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 line of Japanese waiting for a nursing home bed.

With no relatives willing to help, the Tokyo widow had to spend ¥710,000 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 the government were fully prepared for.

With the world's highest proportion of retirees, the nation can't build nursing homes fast enough. By 2025, 1 in 3 people will be 65 years or older from 12 percent of the population in 1990, the Organization for Economic Cooperation and Development estimates. A lack of long-term care facilities means seniors increasingly risk living alone in ill-equipped homes or suffering abuse in the care of resentful relatives.