In early April in a Tokyo suburb, a group of in-home caregivers -- all women -- were absorbed in a conversation about their elderly clients.

"I don't want to go to a house where a man lives alone," one woman in her 40s, said. Others nodded in unison. "Why should I take care of other men when I am tired of taking care of my own husband?" another woman said.

Added another middle-aged woman about her client -- a single man: "His house is so dirty and always stinks. I sometimes feel like I need a gas mask."

Some may deplore their lack of delicacy. Others may be outraged, and say they lack awareness and are unfit to be professional caregivers.

But like it or not, more than a few Japanese female home helpers -- who make up the majority of some 200,000 caregivers nationwide -- are reluctant to offer services to male solitaries. Men's homes, caregivers say, are often unbearably dirty, with kitchens covered in grease and bathrooms overrun with mildew and stinking of urine. Raised in a society where male chauvinism is the norm, elderly men are often arrogant and mistake female caregivers for maids.

Working for male clients sometimes imposes extreme stress on Tsuneko Yamamoto (not her real name), a licensed home helper in Tokyo. Providing customized care and assistance in homemaking tasks such as cooking, shopping, laundry and vacuuming, she had prided herself on her compassion for her clients and strong sense of duty -- until recently.

Assigned to serve single male clients, she soon found she was losing enthusiasm for her job. Not only were the men's homes filthy, but when she tried to clean them, clients bewildered her with orders not to. "In one place, a lot of spoiled food was left in the fridge," she said. "But the man wouldn't let me throw it away."

Further adding to an already stressful situation is the fact that she has tremendous trouble finding common interests to talk about. She often feels awkward in the single man's room, in an atmosphere heavy with silence. "I know it's not a professional attitude to avoid men for such trivial reasons," she said, "but I cannot help it."

There are others who have more serious reasons. Osaka-based care worker Tomoko Saito (not her real name) is mortified every time she visits a particular 60-year-old man, who begs her to get married and sleep with him. Worse, a colleague in her 50s was insulted by another client during her first visit to his home, when he told her "I want someone young instead of a dried up middle-aged woman like you."

"Now we cope with the situation by visiting those men's places by turns and reporting to each other what they said and did, but I wouldn't be able to stand it if I had to visit them alone," she said.

Saito may be even lucky, says Toshiyuki Aizawa, leader of a union for caregivers. He once dealt with a case in which an elderly man clung to a female care worker, demanding sexual intercourse. In another case, he rushed to a man's home where a helper had found the wall plastered with magazine pictures of naked women.

"The issue has long been in the closet, but is just waiting to surface," said Aizawa.

In fact, nearly 50 percent of female home helpers have been sexually harassed by their male clients, according to a survey by Tokai University Professor Chizuko Inoue.

In many cases, managers leave everything up to the caregivers' tact. Some serious cases are secretly resolved by replacing the caregiver with a male helper. The best solution would be to assign male caregivers to male clients from the start, critics say, but the industry has always suffered a shortage of male home helpers.

"More men are becoming caregivers, and care from a same-sex helper is becoming common in nursing homes. But men are reluctant to work as underpaid home helpers," said Aizawa.

Statistics show some 80 percent of residential caregivers work without full-time employment benefits and make less than 200,000 yen a month on average, regardless of career and proficiency. Employers often provide neither social insurance nor transportation expenses. "It's very difficult to make a living as a home helper," said Yamamoto.

Nevertheless, demand for home caregivers, who are said to play a key role in the current nursing care scheme, is enormous. They are expected to shoulder the heavy burden of providing professional services in a kind and caring manner.

"The work of home helpers requires accepting the client in his entirety, including his sexual urges," a home help textbook reads. "[The clients] crave care in the form of sex, which is at the opposite pole to the solitude and fears about disease and death . . . that grow strong with old age. Therefore, [home helpers] must provide the kind of spiritual care that is at the root of sexual acts."

Behind the reluctance to take on male clients lies the stress of being asked too much for very little reward, says nonfiction writer Noriko Okifuji.

"[Elderly] men habitually had their housework done by women, whom they have often looked down on, so many of them do not even try to live alone neatly. And they still think housework is a woman's duty," Okifuji says. "Female helpers sense that their male clients treat them as inferiors."

Okifuji's survey of female in-home caregivers in Fukui Prefecture found that about 70 percent of them prefer female clients. If society makes no effort to improve the situation, future customers are the ones who will have to pay the cost, Okifuji warns.

"The country needs to improve the helper's working conditions, to ease stress and increase the number of male home helpers. If this doesn't happen, men will have a miserable time in their old age," she added.