The gray wave: Japan attempts to deal with its increasingly elderly population

NAGOYA – Eighty-one-year-old Sachiko Miura wakes up at 6 a.m. every day to prepare breakfast at her newly renovated apartment located near a large supermarket, spa and a hospital in the suburbs of Japan’s third largest city.

After cleaning her room and doing her laundry, she takes the elevator down to the ground floor of the residential complex to join others gathered for the 9:30 a.m. rajio taiso (radio calisthenics), a short, communal exercise routine performed to music. Then, by 10 a.m., she drops off a wooden tag into a box installed by the office of Yuimarl Jinnan, the name of the assisted living operator managing Miura’s spacious 62½-square-meter apartment in Nagoya that she rents for around ¥63,000 a month.

If Miura doesn’t leave this tag in the box for some reason, staff will call her or visit her apartment to confirm her safety. She’s also given a portable “emergency button” and her room is equipped with a sensor that reports extended periods of immobility to Secom, the nation’s largest security services provider, which will dispatch personnel if considered necessary. These and other services cost her an additional ¥30,000 a month, fees Miura covers with her state and survivor’s pension.

“After my husband passed away five years ago, I thought of moving into an elderly care facility since I don’t have children who can look after me. But when I imagined being fed three meals a day and having everything around me taken care of, I worried about losing my independence,” the sprightly octogenarian says. “Here, I can live on my own while receiving some oversight. And if I reach a point where I require physical care, I can consult the staff for advice.”

The Yuimarl series of serviced housing units operated by Community Net Inc. offers affordable, barrier-free residences for agile, healthy elders who don’t require round-the-clock care but are looking for the freedom associated with rental housing along with other perks — community events, health consultations and, perhaps most importantly, monitoring services. With over a dozen facilities in operation and more being planned, the company’s business model appears to be thriving in a nation where 1 in 4 people are over 65 years old.

Demand for services catering to old age and death have soared over the past decade as the country struggles to cope with the socioeconomic burdens associated with unprecedented aging. And whether it has the resources to provide the necessary infrastructure to support the swelling ranks of elderly is a topic of interest for other graying industrialized nations following Japan into uncharted demographic territory.

After peaking in 2008, Japan’s population has been shrinking while the numbers of elderly grow. As of September, those older than 65 accounted for a record 28.4 percent of the population, or 35.88 million people. That ratio is forecast to reach 30 percent by 2025 — when all 6.5 million of Japan’s baby boomers become 75 or older — and 35.3 percent by 2040, according to the National Institute of Population and Social Security Research.

By then, the number of women of child-bearing age is expected to decline so sharply that the population is estimated to drop by 15.5 million, equivalent to that of Somalia. And by 2065, there will be just 1.3 working-age Japanese available to support each senior.

One of the most pressing matters Japan needs to address in dealing with the demographic time bomb is appropriate housing for older residents, as the erosion of the family unit has seen a surge in elderly, single-person households such as Miura’s.

Since 2011, when a law on securing elderly housing was revised, the government has been offering subsidies to startups including Community Net that fulfill criteria for what it calls “service apartments for seniors.” Among other requirements, residents must be 60 or older or those with certifications of long-term care, and homes need to be barrier-free and larger than 25 square meters.

Community Net operates 13 Yuimarl brand properties in Japan at present, with various levels of services available. Most are placed near urban centers with medical and nursing care facilities in the vicinity.

Ayuka Muraoka, a spokeswoman for Community Net, says Yuimarl Jinnan, located near Nagoya Port in the city’s southern Minato Ward, is unique since it addresses another major side effect of the nation’s demographic shift — the growing number of abandoned homes.

“Typically, an entire residential complex will be used for senior housing, but at Yuimarl Jinnan we only manage apartment rooms that were left empty without tenants,” she says. That means occupants of Yuimarl Jinnan live among other residents of the apartment complex, giving them a chance to mingle with younger families and children. Of the 150 apartments in Village House Kiba Tower — the official name of the 14-story residential building — Community Net manages 37 under the Yuimarl Jinnan banner. Eighty percent of its tenants are single women like Miura, Muraoka says.

“Pension benefits have been falling and medical fees are growing. Elderly citizens can no longer afford expensive housing options,” she says. “That’s why we aim to offer affordable residences while taking advantage of the millions of abandoned properties dotting the nation.”

Once a phenomenon primarily associated with rural communities, abandoned homes have been spreading in suburbs and crawling into crowded cities at an alarming rate.

In the decade since 2008, the number of unoccupied properties across Japan has grown by nearly 1 million to 8.46 million, according to the most recent 2018 government report. In Nagoya, an industrial hub with a population of 2.33 million, 13.2 percent of its homes are abandoned. Even in Tokyo, which still sees an influx of residents despite an overall fall in the population, more than 1 in 10 homes are empty, a ratio higher than in cities such as London, New York and Paris.

The phenomenon is only expected to worsen in the coming decades — Nomura Research Institute projects the number of abandoned dwellings to grow to 21.7 million by 2033, or roughly one-third of all homes in Japan.

The sweeping demographic change is not only transforming Japan’s landscape, but eroding traditional family support systems and forcing various sectors to adapt, including the funeral industry, says Tatsunori Ohora, the head priest of Komyoji, a Buddhist temple that operates high-tech burial urn storage facilities.

“From now on, temples need to provide services for people who want to mourn the dead without the hassle accompanying customary rituals,” he says.

Komyoji opened its first building-style cemetery a decade ago in Machiya, a district in Tokyo’s Arakawa Ward. Since then, the temple has constructed two more in Tokyo and one more in neighboring Chiba Prefecture, storing a total 14,000 urns.

Visitors to the facility in Machiya can pay their respects to the deceased by passing identification cards over a touch panel in the building’s mourning booths. That activates an automated retrieval system that finds the correct urn and mounts it in the altar. A tablet shows pictures of the loved one while the sound from a rippling water fountain adds to the ambience.

“The definition of what constitutes ‘family’ has been narrowing down,” says Yumiko Waguri, a spokeswoman for Komyoji. “Nieces and nephews, aunts and uncles — even brothers and sisters — are in many cases no longer considered close family members.”

Without relatives to rely on, a growing number of people have been opting for affordable and convenient alternatives to conventional ceremonies and burial services, Waguri says.

The cremated remains of the dead are traditionally stored in urns placed inside family graves that are passed down through the generations, and it’s the bereaved family’s responsibility to pay the local temple for maintenance. But funerals are pricey, costing about ¥2 million on average, while burial plots can be expensive as well.

And with rural depopulation sucking away parishioners, many temples are struggling to stay afloat, leading places like such as Komyoji to turn toward providing innovative, affordable funeral services involving cutting edge technology — including sermons accompanied by projection mapping — to attract business.

A “family type” urn space managed by Komyoji, for example, costs ¥880,000 while a smaller “single” version goes for ¥380,000. An annual maintenance and management fee of ¥15,000 and ¥6,000, respectively, are also required. Many purchasers have recently lost family members, according to Komyoji, while others are those who have decided to move their family graves from the countryside to accessible urban centers. The rest are bought by people planning for their death.

And reflecting the growth in single households, Komyoji now offers a cheaper, fixed term service that sees burial urns transferred to a collective grave managed by the temple after a period of three, five, seven or 10 years.

“People who have opted for this option are buying urn space on behalf of a close relative who had no spouse or children,” Waguri says. “And since the contractor themselves are old, they eventually want to hand over the responsibility of taking care of the grave to us, rather than leaving the burden to other relatives. We’re basically fulfilling their will in advance.”

How to cope with the consequences of living the golden years in isolation has become a widely reported social issue as Japan ages.

In 2010, there were 16.78 million one-person households in Japan. That figure soared to 18.42 million in 2015 and is expected to reach 40 percent of all households by 2040, according to government forecasts. Growth, unsurprisingly, is expected to be most pronounced among households whose residents are over 65.

While the Ministry of Internal Affairs and Communications attributes the trend to an increase in unmarried people and nuclear families, it has also contributed to the rise of a disturbing phenomenon: kodokushi, or lonely deaths, where those living alone are found dead at their home, often going unnoticed for long stretches of time.

Miyu Kojima, 27, works at ToDo Co., a firm that specializes in cleaning the homes that were sites of solitary deaths. She’s seen her share of messy rooms and blood-stained floors and knows that this can happen to anybody, a conviction drawn from her personal experience.

Kojima’s father was an excessive drinker whose alcoholism cost him his job and family. When Kojima was in high school, her mother visited his home to talk about filing for a divorce. Instead, Kojima’s mother found her husband lying on the floor, unconscious from a stroke. Kojima was able to see him at the hospital before he took his last breath, but she still wonders what might have happened if her mother hadn’t dropped by his residence that day.

“I asked myself, would he then be left alone for days or even weeks?”

To convey the imminent nature of the phenomenon, Kojima began recreating miniature models of rooms where people have recently died. First displayed at an annual funeral industry trade show, the immaculate details that goes into her work — from stained tatami-mats and crumpled newspapers to empty pizza boxes — quickly captured attendees’ imaginations and went viral on social media. In August, she published a book chronicling her experience as a “special” cleaner.

At its core, her job is about respecting the dead, she says. “The gruesome aspect of kodokushi is often played up, but I want to let people know that these were real people living real lives.”

In Tokyo, 4,777 people died this way in 2017, according to the Bureau of Social Welfare and Public Health. 3,319, or nearly 70 percent, were over 65 years old. Around a third were found two to three days after their death, while nearly 10 percent were discovered more than a month after they passed away.

Of the few hundred bodies Aqua Quality Staff Co. handles each month, a fair number are cases of kodokushi, says Katsuji Mizusaki, a mortician and the president of the Tokyo-based firm.

Mizusaki is a nōkanshi, a term referring to Japan’s traditional morticians who dress, clean up, apply makeup and sometimes bathe the deceased to prepare them for their final farewell. He says his staff often treats people who died alone and who are sometimes decomposed beyond recognition.

“The futon is a mess, and there are swarms of insects since the body is rotting away,” he says.

Yuko Nakajima, a fellow nokanshi at the company, says the job has made her reflect on her own health and lifestyle.

“You learn firsthand how the cause of death affects the corpse’s appearance. And living alone naturally raises the risk of delayed discovery.”

A survey taken by the Cabinet Office in 2012 showed that 17.3 percent of households whose residents were over 60 felt kodokushi was an issue near at hand. That figure jumped to 45.4 percent among single person households, reflecting how lonely deaths were a source of anticipation looking down the road.

Kazuto and Etsuko Mori, both 69, often contemplate the possibility of losing each other, and how they will cope living in solitude. That concern may have been part of the reason they decided to sell their four-decade-old apartment in Nagoya and move into a renovated serviced apartment operated by Yuimarl Jinnan this June.

“We considered many options, including retirement homes, but decided that was a bit too early for us,” Etsuko says. With their two children grown up and parents deceased, moving to scenic areas such as Hokkaido and Okinawa also crossed their minds, but they decided to prioritize the convenience of city life. “Nagoya residents over 65 can receive a senior pass that allows free access to most public transportation,” Kazuto says.

The infrastructure provided by large cities remain a strong draw. According to a survey taken by the Cabinet Office in 2015, 65.1 percent of respondents raised adequate medical and nursing care facilities as priorities when considering where to live. And when asked whether they would consider relocating to other areas in their old age, only 19.1 percent showed interest.

“We’ve traveled a lot and experienced living in different countries,” Kazuto says. “I think we’ve seen our share of the world.”

In the several months since they moved into their new residence, the couple managed to establish a healthy routine mixed with recreational activities.

Kazuto wakes up at 3:50 a.m. every day for a two-hour walk to and from the city’s landmark Atsuta Shrine. Three days a week, the couple visit a sports club to work out. They also join Miura for the daily 9:30 a.m. rajio taiso exercise, and twice a month on Sundays, Kazuto hosts an afternoon mahjong session at a shared lounge space that is also equipped with a karaoke machine.

“Sure, I’m scared of the prospect of being left alone,” Etsuko says. ” So it’s a race of who goes first, since there’s no use imagining what may happen after you die.”