Japan
“World’s fastest ageing society”
- One in five elderly people over 65 years old is expected to have dementia by 2025.
- One in two elderly is likely to have cancer.
- Over 12,200 elderly people are missing every year.
- 100,000 employees leave a job every year to give nursing care to elderly family members.
- In 2007 a 91 year old man suffering dementia wandered out of his home, went through a fence at a railway station, walked onto a rail track, was run over by a train and died. The railway company sued the family of the old man for compensation for damages of train delays and confusion citing a civil code which tells if a person is incapable of taking responsibility for his/her actions, a person who is in a position of legal supervision is responsible for damages caused by him/her.
This is what is happening in Japan where ageing is advancing fastest in the world. It is a matter of time for the rest of the world to catch up and it is said the world is watching how Japan copes with this ageing issue.
I live in London but I have an ageing parent in Japan, and I too am watching closely how ageing is progressing there. With my career experience in therapy and finance helping me to see it from wider angles, I am becoming more and more aware that ageing can bring an enormous impact economically, socially and individually. It is not just a problem of senior generation, it is not just an issue on who pays care costs. It is not a matter of young generation vs senior generation on wealth distribution.
Ageing has a much wider implication involving us all – young or old. On many levels ageing society has a force to make us change how we live and die drastically.
****************
Every time I am back in Japan, I notice more elderly persons in buses. I notice more places with wheelchairs for customers and the number of wheelchairs increases every year… These are unavoidable reminders of “ageing”, questioning me not only “how I live” but also “how I die” and “how I live to die”. .
****************
Japan is a country where ageing is advancing faster than in any other countries. This rapidly progressing ageing population is creating serious difficulties and more and more ordinary Japanese are seeing their lives affected.
Because of advancing ageing, there is deeper consciousness and understanding about ageing among Japanese. Various problems produced by rapid ageing and seriousness are more widely acknowledged. Japan’s government started to act firmly and set up plans to cope with ageing issues. Companies in Japan also started to offer support to their employees who need to provide nursing care to ageing family members.
Watching Japan, I too have realised the seriousness of deepening ageing society. This is something which forces drastic changes to the way we live as an individual, as a community, as a society and as a nation. It forces us to review how we work, live and die.
It is a matter of time for the rest of the world to catch up with Japan in ageing. It is said the world is watching Japan how to cope with the ageing issue. Because of this, I decided to choose this subject for my blogs and to introduce what kind of impacts Japan’s ageing society is giving to ordinary people’s lives. Because of my career experience in therapy as well as in finance with a background of economics, I can see ageing society has a tremendous force to potentially change everything.
I hope my blogs can give a glimpse of the seriousness and significance. I hope knowing what is happening in Japan will better prepare us for unavoidable changes the ageing population brings to our lives, although what is happening there may not necessarily apply to other countries due to differences in policies, regulations, societies, life styles etc.
I read a doctor in Japan, who has seen many deaths of old people at care homes, talking about the importance of living a life with a sight of death on an extension of life. He said “We need to change the way how we see life. Instead of looking at death from the current point of life, we need to learn to view current life from an ending point of death, and amend how we live current life accordingly.”
“Year 2025 Issue” and “Promotion of Dynamic Engagement of All Citizens”
In September 2016, the number of people over 65 years old reached 34.6 mil in Japan, representing 27.3% of the total population. In 1990 the ratio was 12.1%. Within 26 years, the number tripled. This shows how rapidly an ageing population can advance.
There are currently approx. 15 million people over 75 years old in Japan. This number will increase to 22 million in the year 2025. This will create an ultra ageing society in which one in four people will be over 75. In 2025 problems such as costs of medical and welfare care, and a shortage of suitable homes for the elderly population, will surface. “Year 2025 Issue” is about an explosion of economic burden caused by this ultra ageing society.
In the year 2025, the number of households headed by elderly individuals over 65 is expected to increase to approx. 1.8 million. 70% of these households will be occupied by an elderly couple or an individual over 65 years old. In addition, one in five of these elderly is likely to have dementia – yes, one in five. It will become the norm to have one elderly member with dementia in one’s family or relatives.
Rising problems of elderly persons
In Japan people are seeing rising problems of elderly persons with dementia wandering on the streets. Even if their families live with them, keeping an eye on these elder family members for 24 hours a day, 7days a week, 365 days a year is almost impossible.
You may say they should be kept in a care home. The problem of this is the high cost of care homes. In Japan low cost care homes run by the government are oversubscribed and there is a long waiting list (this is the same in the UK). Private care homes are expensive and not everyone can afford it (private care homes are hugely more expensive in the UK compared to Japan and the average cost is now £55,000 per year in the UK!!). I read that in Japan a female elderly person stays in a care home for 8 years on average. If this is the same in the UK, staying in a private care home here costs £440,000 (£55,000 x 8 years)!! This amount probably does not even include other costs such as food/meals.
Wandering elderly persons with dementia have become a serious social issue in Japan and the police department announced there were over 12,000 elderly people missing every year (as of 2016).
Soon, seeing elderly people wandering on the street may become a common sight not only in Japan but in other countries...
Who is responsible for an elderly person with dementia?
In 2007 news shocked the Japanese nation. A 91 year old man suffering dementia wandered out of his home, went through a fence at a railway station, walked onto a rail track, was run over by a train and died. This caused train delays and confusion. The railway company, JR Tokai, sued the family of the old man for compensation for damages for approx Yen 7.1 million (£52,000), citing civil code which tells if a person is incapable of taking responsibility for his/her actions, a person who is in a position of legal supervision is responsible for damages caused by him/her. The superior court ordered his wife who was in her 80’s to pay Yen 3.4 million (£23,000) due to negligence. This court case brought attention to the issue of who has legal responsibility for elderly persons with dementia.
When I read this court case, I though it ridiculous for his wife to be made responsible for the damage. My heart goes out to her. However, if parents leave a small child wandering outside without supervision and the child causes serious damage to the public, then the parents will be blamed for negligence. An elderly person with dementia is almost the same as a small child.
This court case brought realisation to people in Japan that they cannot just leave elderly people alone and forget their existence. Also at the same time, this also makes it necessary for parents to re-think what kind of relations they would like to have with their family.
However, it is also clear that the ageing issue is something a society and a nation as a whole need to work together to tackle - we cannot just leave it to families of elderly persons.
Remember no one can stay young forever. We all age..
100,000 employees leaving a job every year to give nursing care to their elderly family
In Japan approx. 100,000 employees leave a job every year to give nursing care to their elderly family members. For instance, a man may have to leave a job at the age of mid 30s, in the prime of his life and with a young family to raise, to provide nursing care for his father. He may return to work after the father passing away, but then he may have to leave his job again at the age of mid 40s to take care of his mother. Or a husband may have to leave a job to take care of his parents and his wife for her parents.
Most find it too difficult to keep their job when providing nursing care for elderly family members. A survey done by one life insurance company showed 50% of those taking care of elderly loved ones left their job within a year after starting the nursing care.
They are often in their prime playing a central role at their offices, when they take nursing care leave. This is a serious issue for employers.
Abenomics - Promotion of Dynamic Engagement of All Citizens
This also damages Japan’s overall economy. Acknowledging this, the Abe government introduced a policy called “Promotion of Dynamic Engagement of All Citizens” as part of Abenomics and set up a Minister for this policy with an aim to make zero nursing care leave. The government is undertaking various tasks such as creating more nursing care support services, offering a subsidy to companies which provide nursing care support for their employees.
Following the above government policy, an increasing number of large corporates in Japan are now taking actions to provide employees with support, so they can keep their job while taking care of elderly loved ones.
According to articles by Nippon Keizai Shinbun, a major quality financial paper in Japan, Taisho Kensetsu, one of the leading construction companies, started to offer nursing care support to its employees in 2010. The company started offering basic information on nursing care in leaflets and holding seminars, then in 2014 a programme was set up to provide varied support. Since then, further measures have been introduced. They include offering comprehensive information on nursing care to lessen psychological burdens employees carry when taking care of elderly family members, etc.
Nippon Life, a major life insurance company, hires a professional consultant in the elderly nursing care field and holds seminars for all employees. At the seminars, talks as well as practical training such as moving a chair with an elderly person sitting in it, are given.
At Panasonic, a well known brand for electric goods, 70% of employees are over 40 years old. In December 2015 the company performed a survey for employees regarding the need to provide nursing care to family members. The survey result made the company realise the importance of providing basic information on nursing care. Often employees find themselves unexpectedly in a position to take care of elderly family members. They are often not well prepared and the pressure and stress they feel is huge.
Panasonic then quickly set up a programme providing employees with varied nursing care support. It offers information on nursing care by website, provides one-to-one consultation etc. The company hires a professional consultant who helps with paperwork when Panasonic’s employees apply for public medical and nursing care services. Financial aid in the form of a subsidy or loan for nursing care bills is offered as well. The company also tries to create an office environment where employees can talk about nursing care freely.
Mizuho Financial Group, a leading financial firm, started nursing care support in Autumn 2016. Support measures include doubling the number of working days their employees can take when needing to take care of elderly loved ones (244 days a year as of June 2016). The company is also active on re-employing ex-employees who left to take care of elderly family members.
Goldman Sachs, Japan, offers support not only to employees, but also to family members. GS hired a nursing care service company which provides a GS employee’ family member with nursing care up to 100 hours per year. The company also provides employees with a financial subsidy on nursing care bills.
In April 2015, Daiwa House, one of the leading house builders, set up a support programme. It provides a subsidy for travel costs up to four times a year when employees need to travel for giving nursing care to their parents. The amount of the subsidy is determined according to the distance of travel they made.
(Note: information and numbers above may be changed/updated now)
Only a small number of large companies provide such nursing care support to employees. However, since the government is promoting the zero nursing care leave policy, more companies will follow.
************
Reading these actions and measures the government and companies in Japan are undertaking surprised and impressed me. It is so very good to know they have started to take more firm actions because of the seriousness ageing society creates.
Living in ageing society is not the same as living in non-ageing society. I acutely feel the difference, as the UK is not yet facing such advancing ageing.
Until I lost my father who passed away so unexpectedly, I never thought seriously about ageing. When he passed away, I looked around at what my friends and relatives with elderly parents were doing. Then I saw for the first time they had learnt or were learning to quietly accept what ageing would bring – the possibility of losing their loved ones by sickness such as cancer or in dementia, as well as the possibility of themselves dying by cancer or in dementia when ageing takes place. In the country where one in four is over 65 years old, sometimes the existence of “death” can be felt more strongly in daily life.
I am glad I am now aware how ageing society will be like. This enables a better preparation for me and my family on many levels.
There are many things happening in Japan to cope with the ageing issue. Advancing ageing has a force to change a great many things.
I will continue my blogs to provide further information such as technology, which can help with elderly at home, radical city/town planning the government is pushing to cope with elderly population, competition with AI (Artificial Intelligence) in relation to ageing (it is pushing development and applications of AI much faster in much wider areas than people generally think – we need to think very carefully about career paths so our career will not be stolen by AI in the very immediate future) .
Thank you very much for your interest in reading this blog.
Shigemi Cheves
