Dying at home in Japan

Dying at home in Japan

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After he was diagnosed with leukaemia in July, Katsuo Saito decided not to treat it and opted for palliative care. He had a hard time finding a bed at a hospice or hospital, so he spent most of his remaining weeks at home.

"There are about 20 people on the waiting lists," Saito, 89, told Reuters from his fifth-floor apartment in Tokyo where he lived alone.

. Tokyo, Japan. Reuters/Kim Kyung-Hoon

Many Japanese are reluctant to die at home because they feel hospitals are safer and they don't want to burden family members with caring for them.

But dying at home may prove an acceptable option as hospital beds become ever scarcer in an ageing society where one in four are over 65 and health officials predict a shortfall of more than 470,000 hospital beds by 2030.

. Tokyo, Japan. Reuters/Kim Kyung-Hoon
Doctor and founder of Yamato Clinic, Yuu Yasui (R), works whilst on his way to visit a patient.

"I think it's good to have a doctor supporting people who choose to spend their final days, and naturally face death, in a place they spent their days living," said physician Yuu Yasui.

Yasui, who works at the Yamato Clinic, which has overseen more than 500 home deaths since 2013, hopes to offer hospice care at home for more of the terminally ill.

. Tokyo, Japan. Reuters/Kim Kyung-Hoon

Mitsuru Niinuma, 69, chose to stay at home in order to spend more time with his grandson and his beloved dachshund, Rin.

"Home care allows people to use their abilities to their fullest for as long as possible," he said. "That's not so easy in a hospital. This aspect is really nice."

. Tokyo, Japan. Reuters/Kim Kyung-Hoon

Rising health care costs as the population ages have fuelled apprehension that Japan will eventually cap the number of hospital beds, although a health ministry official who declined to be identified called that scenario unlikely.

The bed shortage stems partly from long hospital stays, which ran 16.5 days on average in 2015, versus six days in Britain, a study by the Organisation for Economic Cooperation and Development (OECD) showed.

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Slideshow

Graves for those who don't have family members.
. Ogose, Japan. Reuters/Toru Hanai

Graves for those who don't have family members.

Audio tapes with recordings of Yasuhiro Sato singing karaoke.
. Tokyo, Japan. Reuters/Kim Kyung-Hoon

Audio tapes with recordings of Yasuhiro Sato singing karaoke.

Katsuo Saito's old family photographs.
. Tokyo, Japan. Reuters/Kim Kyung-Hoon

Katsuo Saito's old family photographs.

Yasuda Toyoko (95), who has stomach cancer and dementia, is helped by her daughter.
. Tokyo, Japan. Reuters/Kim Kyung-Hoon

Yasuda Toyoko (95), who has stomach cancer and dementia, is helped by her daughter.

Mitsuru Niinuma, 69, who has terminal lung cancer, is massaged by a therapist.
. Tokyo, Japan. Reuters/Kim Kyung-Hoon

Mitsuru Niinuma, 69, who has terminal lung cancer, is massaged by a therapist.

Yuu Yasui, doctor and founder of Yamato Clinic, visits Yasuhiro Sato.
. Tokyo, Japan. Reuters/Kim Kyung-Hoon

Yuu Yasui, doctor and founder of Yamato Clinic, visits Yasuhiro Sato.

Yasuhiro Sato's breakfast sits on a tray at his home.
. Tokyo, Japan. Reuters/Kim Kyung-Hoon

Yasuhiro Sato's breakfast sits on a tray at his home.

Yamato Clinic's doctor Shima Onodera examines Yasuhiro Sato, the day before his death.
. Tokyo, Japan. Reuters/Toru Hanai

Yamato Clinic's doctor Shima Onodera examines Yasuhiro Sato, the day before his death.

Doctor Sayaka Ogasawara touches Yasuhiro Sato's hand as she confirms Sato's death.
. Tokyo, Japan. Reuters/Toru Hanai

Doctor Sayaka Ogasawara touches Yasuhiro Sato's hand as she confirms Sato's death.

Doctor Sayaka Ogasawara and caregivers, bow to Yasuhiro Sato on his bed after the doctor confirmed Sato's death.
. Tokyo, Japan. Reuters/Toru Hanai

Doctor Sayaka Ogasawara and caregivers, bow to Yasuhiro Sato on his bed after the doctor confirmed Sato's death.

Undertakers carry the body of Yasuhiro Sato.
. Tokyo, Japan. Reuters/Toru Hanai

Undertakers carry the body of Yasuhiro Sato.

A watch that Yasuhiro Sato wore until his death is placed on a table.
. Tokyo, Japan. Reuters/Toru Hanai

A watch that Yasuhiro Sato wore until his death is placed on a table.

An undertaker bows to Yasuhiro Sato's casket.
. Tokyo, Japan. Reuters/Toru Hanai

An undertaker bows to Yasuhiro Sato's casket.

More than 80 percent of Japanese prefer to die in hospital, according to the Yamato Clinic.

Leukaemia patient Saito finally found a hospice spot in September. Two days after he moved in, he died.

National insurance provides individual hospital rooms only in exceptional circumstances, so they are out of reach for those like pensioner Yasuhiro Sato, 75, a victim of terminal lung cancer.

. Tokyo, Japan. Reuters/Kim Kyung-Hoon

"Somebody rich, like a politician or a singer, they solve everything through money. They can stay in private rooms," Sato said in an interview at his Tokyo apartment in July.

With no close family or friends, he lived a solitary life, except for caregivers' visits. When Sato died on Sept. 13, the only other people in his apartment were doctors, aides and undertakers.

"It's okay. I'm not a burden to anybody," he said. "I will go to the afterlife quietly. Alone."

. Tokyo, Japan. Reuters/Toru Hanai