Must Growing Old Mean Growing Lonely? Reflections from Japan

“I’ll sing a song for you before you go.” Sumi-san’s voice was clear and strong.

“It’s about turning 100,” my guide explained, translating her words from Japanese. “The lyrics basically say, ‘You’re still just a baby when you’re in your 50s, 60s, 70s, and 80s. And then when you turn 97, you’re at your peak.’”

Sumi-san would know. Born in 1918, Sumiko Taira is one of the so-called “super-elderly” in Okinawa’s Ōgimi Village, a community famous for its residents’ longevity. Sumi-san and I met in her home on a hot day in July. She had already done her morning exercises and weeded her vegetable garden. Now she was busy folding paper baskets with her nimble hands.

I was visiting Japan to conduct research on social isolation and connectedness. Given that Japan has the highest proportion of older persons in the world, I was especially keen to learn about the lives of Japan’s older persons — how they’re respected and cared for, what opportunities they have to care for themselves and be useful in their communities.

In Ōgimi Village, the picture I saw was inspiring, to say the least, with visible returns on investments in residents’ wellbeing. The area’s beautiful natural environment encourages people to spend plenty of time outdoors. (Part of the village is so biodiverse that it was designated as a natural park.) The unspoiled environment reinforces an emphasis on healthy, all-natural foods, including shequesar — a nutritious local fruit the locals call “green gems.” Community centers called kominkan allocate resources for twice-monthly social activities that are popular among the older population. In fact, as one local official told me, the activities are such a hit that local businesses complain because no one shops on the days they are held.

Along with their diet, exercise, and relationships, Ōgimi residents are sustained by their shared values and priorities — things like choice, independence, and being able to do things together. These values are captured in concepts such as ikigai (one’s sense of purpose), moai (a circle of lifelong friends whom you can count on for support), and yuimaru (a spirit of cooperation, a commitment to look out for each other).

I saw these values brought to life in the way that Ōgimi elders interact. Over a lunch of seagrass, bitter gourd, and bamboo shoots, a pair of women told me they had known each other their whole lives. They were 89 and 91. Their husbands had passed away, but as one of them explained, “There’s always someone around, so we talk to them. We talk, we laugh, we move our bodies, all very often. No one feels lonely.” Her friend agreed, adding, “At my house, I have the border marked with hibiscus trees, so anyone can come in and out.”

As inspiring as Ōgimi is, the vitality and mutuality of care that I saw there is not the norm nationwide. Even in Japan, a country that is traditionally associated with reverence for elders, and duty toward them, too many older people finish their lives all alone, just like so many older persons in Canada, the United States, the UK, and elsewhere.

Changing demographics in Japan — a function of greater longevity and lower fertility rates — mean that more and more households are headed by single elderly residents. Moreover in Japan, just as in other countries, the vulnerability of old age is compounded by factors such as lack of education or economic resources, making it easier to become socially isolated. I was astonished to read stories of older women committing petty crimes such as shoplifting in the hopes of getting sent to jail, because they knew that at least in jail they would be fed, looked after, and able to find companionship.

Even when family members — typically daughters — want to care for their aging parents, the financial and emotional toll can be daunting. One young woman told me that her one dream for her future was to successfully look after her parents, but she was afraid she wouldn’t be able to manage, and she didn’t know how or even whom to ask for help.

I also noticed how the built environment exacerbates the isolation of older people. For example, consider Atago Danchi — a public housing complex of apartment blocks in Tama City, which I wrote about here.) When Atago Danchi was built in the 1970s, it was considered modern and fashionable. Now one third of residents live alone, and the two local schools, formerly vibrant, have been closed. While some apartments are home to single mothers and their children, more than half of the units in some buildings are occupied by residents older than 65 — and despite the outreach efforts of the residents’ association and the local government, community-building is difficult when there are people who simply never leave their dwellings. On one block, there were half-a-dozen “lonely deaths” in just one year — people whose bodies were not found for a week or more after their passing.

I share these impressions not to criticize Japan, a country I respect and admire. To the contrary, I share them because they raise such familiar and relatable concerns. When it comes to caring for older persons, and preventing the isolation that too often accompanies old age, no country has gotten it right. We all have lots of work to do to create the supportive, caring environment that older people deserve.

To me, that work starts with asking a basic question: What do we value? I don’t think we value our older people anywhere near as much as we ought to, let alone as much as we can. We need a systemic change, beginning with a change in our values, in order to solve this problem. This includes where we send our resources, and what constitutes the financial aspects of care and support. For example, Japan now has a national long-term care insurance program that covers everyone 65 and older, but even that is not enough to keep an individual connected to her or his community, or to hold an aging community together.

During my trip to Japan, I was encouraged to learn firsthand about a number of wonderful initiatives, some of them created by enterprising citizens who have taken matters into their own hands.

Masue Katamaya, for example, has helped transform attitudes and perceptions of assisted living by making nursing homes in Japan more accessible, improving their comfort and quality, and putting empathy and respect toward residents at the core. Among her innovations, Masue employed non-Japanese caregivers and other marginalized individuals, ensuring that her nursing homes are places of social, civic, and economic inclusion. Over the years, she has expanded her efforts to groups beyond older people. Today the nonprofit organization she founded, Shinko Fukushikai, provides childcare, eldercare, assistance to people with disabilities, and other community services as well.

Shinko Fukushikai is an internationally recognized organization, but there are sparks of change at the community level, too. One was an amazing community café I visited in Kitakyushu, called Wazaiya. Wazaiya’s founder Kazuyuki Mimura worked as an occupational therapist at a nearby hospital. He noticed that many of his older patients were living alone and malnourished. He told me, “Knowing that people were living out their final days and not eating properly made me feel sad. I thought that even if their families aren’t around, they should still be eating well and living a good life, so that was how I decided to start this shop.”

In addition, he explained, “I come from the countryside, so I’m accustomed to a society where even after someone stops working, the people around them understand that person’s life and take care of them. But coming into the city and seeing folks who live in big apartment complexes, if they don’t work, then they don’t have connections with those around them, so that means no one is understanding and valuing that person’s life and what they’ve been through. That’s why I was hoping to change that a little bit by creating an opportunity for people to just talk with each other and get to know each other.”

One Wazaiya patron, old in years but young at heart, told me what a difference the café had made for her neighborhood’s vitality. Previously the community had been atomized. Now Wazaiya served as a hub. She described how nice it is when mothers stop in after walking their little ones to school in the morning, or the fun of looking out the windows and seeing children playing soccer in the afternoon. She also noted how much she appreciates the traditional Japanese interior design touches, things such as shoji screens and fresh flowers that remind her of earlier times.

What makes Wazaiya special is not just that it exists, not just that it is accessible, but the thought, the warmth, and the intentionality that have gone into every aspect. Everything is done with love and care, from how it looks, to the freshness of the food, to the emphasis on face-to-face connection. You feel it, even when you’re crossing the threshold for the very first time.

To me, Wazaiya — like Ōgimi Village and Shinko Fukushikai — sends a message that comes through in any language: You are valued here. Not everybody has a family close by, but wherever we are, we can make a family, and we can make it close — no matter our age, no matter where we come from, no matter how much money we have. We don’t have to wait to send that message to someone else.

I’d like to think Sumi-san would agree that’s something worth singing about.