long-term care, and pensions, tripled between 1990 and 2022, financed by government debt. \u201cThe universal system we introduced has lots of advantages, and people are used to it,\u201d says Hirotaka Unami, a senior aide to Prime Minister Fumio Kishida. \u201cTo maintain that, we have to restore the balance between benefits and burdens. Otherwise it\u2019s not sustainable.\u201d<\/p>\n

The solution, he says, is fourfold: accelerate economic growth, incentivize more women and older adults to work, raise the consumption tax, and curb social security expenditures. \u201cThe goal is to have more elderly people be contributors to society rather than receivers,\u201d Unami says.<\/p>\n

It\u2019s a daunting list. Economic growth can\u2019t be engineered at will. Tax increases are unpopular: It took Japan five years to raise the consumption tax from 8 percent to 10 percent. More than 70 percent of Japanese women 64 and younger already work, but mostly part-time because<\/a> of poor childcare options and financial disincentives, including being paid less than men.<\/p>\n

The government is trying to raise the retirement age from 65\ufeff, and people are working longer. In 2021, more than a third of Japanese companies let people work past 70; in 2016, only 21 percent did. Demographics leave no other option: By 2050, almost 38 percent of Japan\u2019s population is projected to be 65 and over, putting enormous pressure on the labor force to support them.<\/p>\n

\u201cI don\u2019t think we\u2019ve got good answers,\u201d says Sagiri Kitao, an economist at the University of Tokyo. \u201cTo be honest, it\u2019s too late. Politicians don\u2019t want to talk about reducing benefits.\u201d\u00a0<\/p>\n

More than half<\/b> of all municipalities in Japan are now designated as depopulated areas, where the population has dropped by 30 percent or more since 1980. In many, older residents are organizing to adapt their communities to this new reality. A housing development in Yokohama, on the other side of Honshu Island from Iwase, is emblematic of how aging is reshaping Japan from the ground up.<\/p>\n

At Kamigo Neopolis,<\/a> 868 detached homes perch atop a steep hill. Daiwa House, one of Japan\u2019s largest homebuilders, opened it in 1974 to house the explosion of young families that followed the postwar baby boom. Designed as a bedroom community for salarymen making the hour-and-a-half train commute to Tokyo, it\u2019s one of 61 \u201cneopolises.\u201d In Kamigo, residents could walk to shops and an elementary school.<\/p>\n

(A detailed look at how we age\u2014at the cellular level<\/a>)<\/i><\/p>\n

These days, more than half of Kamigo\u2019s 2,000 residents are 65 and older. The school closed years ago. The shops are gone. Weeds have taken over the four parks. Residents joke that \u201cNeopolis,\u201d which means \u201cNew Town,\u201d is now \u201cOld Town.\u201d<\/p>\n

The Aeon shopping center at Kamigo\u2019s train station, an 18-minute bus ride down the hill, has a whole aisle of nursing-care products, such as aprons for use while bathing an elderly parent, disposal bags for adult diapers, odor-absorbing cloths to hang on a bed rail, and bags of thickening powder, called toromi,\u00a0<\/i>that\u2019s used in drinks and soups to help prevent choking.<\/p>\n

As Kamigo\u2019s population shrank and its inhabitants aged, residents felt physically and socially isolated. A loose network evolved to check up on one another, and that became a committee called Kamigo Machizukuri<\/a>, a term for a distinctly Japanese form of bottom-up, collaborative community engagement. In 2016 the group started lobbying Daiwa House to create a central area for shopping and socializing. The result was a single-story building with a mini-mart, a produce stand, five tables with chairs, and a video screen. There\u2019s an outdoor terrace with benches. The center\u2019s restroom includes a deep sink reserved for the disposal of ostomy-bag waste, a now ubiquitous fixture in Japan marked by a distinctive icon outside bathroom doors.<\/p>\n

\u201cWe\u2019re thinking about setting up a transportation system to the hospital for people who can\u2019t get around,\u201d says Nobuyuki Yoshii, a 74-year-old retiree and father of three. He moved to Kamigo more than 40 years ago for its easy access to surfing and the then thriving jazz scene in downtown Yokohama, a quick car ride to the north. For decades, Yoshii got up at 5 a.m. to commute to his architectural planning job in Tokyo, often returning at midnight. These days, he heads the machizukuri committee. An on-site nursing-care clinic is also high on the wish list.<\/p>\n

Kamigo is one small example of how Japanese communities are working to enable aging in place. Toyama, a city of more than 410,000 that includes Iwase, is a more ambitious case study in reimagining a city space, one now widely praised as a model. The catalyst was Masashi Mori, who until 2021 was Toyama\u2019s charismatic mayor for nearly 20 years.<\/p>\n

He traveled the world looking for ideas to accommodate the old. Inspired by light-rail systems in Portland, Oregon, and Strasbourg, France, Toyama<\/a> installed trams that the elderly ride at a discount and can board without climbing any steps. They get into local attractions for free with grandchildren. The city turned a shuttered school into a preventive-care center that functions as a health club for older adults, with gym equipment, classes, and waist-deep pools, one with a built-in walking path and handrails.<\/p>\n

\u201cThe more people walk, the less they spend on health,\u201d says Mori, 69, now a pear farmer with a thick shock of dyed black hair and \u201cMr. Mori\u201d embroidered on his shirt cuffs. \u201cYou\u2019ve got to get them active and interacting with other people.\u201d Mori is proud of Toyama\u2019s work to create a more compact, navigable city. \u201cWe took the initiative early,\u201d he notes.<\/p>\n

In Toyama\u2019s rural areas, close to 40 percent of the population is over 65. They\u2019re served by a gleaming care center that delivers home nursing. \u201cWe\u2019re seeing an increase in single sons living with their aging mothers, as well as lots of couples where both have dementia,\u201d says Naoko Kobayashi, one of the center\u2019s three doctors who work to ease the suffering of aging patients and also their exhausted families. \u201cDying is not an easy thing.\u201d<\/p>\n

The city has had less success dealing with the empty ghost houses that no one wants, especially those in which someone died alone. There are more than eight million of them around Japan. Laws are slowly changing to enable local governments to fine and publicly report delinquent property owners to shame them. It took Toyama five years in a drawn-out process to raze just three houses, barely making a dent in the more than 7,000 that are abandoned in the city.<\/p>\n

At Yume Paratiis,\u00a0<\/b>a pristine nursing home in Amagasaki, near Osaka, a robot called the Hug<\/a> carefully transfers 98-year-old Kotoyo Shiraishi from her wheelchair to her bed. Padded armrests gently squeeze and support the tiny woman, who wears fleece pants and cushioned slippers. Staff at the 116-resident home say the Hug enables aides to do lifting and lowering tasks solo instead of in pairs.<\/p>\n

The nursing home industry, naturally, is ground zero of the living lab that is Japan. The Hug is one of 20 technologies that Yume Paratiis is testing, from room monitors to communication robots. The latter include Telenoid,<\/a> which has nubs for limbs and a realistic but expressionless face. It talks via a care worker who operates it from a distance. Telenoid wears an orange-and-white onesie and matching hat. \u201cThis is a boy, right?\u201d asks 89-year-old Kazuko Kori, who tells it to sing her a song. Some residents open up to it, staff members say; others are turned off. Hidenobu Sumioka of Kyoto-based ATR, who helped create Telenoid, concedes that it\u2019s not for everyone, but he envisions a future where robots play a social role for people in nursing homes: \u201cI\u2019d like to use them to form more of a community, the way people used to live.\u201d<\/p>\n

Among the most prominent companies focused on aging is Sompo Holdings, one of Japan\u2019s top insurance companies, which started acquiring nursing homes in 2015. Sompo now owns around 400, making it one of the largest operators. The company is also the only business running one of the eight living labs; the others are overseen by research centers.<\/p>\n

Sompo\u2019s Future Care Lab,<\/a> in Tokyo, houses two spotless testing rooms tricked out like nursing homes on steroids. Motion sensors on the floors and walls detect falls and send alerts to caregivers\u2019 phones. A high-tech bed made by Panasonic has a mattress that splits down the middle so a patient can be rolled onto the outer half, which can fold into a wheelchair. At more than $10,000, though, it isn\u2019t cheap.<\/p>\n

Other devices include a lavender-and-white bathtub that looks like a cross between a giant Easter egg and an isolation tank. A person in a wheelchair gets steered into the tub and sprayed with soapy foam from all sides at the push of a button, followed by warm water. But a full-body soak is a cherished Japanese ritual that nursing homes try to provide. Yume Paratiis prefers a rotating chair lift that gently lowers residents into a tub. When Takeo Okuzono, 85, is immersed, he reclines into the bath and closes his eyes. \u201cI\u2019m sleepy,\u201d he mumbles.<\/p>\n

Sompo is working to make nursing care more efficient. In one ongoing study, workers in 10 Sompo homes collect data from \u201csmart bed\u201d sensors that detect whether residents are asleep, in bed but awake, or out of bed. The technology enables 150 workers to check on 500 residents remotely instead of visiting every room at two-hour intervals, according to Albert Chu, Sompo\u2019s chief digital officer. Sompo now uses the wired pads in nearly all its homes. \u201cThere are empty wings in care homes because they can\u2019t hire enough people,\u201d Chu says.<\/p>\n

Robotics can help\u2014and the Japanese government subsidizes their use\u2014but they\u2019re not a panacea. Only a fifth of the nursing homes in Japan use any type of robotics, according to a 2020 survey, and primarily for monitoring and communication rather than helping lift, bathe, and interact with residents.<\/p>\n

Even industries not explicitly<\/b> focused on nursing care are tackling \u201caging society\u201d problems. In stark contrast to the incremental pace of national fiscal reform, companies throughout Japan, from conglomerates to start-ups, are experimenting with gusto.<\/p>\n

Some big companies are devising incentives to keep seniors active in ways that are equal parts marketing and corporate social responsibility. Rakuten, Japan\u2019s e-commerce giant, launched the app Rakuten Senior in 2019. It rewards steps walked with points that can be used toward purchases, such as trial music lessons. Hitachi partnered with the nationally funded Japan Gerontological Evaluation Study (JAGES) to create a \u201csocial participation encouragement\u201d app that aims to lower the cost of nursing care by keeping people active. The app measures outdoor activity and ranks it in four categories, from beginner to expert. It also recommends events to attend and pushes evidence of the benefits of social participation to users.<\/p>\n

Hitachi says it\u2019s in discussions with 70 businesses and municipalities about partnerships that would link the app to elder-focused services. Yuji Kamata, who leads the Hitachi team that developed the app, notes that the data will also benefit JAGES, which does national surveys every three years; now the information will be digitized at a lower cost and provide real-time results. The app is free. Hitachi hopes one day to sell the anonymized data.<\/p>\n

Even Daiwa House, spurred by Kamigo\u2019s residents, formed a new division, called Livness Town Project, to adapt 10 more of its planned communities for aging. \u201cWe\u2019re not doing this to make money. It could be unprofitable,\u201d says Koji Harano, who runs Livness. \u201cBut it has social value. It helps our brand.\u201d He hopes the company will market its aging-related housing expertise overseas.<\/p>\n

Other services have emerged to address the ripple effect of solitary deaths. In 2020 more than 4,200 people over 65 in Tokyo died alone<\/a>. Many companies now insure owners of rental units against the risk of someone dying and going undiscovered on their properties, addressing the growing reluctance of landlords to rent to older tenants. Such policies cover the loss of rent as well as the cost of cleaning. Thousands of companies now specialize in residential deep cleaning after a solitary death, a fate likely to become more common in Japan given that more than one in four adults 65 and older lives alone.<\/p>\n

Japan\u2019s economic prowess and industrial innovation were envied around the world until the Lost Decade<\/a>, a long stretch of stagnation that began in the 1990s. Although the country remains a digital laggard, Japan\u2019s creative responses to its aging citizens may become a source of inspiration as the world grows older.<\/p>\n

\u201cYou see next-generation talent thinking about aging as a big opportunity,\u201d says Jin Montesano, a senior executive at Lixil, which sells bathroom and other housing products. One of Lixil\u2019s newer items is a shower that dispenses cleansing foam from two adjustable bars that lower to wheelchair height. Increasingly focused on aging in the home, the company is encouraging employees to come up with more ideas.<\/p>\n

\u201cAge tech\u201d is also beginning to be seen as an opportunity for Japanese start-ups. The amount of venture capital in Japan is comparatively low but growing. One VC funding recipient is Tokyo-based LifeHub, which is developing a wheelchair that can raise its user to a standing position and can ascend stairs and escalators. \u201cWheelchair users want legs\u2014healthy legs,\u201d says Hiroshi Nakano, LifeHub\u2019s co-founder and CEO.<\/p>\n

Start-ups are also taking on the most intimate nursing tasks. Yoshimi Ui, an outgoing 33-year-old engineer, invented the Helppad, a mattress-odor sensor that detects and tracks excretions to make toileting care more efficient. She runs her company, called Aba, out of a small two-story house near Tokyo. Ui grew up with an ailing, severely depressed grandmother at home and was troubled by her suffering. That motivated her to marry engineering know-how with social impact. Ui says that her Helppad, which is being tested in Sompo\u2019s Future Care Lab, is used at about a hundred Japanese nursing homes.<\/p>\n

Both LifeHub and Aba envision international sales. Aba, whose website proclaims, \u201cLive well, die well, build the future,\u201d is getting inquiries from South Korea, Taiwan, and Singapore.<\/p>\n

Japan\u2019s present challenges are our collective future. Just as no one wants to dwell on getting old, Ui says, most people don\u2019t give nursing care a second thought until a parent becomes ill and the burden suddenly falls on them. She wants to change that mindset. Her vision, she says passionately, is to \u201cmake the world a place where there\u2019s nursing-care support everywhere.\u201d<\/p>\n

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Sarah Lubman\u00a0<\/b>studied Japanese literature, lived in Japan, and has traveled there regularly over the past 15 years.\u00a0Noriko Hayashi\u00a0<\/b>focuses on documenting social issues. She is based in Tokyo.<\/p>\n

This story appears in the February 2023 issue of National Geographic<\/i> magazine.<\/p>\n<\/div>\n<\/div>\n<\/section>\n

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\n Sarah Lubman<\/p>\n","protected":false},"excerpt":{"rendered":"

Published January 12, 2023 30 min read On an overcast Saturday morning in Iwase, a sleepy port district on the lip of Toyama Bay on Japan\u2019s largest island, the streets are deserted until the appointed hour approaches. An elderly woman pokes her head out of her doorway and peers down the main thoroughfare lined with […]<\/p>\n","protected":false},"author":1,"featured_media":596792,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2992,534,22487],"tags":[],"class_list":{"0":"post-596791","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-confronts","8":"category-financial","9":"category-japan"},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts\/596791","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/comments?post=596791"}],"version-history":[{"count":0,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts\/596791\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/media\/596792"}],"wp:attachment":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/media?parent=596791"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/categories?post=596791"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/tags?post=596791"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}