Where they go to die

Several weeks ago in Shibukawa, a town about 100 kilometers north of Tokyo, ten bedridden residents of a private nursing home died in a fire that was probably caused by a cigarette. The idea that one of the elderly men who lived in the facility was smoking proved to be less of a media scandal than the social circumstances surrounding the facility and how these particular people ended up there. Though it’s no secret that older people basically go to nursing homes to die, in this case they just did it a little sooner.

As in most developing countries, the population of Japan is rapidly aging, and one of the most pressing questions for the near future is where all these old people are going to live. Traditionally, older people lived with their children in the same house, but since the end of the war and with the creeping dominance of the nuclear family more and more seniors are spending their twilight years alone. Naturally, this situation places a huge strain on Japan’s social security system, which has not been up to the task. The most that a retired couple can receive in company-sponsored state pensions is about ¥200,000 a month, which is difficult to live on in any Japanese city, even if the couple owns their own home. The worst case scenario would be an elderly person with no job or supplemental income (meaning other than his or her pension) living alone in a rental property and falling ill. In such cases, the local government will provide welfare, but if the person’s illness or disability is severe, than the person will have to be moved to some sort of facility.

For whatever reason, Japan is way behind in nursing facilities for the elderly. At present many are being built, but they are mostly private care facilities that cater to people of considerable independent means. So-called “special facilities” that take in welfare or low-income cases are also spreading, but there is no oversight authority to inspect and license them. They are basically filling a very desperate need faster than national or local governments can get a handle on the situation. The total capacity of such facilities nationwide is about 430,000, leaving about 385,000 people on waiting lists. 

Of the ten people who died in Shibukawa, six were from Sumida Ward in Tokyo. They had been sent there by the Sumida welfare department, because there are no low-income faciilities in Tokyo, where land is too expensive. The Shibukawa home received the welfare/pension payments from Sumida Ward. This is the norm. Old people living in Tokyo with no family to take care of them and who become too sick to care for themselves are inevitably shipped out to remote nursing facilities where they know no one. Some media reports have said that the Shibukawa facility locked some of their residents in because they didn’t have enough staff to stay in the building at night. The media has said that such facilities should be shut down or, at least, regulated appropriately, but local governments have avoided the matter because they know if these facilities are shut down they will have to find places to put these people, and there are none. But they’re still responsible. The six dead bodies were shipped back to Sumida Ward, which now has to deal with them. No families have claimed them.

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