Dying at home rather than in hospital, elderly Japanese 'go to the afterlife quietly'

TOKYO, Nov 21 (Reuters) - After he was diagnosed with leukemia 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.

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.

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Elderly people in Japan are dying at home rather than in the hospital
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Elderly people in Japan are dying at home rather than in the hospital
Katsuo Saito, 89, who has leukaemia, uses an oxygen tube as he rests at his house in Tokyo, Japan, September 8, 2017. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. TPX IMAGES OF THE DAY.
An undertaker from a funeral company bows to Yasuhiro Sato's casket after placing the casket in the morgue in Tokyo, Japan, September 13, 2017. REUTERS/Toru Hanai SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Yasuhiro Sato, 75, who has terminal lung cancer, rests on a bed at his home in Tokyo, Japan, July 11, 2017. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
ATTENTION EDITORS - VISUAL COVERAGE OF SCENES OF INJURY OR DEATH Yamato Clinic's doctor Sayaka Ogasawara (top left) and caregivers, bow to Yasuhiro Sato on his bed after the doctor confirmed Sato's death at his house in Tokyo, Japan, September 13, 2017. REUTERS/Toru Hanai SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. TEMPLATE OUT
Yasuhiro Sato, 75, and has terminal lung cancer, grimaces with pain in his bed in Tokyo, Japan, July 19, 2017. A portrait of his grandmother hangs on the wall. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A watch that Yasuhiro Sato wore until his death is placed on a table after he died of lung cancer at his house in Tokyo, Japan, September 13, 2017. REUTERS/Toru Hanai SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Yuu Yasui, doctor and founder of Yamato Clinic, visits Yasuhiro Sato, who has terminal lung cancer, at his house in Tokyo, Japan, July 11, 2017. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Graves for those who don't have family members including Yasuhiro Sato, who died from lung cancer at his home, are pictured in Ogose town, Saitama Prefecture, Japan, October 24, 2017. REUTERS/Toru Hanai SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
ATTENTION EDITORS - VISUAL COVERAGE OF SCENES OF INJURY OR DEATH Undertakers from a funeral company close the casket containing Yasuhiro Sato's body in Tokyo, Japan, September 13, 2017. REUTERS/Toru Hanai SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. TEMPLATE OUT
Yamato Clinic's doctor Sayaka Ogasawara touches Yasuhiro Sato's hand as she confirms Sato's death at his house in Tokyo, Japan, September 13, 2017. REUTERS/Toru Hanai SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Yuu Yasui, doctor and founder of Yamato Clinic, examines Yasuhiro Sato, who has terminal lung cancer, at his house in Tokyo, Japan, July 11, 2017. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Yasuhiro Sato's breakfast sits on a tray at his home in Tokyo, Japan, July 19, 2017. Sato has terminal lung cancer. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
ATTENTION EDITORS - VISUAL COVERAGE OF SCENES OF INJURY OR DEATH Undertakers from a funeral company carry the body of Yasuhiro Sato, who died from lung cancer at his house, in Tokyo, Japan, September 13, 2017. REUTERS/Toru Hanai SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. TEMPLATE OUT
Audio tapes with recordings of Yasuhiro Sato singing karaoke are placed in a corner of Sato's room in Tokyo, Japan, July 11, 2017. Singing karaoke was Sato's hobby when he was healthy. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Yamato Clinic's doctor Shima Onodera examines Yasuhiro Sato, who has terminal lung cancer, the day before his death at his house in Tokyo, Japan, September 12, 2017. REUTERS/Toru Hanai SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Mitsuru Niinuma, 69, who has terminal lung cancer, is massaged by a therapist in his room which was decorated with puzzles, put together by Niinuma's grandson in Tokyo, Japan, July 19, 2017. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A banner featuring tips for staying healthy hangs on the wall of Katsuo Saito's room in Tokyo, Japan, September 7, 2017. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Mitsuru Niinuma, 69, who has terminal lung cancer, pats his pet dog Rin on his bed at his home in Tokyo, Japan, July 19, 2017. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Doctor and founder of Yamato Clinic, Yuu Yasui (R), works whilst on his way to visit a patient with his assistants in Tokyo, Japan, July 4, 2017. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Yasuda Toyoko (95), who has stomach cancer and dementia, is helped by her daughter in Tokyo, Japan, September 6, 2017. Yasuda is being taken care of at her daughter Terada's home. Terada said she decided to take care of her mother because she believed being in hospital weakened her and worsened her dementia. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Yasuda Toyoko (95), who has stomach cancer and dementia, watches television in the living room of her daughter's house in Tokyo, Japan, September 6, 2017. Yasuda is being taken care of at her daughter Terada's home. Terada said she decided to take care of her mother because she believed being in hospital weakened her mother and worsened her dementia. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Katsuo Saito's old family photographs are displayed in his room in Tokyo, Japan, September 7, 2017. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Katsuo Saito, 89, who has leukaemia, uses his mobile phone in his bed at his home in Tokyo, Japan, September 8, 2017. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. TPX IMAGES OF THE DAY.
Katsuo Saito, 89, who has leukaemia, holds a personal alarm button which can send an alert to a security company monitoring the aged in Tokyo, Japan, September 8, 2017. REUTERS/Kim Kyung-Hoon SEARCH "JAPAN DYING" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
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But dying at home may prove an acceptable option as hospital beds become ever scarcer in an aging society where one in four are over 65 and health officials predict a shortfall of more than 470,000 hospital beds by 2030.

"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.

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."

RISING COSTS

Rising health care costs as the population ages have fueled 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.

More than 80 percent of Japanese prefer to die in hospital, the highest figure among 35 nations surveyed by the OECD.

Leukemia 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.

"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."

(Reporting by Megumi Lim and Kim Kyung-Hoon; Writing by Elaine Lies; Editing by Malcolm Foster and Clarence Fernandez)

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