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Choosing to die at home

Most terminally ill patients in Japan choose to spend their final days in a hospital. While some prefer to die among their loved ones, others are forced to remain at home because of waitlists and hospital expenses.

With Rin at his side

When Mitsuru Niinuma found out he was terminally ill with lung cancer, he made the choice to stay at home rather then die in a hospital. This way, he can spend more time with his grandson and keep his beloved dachshund, Rin, at his side. "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."
His own four walls

The walls in Mitsuru's bedroom are decorated with brightly colored puzzles his grandson put together. A physical therapist visits the 69-year-old on a regular basis, massaging and stretching his legs left numb and weak from months of bedrest.
The dementia got worse in the hospital

Yasudo Toyoko is living in her daughter's house in Tokyo. The 95-year old has stomach cancer and dementia. Her daughter cares for her. She took Yasudo in because she believes that being in hospital weakened her mother and worsened her dementia. Home care is an exception in Japan — 80 percent of Japanese would prefer to die in a hospital if terminally ill, according to an OECD study.
Long waiting lists

Not everyone who spends their last few weeks at home does so voluntarily. After being diagnosed with leukemia, Katsuo Saito decided that he wanted to die in hospice. But wait lists were so long he spent several months at home before finally transferring. He died just two days later.
Not enough hospital beds

Hospital and hospice beds are becoming scarce commodities in rapidly aging Japan. With one in four people living in the Asian nation currently over the age of 65, the Japanese population is among the oldest worldwide. Health officials predict that by 2030, there will a shortage of close to half a million hospital beds.
Hospital rooms are expensive

Yasuhiro Sato has terminal lung cancer. He would prefer to live in an individual room in a hospital. But since the retiree cannot afford to pay the costs himself and the national health insurance rarely pays for individiual rooms, he stays in his Tokyo apartment. "Somebody rich, like a politician or a singer, they solve everything through money. They can stay in private rooms," he says.
The traveling doctor

Physician Yuu Yasui (right) runs a mobile clinic that provides care to hospice patients staying at home. His clinic has overseen more than 500 home deaths since its founding in 2013. "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," he says.
A lonely death

Some patients of doctor Yasui live with family, or have relatives or friends who visit them regularly. But for others, the appointments with the doctor and other caretakers are the only contact to the outside world. Cancer patient Yusuhiro Sato has no close family left in Tokyo. He leads a solitary life in his Tokyo apartment.
'I will go to the afterlife quietly'

"It’s okay. I‘m not a burden to anybody," Yasuhiro says. "I will go to the afterlife quietly. Alone." On September 13th, he stopped breathing. The only other people in his apartment that day were doctors, aides and undertakers.

With Rin at his side

When Mitsuru Niinuma found out he was terminally ill with lung cancer, he made the choice to stay at home rather then die in a hospital. This way, he can spend more time with his grandson and keep his beloved dachshund, Rin, at his side. "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."
His own four walls

The walls in Mitsuru's bedroom are decorated with brightly colored puzzles his grandson put together. A physical therapist visits the 69-year-old on a regular basis, massaging and stretching his legs left numb and weak from months of bedrest.
The dementia got worse in the hospital

Yasudo Toyoko is living in her daughter's house in Tokyo. The 95-year old has stomach cancer and dementia. Her daughter cares for her. She took Yasudo in because she believes that being in hospital weakened her mother and worsened her dementia. Home care is an exception in Japan — 80 percent of Japanese would prefer to die in a hospital if terminally ill, according to an OECD study.
Long waiting lists

Not everyone who spends their last few weeks at home does so voluntarily. After being diagnosed with leukemia, Katsuo Saito decided that he wanted to die in hospice. But wait lists were so long he spent several months at home before finally transferring. He died just two days later.
Not enough hospital beds

Hospital and hospice beds are becoming scarce commodities in rapidly aging Japan. With one in four people living in the Asian nation currently over the age of 65, the Japanese population is among the oldest worldwide. Health officials predict that by 2030, there will a shortage of close to half a million hospital beds.
Hospital rooms are expensive

Yasuhiro Sato has terminal lung cancer. He would prefer to live in an individual room in a hospital. But since the retiree cannot afford to pay the costs himself and the national health insurance rarely pays for individiual rooms, he stays in his Tokyo apartment. "Somebody rich, like a politician or a singer, they solve everything through money. They can stay in private rooms," he says.
The traveling doctor

Physician Yuu Yasui (right) runs a mobile clinic that provides care to hospice patients staying at home. His clinic has overseen more than 500 home deaths since its founding in 2013. "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," he says.
A lonely death

Some patients of doctor Yasui live with family, or have relatives or friends who visit them regularly. But for others, the appointments with the doctor and other caretakers are the only contact to the outside world. Cancer patient Yusuhiro Sato has no close family left in Tokyo. He leads a solitary life in his Tokyo apartment.
'I will go to the afterlife quietly'

"It’s okay. I‘m not a burden to anybody," Yasuhiro says. "I will go to the afterlife quietly. Alone." On September 13th, he stopped breathing. The only other people in his apartment that day were doctors, aides and undertakers.

Date 22.11.2017
Number of pictures 9
Author Mara Bierbach (with Reuters)
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SPECIAL

About DW

Choosing to die at home

With Rin at his side

His own four walls

The dementia got worse in the hospital

Long waiting lists

Not enough hospital beds

Hospital rooms are expensive

The traveling doctor

A lonely death

'I will go to the afterlife quietly'