Nearly 70,000 Japanese will die this year alone, and with a rapidly ageing population, it could get much worse - Sun 25 Aug.
A)
When Takuya Shiota's cleaning company was called to a small apartment in Tokyo, its elderly occupant had been lying dead on the floor for more than three weeks.
The resident, in her 70s, had only been discovered when her landlord tried to collect unpaid rent.
She had no family or friends to look after her. She lived and died in solitude.
With Tokyo's sweltering summer in full swing, the scene was so horrific that Mr Shiota had to cut out the floorboards where the woman was found.
"The smell in the room was so strong," he recalls.
"We treated the liquid, then cut out the floor and disinfected it."
B)
The work of Mr Shiota and his colleague Kyohei Kudo is unpleasant but vital.
Japan has long struggled with what's known as "solitary death", where people die without a support network and remain undetected for long periods.
In one notorious case more than two decades ago, an older man was discovered three years after his death.
His rent and utilities had been automatically deducted from his bank account, and when it was finally depleted, the authorities came to investigate.
C)
This year, the Japanese government released its first official count of deaths in solitary confinement.
In the first three months, nearly 22,000 people died alone and went undetected for long periods.
Most are elderly.
This means that around 88,000 people are expected to die alone in Japan this year.
It's a crisis that will only get worse - Japan has the oldest society in the world, with more than one in ten people over the age of 80.
But it's not just a problem of an ageing population.
For many, Japan's lonely deaths reflect a society that has lost its sense of community; neighbours no longer look out for each other, while many residents isolate themselves.
"The number of inquiries is increasing significantly," says Mr Shiota.
"We do about 100 cases a year, especially in the summer. It's the busy season.
D)
Ageing residents in a shrinking boomtown
In Yokohama, a city just a short train ride from Tokyo lies the Kotobuki district.
It's a densely populated suburb where outsiders from all over Japan have come to escape their old lives and find work in the big city.
Many apartments are tiny—often less than five square metres—and have shared kitchens and bathrooms.
During Japan's economic boom in the 1980s, it was a thriving, bustling place.
Now, the residents are mostly elderly, often with a litany of health problems, including alcoholism and poor mental health.
It was here that Osamu Yamanaka pioneered regular home health checks.
"There were people who were found dead in their rooms, even skeletal," he said.
"I was young, and I thought this was unforgivable."
E)
Dr Yamanaka visits his lonely patients weekly to carry out tests.
Some are in the last stages of life.
Dr Yamanaka discusses their treatment options, but many refuse medical intervention.
They've given up. Dr Yamanaka respects their decision. But he'll continue to monitor them.
"If I didn't, there would be a lot of lonely deaths," he says.
These visits are about making crucial human contact.
"I'm such a low-class person," says patient Yasuo Inayama, 74.
"There aren't many people willing to deal with people from the lowest strata of society. But he is willing to come to see me. I appreciate it".
F)
Throughout Japan, elderly residents with health problems may be eligible for varying levels of home care.
It's a service that's much more accessible now than when Dr Yamanaka started.
Dr Yamanaka says the workload is manageable, and he's not worried about Japan's ageing population.
But he says the medical profession can only do so much to address the dilemma of lonely deaths.
Sometimes, people don't know how to ask for help.
Others have chosen to cut themselves off from family and society in general.
Not all people who die alone are elderly.
In these cases, it's up to the community to provide support.
"If they do not socialise with their neighbours, they will end up dying alone," says Dr Yamanaka.
"It's tough to prevent that."
G)
Building a community to prevent loneliness
It's a challenge that Yoshiko Sato, 81, has accepted.
Her massive apartment complex was once filled with families.
But now it's home to nearly 400 elderly residents who live alone.
H)
Just over two decades ago, she founded the Zero Lonely Deaths community campaign after a spate of lonely deaths, including that of a dear friend.
"Every year, four out of five people were dying alone," she says.
"People around me started to ask why such a good friend of ours was dying so lonely and alone."
Volunteers began to carry out routine checks on older people in the neighbourhood.
The group also liaised with authorities to be alerted to suspicious activity.
For example, the electricity company would call them if there was a sudden and prolonged drop in electricity use in a registered flat.
"After five years, we were able to say that there were no more lonely deaths," says Ms Sato.
I)
The programme has become much more than preventing lonely deaths.
It's also saving lives and restoring a sense of community.
In one case, a sleeping man was saved after an incense candle fell and ignited a pillow.
In another, an elderly diabetic man was found immobile and taken to hospital.
"In our complex, everyone comes together," says elderly resident Shigeko Maeda proudly.
On one of her regular visits, Mrs Sato brings fresh vegetables and receives a freshly cooked lunch.
"I look forward to cooking with the vegetables she gives me," says elderly resident Akiko Yoshida.
"It makes my life worth living.
J)
Money needed to sustain initiatives
While Yoshiko Sato's programme has succeeded, she worries about the future.
Community initiatives like hers are disintegrating despite their importance.
"A community has to be built by everyone, but that is not possible in Japan at the moment," she says.
K)
"People are becoming selfish, saying they don't have to join a community or don't need a community."
It's a concern shared by cleaner Takuya Shiota.
Both call on the government to provide financial support for community groups.
"Lack of interaction between people and local communities in Japan is widespread," says Mr Shiota.
"There is data that loneliness is the most significant factor in reducing life expectancy.
"Japan is a society of depression."
Japan's lonely death crisis: Why are so many elderly Japanese dying alone? | ABC News
https://www.abc.net.au/news/2024-08-25/dying-alone-japan-solitary-deaths/104252356
https://www.youtube.com/watch?v=xAdugD09vps
Almost 70,000 Japanese people will die alone this year, with many not being found for weeks. ABC East Asia correspondent James Oaten speaks to people on the frontline of Japan's lonely death crisis to find out how much worse the situation could become.
//Postscript//
In Japan, many older adults cut off contact with family and friends as they age, not wanting to cause trouble for others.
However, they do not realise that this will cause a lot of trouble in the end.
Understandably, socialising becomes a problem as we get older.
Close friends die before us, and there are issues of inheritance and care when it comes to interacting with family. In cities, local communities are weak, and we end up isolated.
What can we do to prevent this?
We need to create new local communities.
Interacting with people may take time, energy and money, but we cannot live without it.
Because we cannot live alone.
What kind of relationships are we building on the internet and social media?
Do they create the relationships we want?
Aren't we creating deeper divisions by denigrating others?
We need to build genuine relationships of trust now.
Relationships are where we respect, forgive, and love one another.
We must accept each other's differences and find the proper middle ground.
