Japan has traditionally had a simple answer to the problems of caring for the elderly: The wife of a family's eldest son looked after aging parents. Now, at a time when the number of working women is increasing and married children are no longer living with parents, this traditional practice is becoming difficult to carry on.
Organizations in both the public and private sector are looking for new solutions as Japan becomes more and more of an aging society. In about 30 years, one out of four Japanese, or 31.7 million people, will be 65 years and over, according to Nihon University's population research office.
Private companies are taking advantage of this need and are moving to target this rapidly growing consumer group. In March last year, more than 150 private companies got together and created the Elderly Service Providers' Association, an organization to promote services for senior citizens, such as retirement homes and home-care services.
The Health and Welfare Ministry welcomed the event, expecting the private sector to improve the quality of the nation's welfare system.
``We are not going to regulate their voluntary activities by making a new law,'' says Katsuaki Matsumoto, deputy director of the ministry's section that supports service businesses for the elderly.
In recent years Japan's medical costs have been soaring. In fiscal 1986, they hit the 17-billion-yen mark ($127 million) for the first time, their growth rate outpacing the growth rate of national income. The ministry, in its struggle to reduce the costs, has been promoting home care instead of hospitalization of some senior citizens.
``Demands for our services will increase,'' says Tsuguo Sato of France Bed Medical Service Co., which started the nation's first rental services of home-care equipment in 1983. Renting and selling equipment like wheelchairs and reclining beds, the firm has seen its annual sales rise by an average of 20 percent.
Other pioneers in the industry have directed their attention to changing tastes in Japanese society, where the public welfare system offers a certain level of services for the elderly at a lower cost.
``We thought some people would pay to get more satisfying and convenient help,'' says Eiji Yoshida of Healthy Life Service Company. Dispatching helpers around the Tokyo area since 1984, the firm's monthly sales have jumped from 1 million yen ($7,500) at the start to 25 million yen ($187,500) now. He describes those customers as ``practical people'' who do not mind a stranger nursing them.
These service companies are counting on old people's relatively stable assets. The average savings of people aged 65 and over is more than 11 million yen ($82,500), and about 85 percent of those people own their own homes. ``With those fixed and floating assets, their latent income is large,'' says Katsuhiro Hori of the Social Development Research Office.
Among the younger generation, there is concern about future pensions. With an increasing number of retired people and a decreasing number of wage-earners, insurance companies are advising the middle-aged and even the young to put aside money for their later years since they may not be able to count on pensions.
The Japanese branch of American Family Life Assurance Co. introduced the world's first insurance to cover costs for senility treatment in 1985.
Though many consumers are looking to the future, many of the service companies are still struggling in the present. Of some 160 current members of the Elderly Service Providers Association, ``not so many companies have really started service businesses for older people,'' says Takashi Inoue of the association.
``I don't want other companies to hold the illusion that they can immediately register a profit,'' warns Mr. Sato of France Bed Medical Service, which is still in the red. He finds it difficult to encourage people to buy and rent more products because such spending is not tax deductible under Japanese law.
The high costs of rentals are also an obstacle. ``[This equipment] is expensive and when you are going to rent something, you'll also need accessories. That will add expenses,'' says Miyoko Yokoyama, who has been taking care of her father at home for half a year. Instead, she borrowed a wheelchair from a local public service system for free.
Private suppliers of assistance to the elderly can find promoting their products difficult because of the sensitivities involved. ``Those who see themselves as still young may be offended when we directly say that this is a service for the elderly,'' Mr. Inoue says.
There are also shortages of manpower and legal restrictions. ``We recognize the need to educate more people to become paid helpers,'' says Inoue. ``But, education needs funding and one private company cannot afford this.''
Current law does not allow the helpers to administer medicine without permission from a licensed doctor.
One observer sees this trend as wrong from the start. ``The companies are like people rushing to get on a bus without knowing where the bus is going,'' argues Masuhisa Amemiya, chief editor of Japan's first magazine for people involved in home care. ``Before grasping the real needs of old people, they just assume profitability for demographic reasons. They must think about the social meaning of their duty first.''