Japan's Elderly Hit Especially Hard In Disaster

Mar 23, 2011
Originally published on March 23, 2011 8:03 am

It's dinner time at the House of Blessings and Longevity, a nursing home in Japan's Iwate prefecture. Seniors eat their tofu and rice while documentary footage of past tsunamis airs on the television.

Daisuke Hirata, the manager of another nursing home in nearby Ofunato city, is looking after nine of his elderly residents who were brought here to Oshu city after the tsunami damaged his facility. Hirata still looks shocked as he recalls the seniors' reactions when the powerful quake hit.

"Some people hid under tables," he remembers. "Those suffering dementia couldn't understand what was happening. They just squatted down or covered their heads with cushions."

Once the shaking stopped, nine caregivers and 23 seniors, some of them in wheelchairs, headed for an assembly hall on high ground. Hirata went back to the nursing home to turn off the gas and batten down the hatches before returning to the hall. That's when he saw the tsunami coming.

"It rose up and sloshed around like water boiling in a pot," he says, gesturing to describe the turbulence. "Unlike normal waves, the tsunami kicked up huge amounts of spray. It was like a scene from a movie. Houses were creaking as the tsunami crushed them together."

Of 67 seniors in another part of his facility, 13 managed to escape, Hirata says. The rest were killed by the tsunami.

Initial reports from parts of northeast Japan devastated by this month's earthquake and tsunami suggest that elderly residents account for a disproportionate number of the disaster's victims.

Risk Factors Include Mobility, Lifestyle, Psychology

Besides being one of the world's most earthquake-prone countries, Japan has a population with the world's longest life expectancy. Confucian concepts of respect for parents and ancestors are still strong, and the country's laws put the responsibility for taking care of aging parents squarely on their children. In northeast Japan, the median age of residents in many communities is over 50, as younger residents leave to find work in the big cities.

Keiko Yoshizawa, who runs the House of Blessings and Longevity, says large government subsidies cover 90 percent of the cost of institutions like hers, while families pick up the remaining 10 percent. Demand for care of the elderly, she says, far outstrips the supply.

"We have 500 people on the waiting list here," she confides. "In all of Japan, there are 400,000 people on waiting lists for nursing homes. Our waiting list is three times the capacity of our facility."

Most of the nearly 6,500 people killed in the 1995 Kobe earthquake were elderly, says Noritoshi Tanida, a scholar at the Yamaguchi Graduate School of Medicine in southern Japan. Seniors' lack of mobility is not the only reason for this, he says. Lifestyles and psychology are also factors. For example, older Japanese tend to live in more fragile wooden houses. They often prefer to live on the first floor, where they are more easily killed by collapsing buildings.

"In emergency shelters," he says, "elderly people tend not to express their needs for food and water. When that happens, they can get dehydrated more easily than younger people."

'Just Destined To Live Through These Things'

Hisaho Koseki, 82, barely escaped the tsunami when a neighbor drove her to safety. Now she sits among piles of blankets and boxes of donuts at a local evacuation center. Koseki has a bright smile and happily chats with visitors. But she says the disaster has left her homeless, and she's afraid of being kicked out of the shelter. Her son has offered to take her in, but she doesn't want to burden him.

"I have chronic ailments, and I don't know how much longer I'll live," she frets. "I don't want to die, but in this situation, perhaps it would be better if I did."

Koseki has survived worse calamities than this one. During World War II, she worked in Tokyo as allied bombing raids turned the capital into a sea of flames. She says many colleagues just did not show up for work in the mornings at her electronics factory.

"I asked about them and was told they were killed," she recollects. "It was a military factory, so I think the Americans specifically targeted us. The war was scary, but we couldn't do anything about it. Now this tsunami has happened. I guess I was just destined to live through these things."

Koseki says her body is covered with the scars of her many past operations. But she promises to keep on living — with strength — for as long as she can.

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STEVE INSKEEP, Host:

The dead are still being counted in the aftermath of the earthquake and tsunami. And many of them are elderly. That's because Japan is the world's most earthquake-prone country, as well as its most aged society. NPR's Anthony Kuhn reports from the city of Kesennuma.

ANTHONY KUHN: Daisuke Hirata is the manager of another nursing home in a nearby city. Nine of his residents were brought here after the tsunami damaged his facility. He recalls when the powerful quake hit.

DAISUKE HIRATA: (Through Translator) Some people hid under tables. Those suffering dementia, they couldn't understand what was happening. They just squatted down or covered their heads with cushions.

KUHN: Once the shaking stopped, nine caregivers and 23 seniors, some of them in wheelchairs, headed for high ground. Hirata remembers seeing the tsunami coming.

HIRATA: (Through Translator) It rose up and sloshed around like water boiling in a pot. Unlike normal waves, the tsunami kicked up huge amounts of spray. It was like a scene from a movie. Houses were creaking as the tsunami crushed them together.

KUHN: Keiko Yoshizawa, who manages the House of Blessings and Longevity, says that even with large government subsidies demand for care of the elderly far outstrips the supply.

KEIKO YOSHIZAWA: (Through Translator) We have 500 people on the waiting list here. In all of Japan, there are 400,000 people on waiting lists for nursing homes. Our waiting list is three times the capacity of our facility.

KUHN: Noritoshi Tanida is a scholar at the Yamaguchi Graduate School of Medicine in southern Japan. He says that most of the nearly 6,500 people killed in the 1995 Kobe earthquake were elderly. Tanida says that seniors' lack of mobility is not the only reason for this. Lifestyles and psychology are also factors.

NORITOSHI TANIDA: (Foreign language spoken)

KUHN: Eighty-two-year-old Hisaho Koseki barely escaped the tsunami. Now she sits among piles of blankets and boxes of donuts at a local evacuation center. She says the disaster has left her homeless, and she's afraid of being kicked out of the shelter. Her son has offered to take her in, but she doesn't want to burden him.

HISAHO KOSEKI: (Through Translator) I have chronic ailments, and I don't know how much longer I'll live. I don't want to die, but in this situation, perhaps it would be better if I did.

KUHN: Koseki has survived much worse than this. During World War II, she worked in Tokyo as allied bombing raids turned the capital into a sea of flames. She says many colleagues just didn't show up for work in the mornings at her electronics factory.

KOSEKI: (Through Translator) I asked about them and was told they were killed. It was a military factory, so I think the Americans specifically targeted us. The war was scary, but we couldn't do anything about it. Now this tsunami has happened. I guess I was just destined to live through these things.

KUHN: Anthony Kuhn, NPR News, Kesennuma. Transcript provided by NPR, Copyright NPR.