Services and Housing for the Elderly in Japan
Japan’s population is aging at the rate the world has never experienced before.
As you may be familiar already with the terms, aging society, aged society and superaged society, if the percentage of elderly persons in the total population exceeds 7%, asociety is called an aging society. Japan became an aging society in 1970, followed by anaged society (14%) in 1994 and a super-aged society (21%) in 2007. In 2023, Japan’spercentage of the elderly in the total population even went further and reached to 29.1%and I think it is not exaggerating to say that Japan is a super-super aged society.
The aging of the population is expected to advance further and by 2040 when thesecond baby boomers, who were born in between 1971 and 1974, become 65 years oldand older, the aging rate is said to be over 35%.
Aging population is not unique to Japan but seen anywhere around the world.
When looking at the global aging rate, it was 9.4% in 2020, and it is expected to be
18.7% in 2060.
Japan has run ahead of other countries for about 60 years when it comes to the aging
rate; however, South Korea will catch up with Japan in 2040 and Singapore, then followedby China and Thailand, will catch up in 2060.
According to the World Health Statistics 2023 released on May 19, 2023, the country
with the highest average life expectancy is Japan with the age of 84.3. Switzerland comesin the second place with 83.4 and South Korea comes in the third place with 83.3. (Notethat the result is different from the one released by UNFPA.)When looking by gender, Switzerland ranks first at 81.8 years old, followed by Japanat 81.5 years old for males.
Japan ranks first at 86.9 years old followed by South Korea at 86.1 years old for female.
The average life expectancy exceeds 80 years old in 31 countries.
Aging has surely become the global issue.
While the longer average life expectancy is somewhat desirable, the lower birth rate isproblematic. To be precise, the problem is the declining birthrate with the aging
population.
Some fifty years ago, one elderly person was supported by nine working-age persons
in Japan; however, in another 20 years or so, the day will come where one elderly person
is supported by two or less working-age persons.
Problems such as the shortage of labor and the reduced tax revenue due to the shrinkageof the working population caused by the fewer children have arisen.
Transportation and nursing care industries will be hit the hardest by the decline of theworking population. Although the utilization of AI and robots is much anticipated, thenursing care industry where the number of users (the elderly) is increasing while it is hard
to secure workers is the one of the industries easily affected by the changing
demographics.
In Japan, there is a movement to consider revising the definition of the elderly.
In reference to the current definition and classification of the elderly, those who are 65
years old and older are defined as the elderly. However, when examining the long-timechanges of the various data on the senility of the today’s elderly, the result is that themental and physical health among those who aged between 65 and 74 is well maintained,
and the majority of them are still possible to actively engage in the social activities. Thereare also the number of growing negative opinions against the traditional definition thatstates people aged 65 and over are considered the elderly, according to many surveys. Assuch, redefying the elderly that the elderly should be those who are 75 years of age andolder is being proposed. (“Redefining the elderly as aged 75 years and older: Proposal
from the Joint Committee of Japan Gerontological Society and the Japan Geriatrics
Society”, March, 2017)
In fact, there is data that the elderly today are physically 10 to 15 years younger andmentally 5 to 8 years younger compared to that of 20 years ago.
That being said, the number of those who require nursing care is constantly increasing.
In addition, while the total population is shrinking, the number of people who aged 75
years and older is expected to increase until 2055.
I have just mentioned about the movement of redefying the elderly as 75 years of age
and older instead of current 65 years, the actual number (percentage) of people who
require nursing care for the old-old (75 years old and older) is 8 times as many comparedto the young-old (between 65 years old and 74 years old).
Sure enough, the need for nursing care services will rise in the future.
The nursing care services available for the elderly in Japan are as follows.
Elderly Care Services⚫ Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly(Intensive Care Homes for the Elderly)⚫ Long-Term Care Health Facilities⚫ Home-Visit Long-Term Care
⚫ Home-Visit Nursing⚫ Outpatient Day Long-Term Care
⚫ Short-Term Admission for Daily Life Long-Term Care
⚫ Daily Life Long-Term Care Admitted to a Specified Facility⚫
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Rental Service of Equipment for Long-Term Care Covered by Public Aid
Home Modification for In-Home Long-Term Care
In-Home Long-Term Care Support
Communal Daily Long-Term Care for a Dementia Patient
Outpatient Long-Term Care for a Dementia Patient
Multifunctional Long-Term Care in a Small Group Home
Home Care - Regular and On-demand
Community-Based Outpatient Long-Term Care Service⚫
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Nursing and Small-scale Multifunctional Domiciliary Care
Nursing Homes for the Elderly
Low-Cost Homes for the Elderly (Type A)
Low-Cost Homes for the Elderly (Type B)
Low-Cost Homes for the Elderly (Care House)
Low-Cost Homes for the Elderly (Urban-type)

Elderly care services include welfare equipment and housing renovation for those whoare cared at home.
These services are provided in the form of the allowance for rental or purchase (notsuitable for rent) costs for welfare equipment or the allowance for construction costs forsuch as installing handrails or improving accessibility (some requirements and restrictionsapply).
Medical care, such as home-visit nursing, is also available.
The following is the list of facilities for the elderly.
In 1980, a half of households with people aged 65 and over were three-generationhouseholds, but today such households account less than 10%. Instead, households
consisted of married couple account 32%, and single-person households, 28.8%. 60 % ofhouseholds with people aged 65 and over are the elderly-only households.
Facilities for the elderly[For the elderly who require nursing care or/and medical care]⚫ Facility Covered by Public Aid Providing Long-term Care to the Elderly (IntensiveCare Homes for the Elderly)⚫ Long-Term Care Health Facilities⚫ Sanatorium Medical Facility for the Elderly Requiring Long-Term Care⚫ Integrated Facility for Medical and Long-term Care⚫ Special Facility Providing Daily Long-Term Care⚫
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Community-Based Specified Facility Providing Daily Long-Term Care
Community-Based Facility for Preventive Daily Long-Term Care of the Elderly
Covered by Public Aid
Private Assisted Living Facility
Communal Daily Long-Term Care for a Dementia Patient (so-called Group Home)
Serviced Residence for the Elderly[For the elderly who have difficulties to live at home]
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Nursing Homes for the Elderly
Low-Cost Homes for the Elderly
Care Houses (Type A and B, Urban-type)
Private Residential Homes
Life Support Houses

In Japan, we have a special expression, Tsui no sumika, which refers to one’s final
abode. Will you be able to live the house you built when you were young, intending tolive to the end of your life, even though you’d come to require nursing or medical care?
As there are issues of living alone and the elderly caring the elderly, I will discuss indetails the housing for the elderly in my next report.

References
The Statistics Bureau of Japan (2023, September 17) Statistical Topics No. 138,
“Statistical Observation over Japan's elderly - In honor of "Respect for the Aged Day"
Ministry of Internal Affairs and Communications
Cabinet Office (2021) Annual Report on the Aging Society FY2021.
Cabinet Office (2023) Annual Report on the Aging Society FY2023.
Takao Suzuki (2007) Basic knowledge of super-aged society, Kodansha Gendaishinsho
Tokyo Metropolitan Foundation for Social Welfare and Public Health (2023),
Comprehensive Guidebook for Welfare Services in Tokyo – Housing Facilities for theElderly. https://www.fukunavi.or.jp/fukunavi/

About the writer:

Yuko Horiuchi, Gerontologist
President, Senior Life DesignPresident, Gerontology Design Lab
Collaborative Researcher, Institute for Gerontology, J.F. Oberlin University
Yuko Horiuchi started her career working for an architectural firm, involving a homerenovation for a client requiring care services. Before reaching her current position, she
has worked as a marketing consultant at a consulting company specialized in the seniormarket. She holds Master of Arts in Gelotology from J.F. Oberlin University.