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In Japan’s rest homes, staff as gray as the residents

  • Kunio Odaira, 72, is one of 119 caregivers at the Cross Heart rest home in Yokohama, Japan. More than half of the staff are over 60. Washington Post

  • Kunio Odaira, 72, works four days a week at the Cross Heart rest home in Yokohama, Japan. “As long as I can keep working, I will,” he said. Must credit: Washington Post photo by Anna Fifield



Washington Post
Friday, February 17, 2017

It’s lunch hour at the Cross Heart nursing home, and a 72-year-old, slightly stooped man is spooning soup and filling tea cups.

But Kunio Odaira isn’t one of the residents. He’s one of the staff, part of an increasingly gray workforce in an increasingly gray country.

“I enjoy talking to the people here. It’s fun, but it’s also hard work,” Odaira said during a break from his caregiving duties on a recent day.

Japan is considered a “super-aging” society. More than a quarter of the population is over 65, a figure set to rise to 40 percent by 2050. (In New Hampshire, people older than 65 are about 16 percent of the population.) The average life expectancy is 85, and that means many Japanese remain relatively healthy for a good two decades after retirement age.

At the same time, the birthrate has plummeted to well below the level needed to keep the population stable. Now home to 128 million people, Japan is expected to number less than 100 million by 2050, according to government projections.

That means authorities need to think about ways to keep seniors healthy and active for longer, but also about how to augment the workforce to cope with labor shortages.

Enter the septuagenarian caregiver.

At Cross Heart, more than half of the 119 caregivers are over 60, and 15 of them are over 70.

“When we advertise for people to work here, we get lots of responses from older people, not younger people,” said nursing home director Kaori Yokoo in the lobby where residents were doing leg curls and chest presses on weight machines.

The foundation that runs this nursing home and others in Kanagawa Prefecture has raised the official retirement age to 70 but allows employees to keep working until 80 if they want to and can. Municipalities around the country are also actively recruiting people over 60 to do lighter duties at nursing homes.

It’s one way of dealing with the problem. Meanwhile, researchers are working on robots that can lift the elderly out of beds and wheelchairs, and inward-looking Japan is slowly coming around to the idea that it may need to allow in more foreign workers.

Although older workers have constraints – some can’t do the heavier tasks – they also offer advantages over younger workers who want time off for their children, said Yokoo, who is 41.

“Plus, because they’re close in age to the residents, they can relate to each other more,” she said. “We younger people think this must be nice for them. Older staff can understand things like physical pains more because they are living through the same things.”

Some of the older workers here are doing it because they need the money. For others, the money is a nice benefit, but the main motivation is the activity and sense of community.

Kiyoko Tsuboi, a 95-year-old who comes into the rest home during the day, said she likes having Odaira around.

“He’s very attentive to our needs and knows things like how hot we like our tea. My son is not as kind as Odaira-san,” Tsuboi said as Odaira cleared away the lunch dishes. “He’s quite active despite his age, and even though he’s a man, he has an eye for detail.”

The dynamic works well for Odaira, too, who started here 17 years ago after retiring from his job in the sales department of an auto parts maker. He works eight hours a day, four days a week.

His father died when he was small, his mother when he was 22. “It’s not like I’m replacing my mother, but I thought I could help someone else’s parents,” he said.

He also does it to stay young, Odaira said with a twinkle in his eye. “I think it’s good for me physically and mentally, so as long as I can keep working, I will.”

He’s not the oldest worker here, though. That title is shared by two 78-year-olds, a man who works in the office, and Noriko Fukuju, who helps with pickups and drop-offs and does activities with “the old people.”

“It’s fun. I enjoy it,” she said.

Hiroko Akiyama, at the University of Tokyo’s Institute of Gerontology, said a Japanese 65-year-old is in much better physical and mental shape than a 65-year-old a few decades ago. “They are full of energy, and healthy and long-living,” she said.

Akiyama’s research has found that working helps keep seniors that way. “They operate on a regular schedule. They wake up, get ready, go to work and talk to people and stay connected,” she said. “We had a depressed old woman who changed completely after she started working.”

Still, Japan can’t rely solely on seniors or, potentially, robots to staff its nursing homes, where the need will only grow as the population ages, analysts say.

Japan has agreements with Indonesia, Vietnam and the Philippines under which applicants who complete job training and pass a Japanese language test can work at a Japanese nursing home.

But if they want to stay beyond three years, they must pass a national caregiver’s exam so difficult that 40 percent of Japanese applicants fail. Many Japanese also express concern about cultural differences.

Next year, the Japanese government will loosen the regulations slightly and set up a technical intern program, but there will still be time limits and difficult tests to pass.

Perhaps 2,000 people will come to Japan through the intern program, said Yasuhiro Yuki, an expert on elderly care at Shukutoku University. “But we hear we will need 300,000 more caregivers in the next 10 years,” he said. “So I still don’t think we will have enough.”

That means aging caregivers will increasingly become the norm.

“I can do this at least for two more years,” said Fukuju, the 78-year-old, before she dashed out the door to renew her driver’s license.