First Impressions From A Visit To The World’s Most Rapidly Aging Nation (Part 1)
Last month, I got to visit Tokyo to give the keynote at the Carter Japan Marker Resource Network AgeTech event. I met some truly fascinating individuals, got to visit a senior living community and an adult day center, saw some robots “in the wild” and was incredibly impressed by how accessible Tokyo is.
In the first part in this series, I will review the basic stats about Japan as a market for AgeTech, the challenges of aging in Japan and some traditional and not-so-traditional solutions that exist in Japan. In part two, we will review some tech-enabled solutions and insights from AgeTech founders that I got to meet during my visit.
Let’s Start With The Facts
With 36 million people over the age of 65, Japan is the world’s most rapidly aging nation. Climbing life expectancy and record low birth-rates. Japan’s elders are a staggering 29% of the population. In some of the Genkai shūraku (roughly translates to “marginal villages”) in rural Japan, it’s not uncommon to find that more than 50% of remaining residents are over the age of 65.
Japan also has the world’s lowest potential support ratio (the number of potential caregivers for every older adult). There are only 2x people between the ages of 20-64 for every Japanese person over the age of 65.
When it comes to aging in place, it should come as no surprise that more than 90% of people over the age of 65 in Japan prefer to remain in their home of choice. Even more interesting is the fact that over 50% of Japan’s elders prefer to die at home, but only ~13% end up doing so.
Older adults who require long-term care can receive it, thanks to universal long-term care insurance. Japan’s Long-Term Care Insurance was enacted in April 2000, and it provides service to more than 5 million people over the age of 65. The benefits, which include institutional, home and community-based services, are accessed through a care manager.
I got to visit a day center during lunch time, and noticed that the staff had prepared and served a traditional home-made meal in beautiful plates that was not only nutritious but actually looked like something that you would want to eat. Very un-institutionalized.
I don’t know if this represents lunch or meals in general across Japan’s long-term care system, but I can say that I’ve never seen food prepared or served in this manner in any Western LTC facility.
The Challenges of Aging in Japan
Many of the challenges of aging – such as health & wellness, maintaining independence throughout the adult life span, and social isolation and loneliness – are fairly universal. However, Japan is ahead of the curve in dealing and coming up with solutions to some of them.
Health & Wellness
Thanks to Japan’s universal health care system, the average Japanese person who has reached the age of 60 can expect to live ~25 more years, with ~20 of them being in good health.
Japan’s government puts a lot of emphasis on preventive medicine, and over the years, it has enacted several policies designed to help citizens to maintain a healthy lifestyle. For example, citizens are encouraged to go through regular health check-ups, and local governments are expected to build physical power-up stations for older residents.
The Economics of an Aging Society
Despite it being the world’s third largest economy, with a $5 trillion GDP, Japan’s economy is slowing down. It has some of the lowest GDP growth rates among G7 countries (Edmond, 2019). This stunted growth can be attributed to the shrinking working age population and to mandatory retirement policies that are still common among Japanese companies. “Nearly 70 percent of older Japanese wish to work beyond age 65, but only 20 percent are actually employed”. Additionally, caring for young children and the elderly prevents women from fully participating in the workforce.
Due to the aging of its population, lack of eldercare is a much more likely reason for a Japanese woman to leave the workforce than is lack of child care. 38% of Japanese females leave due to lack of eldercare, compared to 32% who leave due to lack of childcare.
lack of eldercare is a much more likely reason for a Japanese woman to leave the workforce than is lack of child care
When it comes to government spending on caring for the country’s elders, Japan spends more than 20% of its GDP on social security benefits (~50% for pensions, ~30% for medical subsidies, and ~20% for welfare which includes long-term care for the elderly).
To tackle the issue of a shrinking workforce, Japan’s government has implemented new policies to help working parents, and created the concept of the Silver Jinzai (Jinazi translates to human resources). Silver Jinzais are Local HR agencies that specialize in older workers and provide employment opportunities for local elders. Contrary to what you’d expect, some of the work opportunities are quite physical so it could also count as light exercise. For example – gardening, snow shoveling are among the services offered by Silver Jinazis. This could potentially help reduce or curb government spending on healthcare.
Loneliness and Social Isolation
While there is no current research to assess the scope of the issue, loneliness and social isolation are an issue for Japan’s elders. The Japanese word kodokushi means “lonely death”, and is used to describe a situation in which corpses remain undiscovered for long periods, sometimes even for months or years.
While there is no government policy to tackle loneliness and social isolation, some people have come up with services and creative solutions to deal with this issue.
For example, a service titled “Family Romance” allows people to hire freelancers to act as family members in certain social situations, like attending a wedding.
Another creative solution was created by Tsukimi Ayano, a 65 year old woman living in Nagoro which is one of Japan’s depopulated rural villages. Ayano has created dolls to replace neighbors who have died or moved away, and now they outnumber Nagoro’s living residents.
Companion robots like Paro and Lovot can be found in stores at the mall – we’ll dive deeper into robots for older adults in Japan in part 2.
Making Cities Age Friendly
With more than 91% of the population living in cities, Japan has one of the highest rates of urbanization in the world. Generally speaking, urban areas are better equipped to meet the changing needs we have throughout our lives, and especially in our later years. What I found to be remarkable in Tokyo, is how accessible it is.
In fact, I can safely say that Tokyo is the most accessible city I ever visited.
The first thing that struck me as soon as I landed was how much effort was put into making public spaces – particularly high-rise buildings and shopping centers, accessible.
The sink at the airport bathroom had grab bars, elevators had signage indicating priority access for older adults, people with disabilities, and parents with strollers. The elevator’s buttons were placed low so people in wheelchairs could reach them easily, and some of them even had seats with a built-in emergency button.
It is clear that there are plenty of opportunities to create innovative solutions in Japan, that would not only serve the country’s older adults but Japanese society as a whole, deal with the aging of its population. What opportunities are addressed by Japan’s AgeTech startups? And what advice do founders in Japan have for aspiring entrepreneurs in this space?
Stay tuned for part 2!