• 100,000 people a year leave their jobs to nurse relatives
  • Ranks of Japan's over-75s set to balloon as baby-boomers age

When Akihiro Takano resigned from his well-paid job as an events manager at a Tokyo department store at age 45 to take care of his ailing father, he had no idea he was about to slip down the ranks of society until he was penniless and living in a park.

After his father’s death, Takano struggled to make ends meet with a series of insecure jobs while keeping an eye on his frail mother. Nine years later, in 2009, he spent the last of his savings on her funeral, fell behind on rent and was evicted from the apartment that had been the family home for 30 years.

Akihiro Takano
Akihiro Takano
Photographer: Akio Kon/Bloomberg

He left with his mother’s ashes in an urn and her pet cat in a cage. Now, back on his feet thanks to a chance encounter with a group of volunteers, Takano has paid work as a counselor for people on low incomes and has become a public face for what the Japanese refer to as “kaigo rishoku,” or the growing phenomenon of job loss due to caring for elderly family members.

“My boss told me that once you take off your necktie, it’s not easy to put it back on,” Takano said in an interview as trains clattered by outside the office of a charity in Saitama, north of Tokyo, where he works sometimes. “I had stepped on a slide with no means of stopping. But I didn’t realize it myself -- I thought I would manage somehow.”

More than 100,000 people a year in Japan leave their jobs to care for sick relatives, according to the government, and most of them remain unemployed.

Baby Boomers

The tally is set to balloon as the nearly 7 million-strong baby-boomer generation reaches the age of 75 in the coming decade, potentially dragging their children from the workforce in their prime earning years. That’s something Japan can ill afford, as the working-age population shrinks due to the low birthrate and the government’s rejection of immigration.

Prime Minister Shinzo Abe in September vowed to stem the flow, which he referred to as an “imminent crisis.” In a speech, he set out targets for growing the economy to 600 trillion yen ($4.9 trillion) from the current 500 trillion yen, preventing the population from falling below 100 million from the current 127 million, and enabling as many people as possible to work, whatever their family responsibilities.

More Beds

As a first step, the government last month announced plans to provide an extra 120,000 people with beds in homes for the elderly or other forms of support by the early 2020s, on top of a previously planned increase of 380,000 beds over that period. Regulations will be eased to make it easier to open nursing homes in major cities and entitlements to leave and allowances will be revised

The measures may boost Japan’s workforce by a modest 0.2 percent a year, Mark Williams and Marcel Thieliant of Capital Economics said in a report this month. Still, some researchers say the government’s proposals don’t address the complexity of the issue.

“It’s not something that can be resolved by just building more nursing homes,” said Takanori Fujita, author of Elderly Underclass, a book about the risk of poverty in old age that threatens even those with comfortable incomes. “What’s needed are more stable jobs with benefits, less overtime work, more childcare places and more support for women in the workplace. Society needs a complete rethink.”

Japan has 16.4 million people who are 75 or older, the age-group among which the need for medical and nursing care expands rapidly. By 2025, the number is projected to swell to 21.8 million.

The country is already saddled with waiting lists for government-subsidized nursing homes -- about 260,000 people were being cared for at home while awaiting a bed in a publicly subsidized facility as of March last year. There is also a shortage of people to look after them, partly because Japan has admitted few care workers from overseas, and the barriers to employing more remain high.

Better Pay

Noriaki Tsushima heads a group operating facilities for the elderly on the northern island of Hokkaido and serves on a panel advising Abe on ways to maintain Japan’s population and keep people in work. Tsushima proposes opening more nursing homes in urban areas that can act as hubs for the care of elderly people living in surrounding communities.

Resolving staff shortages is simple, he said: “We need to raise salaries,” Tsushima said in an interview. “If you build the facilities, but you don’t have any care workers, you won’t get anywhere.”

Nursing home workers earn an average 220,000 yen a month, compared with about 330,000 yen on average across all industries, according to the Health Ministry.

Insurance Premiums

The funds to make up the difference could be found by collecting insurance premiums that help cover the cost of nursing care from younger people, Tsushima said. The long-term care insurance system, introduced in 2000, currently requires Japanese residents to pay premiums from age 40.

Mie Waki, 44, combined her property development job with caring for her severely depressed mother for years before starting Work and Care Balance Laboratory, a business offering seminars for other carers.

The central government alone can’t solve the problem of carers leaving the labor force, she said, which is why she encourages individuals to tell their employers about their needs and to take advantage of the services offered by local municipalities. Waki not only urges carers to avoid giving up work, but tells them not to take long-term leave for fear of losing motivation.

Silent Supporters

“The central government needs to work on this, but also corporations, professional care workers and we ourselves need to make an effort,” Waki said. “There are tools, and you have to learn to use them.”

The key is to spread the know-how gained by those who are already successfully combining work and caring, she said, rather than focus only on studying those forced out of their jobs.

Takano speaks on the telephone in Saitama
Takano speaks on the telephone in Saitama
Photographer: Akio Kon/Bloomberg

Takano, now 60, unmarried and estranged from his only brother, said he thought about suicide during his months living rough. While he’s back in an apartment, he dismissed the government’s chances of eliminating the “kaigo rishoku” problem.

He cited a barrage of obstacles, from the difficulty of combining long hours at work with nursing care to a lack of information about state support systems and the barriers to finding a new job in middle age, particularly for those like him who bear the stigma of a period living on welfare.

“They are talking about ‘kaigo rishoku,’ but they don’t have the systems in place to tackle it,” Takano said of government policies. “We need to create a society where people can ask for help.”

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