TOKYO, Japan /The Asahi Shimbun / Society / Lifestyle / June 27, 2009
By Kiyoko Miichi,
The Asahi Shimbun
After a solitary life that unraveled in cheap, dingy lodgings, an 81-year-old man finally found sanctuary and peace of mind at a residence in Tokyo. His new "home" is Furusato Hotel Sanko in Taito Ward, run by a nonprofit organization that assigns two to three workers around the clock to watch over dozens of mostly elderly residents, all of whom live on welfare.
Elderly care in Japan: Photograph used here only for illustration of elderly care in Japan. Courtesy JAPAN TODAY/REUTERS/Issei Kato
Like his new neighbors, the man uses his benefits to pay a monthly rent of 69,800 yen, and 70,000 yen for meals and utilities. He was divorced at age 45, then lost a job through illness five years ago and was forced to shift between uncomfortable, low-rent accommodations until he moved into Sanko last year. He says he can no longer return to his hometown. "I live in a private room and get three meals a day. I feel safe because a staffer comes as soon as I call," the man said. But his sense of security is not shared by many like him, who have little money and no relatives to help them in the twilight years of their life. A fire at the Tamayura home for poor, elderly people in Shibukawa, Gunma Prefecture, highlighted the tribulations these people endure, and the lack of administrative support they receive. Of the 10 residents killed in the March 19 fire, six were receiving livelihood assistance from Tokyo's Sumida Ward. With no homes to accept them in Tokyo, ward officials sent them to Tamayura, which was not registered as a nursing home for the aged that must satisfy standards under the Welfare Law for the Aged. Repeated renovations had turned the buildings into a maze. It had no smoke alarms. Where central and local governments fail, more NPOs are coming in to provide much-needed help for solitary, elderly people who cannot afford to pay to live in fee-charging, privately run old people's homes. But their facilities and operations vary, as do their legal status. Even Sanko, where the 81-year-old man found solace, remains unregistered under welfare laws, despite the fact welfare officials often rely on it in their desperate search for facilities ready to accept old people on welfare. Welfare workers and volunteers say they have little choice. Where else can they turn when they need support for these frail members of the community? The operator at Sanko, an NPO called Furusato no kai, calls it a "home to support self-reliance." It says the facility is a temporary lodging where people can stay before moving on to a special nursing home for the elderly or some other facilities. But waiting lists are getting longer at such nursing homes, which are run by municipalities or welfare entities. Sanko was opened in 2005 in Sanya, a district known as a day laborers' town. Furusato no kai started as a group to help homeless people. Many of its residents have no relatives. A man in his 60s who moved into Sanko last year died from illness at a hospital this year. Two Sanko staffers were the only people to attend his cremation. The man had a younger sister, who was contacted when he was in critical condition. Her response was: "We have no grave. I'd rather welfare authorities took care of his funeral." The manager at Sanko, 44-year-old Noboru Tanabe, said that it was "very rare for relatives to attend the cremation of a deceased resident." He said the mortuary urn of one resident who had dementia bore the title "Mr. Unknown Name" because staff had been unable to ascertain his identity. Sanko can accommodate up to 78 people. Six out of 10 residents require nursing care or assistance with day-to-day activities. Most are introduced by welfare officials, as in the recent case of a 78-year-old man who had to be supervised at all times and often taken to hospital as a result of an injury he had suffered. Sanko worker Kenichi Shibayama, 27, welcomed the man, who walks with a stick. "Please take it easy; you can stay here as long as you want," he told him. Many initially worry they might be forced out at any time, Sanko workers said. Their anxiety stems from earlier poor treatment at profit-driven facilities that found ways to get rid of them when they began to need expensive nursing care. Besides Sanko, Furusato no kai operates eight similar homes in Sumida and Taito wards. Altogether, the NPO provides shelter for 200 people. About 100 more are on a waiting list. Still, Ken Takiwaki, 37, a director in charge of the group's lodging operations, often receives hopeful calls from case workers looking for help. "We can't find any room; isn't one available?" inquired a welfare official from a Tokyo ward in one such call recently. Takiwaki had to decline. "Case workers are often desperate," he said. "They insist they have nowhere else to turn if we say no. There's no recourse available." At the time, Takiwaki was on his way to visit an unregistered home in another prefecture where several elderly welfare recipients from another Tokyo ward had been placed. The purpose of the visit, by Takiwaki and others, including a ward official, was to see whether they need to be relocated to Sanko's facilities. In the wake of the Tamayura disaster, the ward was hopeful it could move some of its residents back to Tokyo. The home was on a mountain slope far from shops and other residences. "It's (like) an elderly dumping site ... ," said one of the visitors. Later, Takiwaki said: "Our main fear is that a home (like this) is isolated from society." "Even within Tokyo, we can support elderly people if regional services such as home visits by doctors and helpers are put to good use," he said. "But such services do not reach those who actually need them. I hope the central and Tokyo metropolitan governments will try to meet these needs." Formerly, hospitals accepted elderly people requiring nursing care, but that led to ballooning health care expenses. In 2000, the government introduced a long-term nursing-care insurance program aimed to shift treatment to home-based care. In 2006, it went further by reducing hospital "convalescent wards"--which had effectively been facilities for elderly patients requiring care. These and other steps to cut medical costs have deprived many frail elderly citizens of a place to stay when they begin to require nursing care. Sadao Shibasaki, who uses a wheelchair, was one such person. His rescue came from another Tokyo-based NPO. In April, Shibasaki, 74, went to see what would soon be his new "home," and was overjoyed at what he found. "It's nice and clean," said Shibasaki, who had spent years in lodgings for day laborers in Sanya. The welfare recipient depends on an oxygen cylinder to support his lungs, which have been weakened by a battle with tuberculosis. Opened by Home-visiting Station Cosmos in May, his new home, the Cosmos House Ohana in Taito Ward, accommodates 13 low-income elderly people like him. Residents started moving in on May 11. At least one worker is always on hand to help residents at the facility, which has an elevator to help frail residents access their rooms with minimal strain. A visiting nurse provides health checks, and helpers assist them when they use the barrier-free bath. The rent and other fees are the same as at Sanko, so residents can afford to pay them out of their welfare benefits. "It's too good for me," an apparently relieved Shibasaki said. "I feel I might receive a divine punishment (for having so much luck)." He was accepted by Ohana, which means "family" in Hawaiian, because he had been covered by the Cosmos nursing visit program. However, there is a limit to what one NPO can do. Ohana has a quake- and fire-proof structure and is equipped with smoke detectors and evacuation lights. Even so, it does not meet the standards to register as a fee-charging nursing home under the Welfare Law for the Aged. The NPO has registered the home with the Tokyo metropolitan government as a low-rent lodging under the Social Welfare Law instead. Many NPO facilities remain unregistered under welfare laws mainly due to the high costs involved in meeting building standards, fire safety and other laws. Tamayura was one such facility. According to Cosmos, Ohana is expected to chalk up a monthly loss of more than 500,000 yen from its operations, construction costs excluded. The NPO plans to make up for the loss with profits from its home nursing care programs. Mamiko Yamashita, a nurse who serves as Cosmos representative, says the NPO decided to build Ohana, costs notwithstanding, because it "wanted to do something" for an increasing number of elderly people with no support. "There are too few places where elderly people can live at ease while receiving welfare assistance," Yamashita says. "But making a fee-charging nursing home is too costly. It couldn't be done easily in an urban area with high land costs." Cosmos opened Ohana to help fill a gap left by administrative inaction. But it is now inundated with applications and inquiries from welfare officials of Tokyo municipalities.[rc] Related earlier report Copyright 2009 The Asahi Shimbun Company
