After he was diagnosed with leukemia in July, Katsuo Saito decided not to treat it and opted for palliative care. He had a hard time finding a bed in a hospice or hospital, so he spent most of his remaining weeks at home.
“There are about 20 people on the waiting lists,” Saito, 89, said in his fifth-floor apartment in Tokyo, where he lived alone.
Many Japanese are reluctant to die at home because they feel hospitals are safer and they don’t want to burden family members.
But dying at home may prove an acceptable option as hospital beds become ever scarcer in an aging society where 1 in 4 are over 65 and health officials predict a shortfall of more than 470,000 hospital beds by 2030.
“I think it’s good to have a doctor supporting people who choose to spend their final days, and naturally face death, in a place they spent their days living,” said physician Yuu Yasui.
Yasui, who works at the Yamato Clinic, which has overseen more than 500 home deaths since 2013, hopes to offer hospice care at home for more of the terminally ill.
Mitsuru Niinuma, 69, chose to stay at home so he could spend more time with his grandson and his beloved dachshund, Rin.
“Home care allows people to use their abilities to their fullest for as long as possible,” he said. “That’s not so easy in a hospital. This aspect is really nice.”
Rising health care costs as the population ages have fueled apprehension that there will eventually be a cap on the number of hospital beds, although a health ministry official who declined to be identified called that scenario unlikely.
The bed shortage stems partly from long hospital stays, which ran 16.5 days on average in 2015, versus six days in Britain, according to a study by the OECD.
More than 80 percent of Japanese would prefer to die in a hospital, according to the Yamato Clinic.
Leukemia patient Saito finally found a hospice spot in September. Two days after he moved in, he died.
National insurance provides individual hospital rooms only in exceptional circumstances, so they are out of reach for people like pensioner Yasuhiro Sato, 75, who had terminal lung cancer.
“Somebody rich, like a politician or a singer, they solve everything through money. They can stay in private rooms,” Sato said in an interview in his Tokyo apartment in July.
With no close family or friends, he lived a solitary life, except for caregivers’ visits. When Sato died Sept. 13, the only other people in his apartment were doctors, aides and undertakers.
“It’s OK. I’m not a burden to anybody,” he said. “I will go to the afterlife quietly. Alone.”