End-of-Life Planning in Japan

Part
01
of two
Part
01

End-of-Life Planning in Japan: Competitive Landscape

After extensive research, information on companies in Japan that are providing end-of-life planning services does not appear to be available in the public domain. However, the research team was able to gather valuable insights about the reason why the Japanese find it difficult planning and talking about end-of-life care, barriers in opting end-of-life planning services, among others.

HELPFUL FINDINGS:

End-of-Life Planning in Japan

  • The Japanese people have difficulty talking about end-of-life care and planning their death because of their distant family relationships.
  • Some barriers in opting end-of-life planning services for the Japanese include filling out forms, lack of confidence on doctors, miscommunication between caregivers, and dependency on other family members in decision-making.
  • In Japan, as per the health ministry of Japan, around 97% of Japanese lack knowledge on end-of-life planning services, and only 3.3% are aware of advanced death care planning.
  • Another survey states that only 8% are writing a living will, and 49% are just aware of “living will.”
  • As per Kaiser Family Foundation, only 26% of Japanese caregivers said they knew exactly what the person wanted with the perspective of s person's death, 37% said they had a good idea on person's death, and 3% of caregivers were unsure of a person's death.

Other Services

  • Japan Society for Dying with Dignity offers services for managing living wills, and the organization charges membership fees based on its services.
  • Funeral Company of the Wing offers a variety of funeral services such as a family funeral, simple funeral, home funeral, and temple arrangement of the funeral.
  • Endex Japan is an exhibition that comprises shows from funeral services, end of life businesses, equipment and outsourcing service companies of funerals.

RESEARCH STRATEGY

Firstly, we looked for information on the Cake company provided to understand the services of end-of-life planning business and found that the company does not serve in Japan. So, we started looking for lists of Japan companies that offer end-of-life planning services in industry market reports and articles such as the Japan Times, European Association for Palliative Care, ILC-Japan, among others. The information found focused mostly on the variety of funeral services, and nothing specific to comprehensive end-of-life planning services like the Cake company.

As there was no information on key players or lists of companies in the end-of-life planning services, we looked for surveys on the Japanese end life services in various media releases and scholarly articles such as Springer, Research Gate, and NCBI. We found that as per the health ministry of Japan, around 97% of Japanese lack knowledge on end-of-life planning services, but nothing specific to companies that serve end-of-life planning services.

Further, we tried to check for any global players to check Japan's subsidiaries but could not locate any company that exactly matches the end-of-life planning services like Cake in Japan. Most of the information found was on companies offering living wills services and funeral services such as Fuelfor, Aeon, Ever Plans, Funeral One, and eFuneral.

As a last resort, we expanded our scope of the research and explored beyond 24 months in reports of Japan's elderly and deaths society, and Japan's death service exhibition to derive at entities that involve in end-of-life planning services, but could not locate any company that exactly matches the end-of-life planning services like Cake. Most of the information was on companies offering living wills services and funeral services in websites such as Life Ending Industry Expo Japan, Kaiser Family Foundation, and 283Osoushiki.

In the course of working on the above strategies, we could locate in-depth analysis on barriers of end-of-life planning services in Japan. It is to be noted the end-of-life planning services segment specific to Japan is very niche and novice. So, we presented the available insights above.


Part
02
of two
Part
02

End-of-Life Planning in Japan: Market Potential

People in Japan had difficulty talking about end-of-life care and planning of their death because of their distant family relationships. But because of some circumstances like the 2011 tsunami and the rising number of "Kodokushi" or dying alone, the end-of-life planning business in Japan is gaining a market potential. Below are some insights discussing these potentials.

CURRENT PUBLIC KNOWLEDGE OF THE END-OF-LIFE BUSINESS

  • Japanese are not open with end-of-life planning business. People that become member of a supportive advance directive group called Japan Society for Dying with Dignity (with legal documents that allow elderly tell decisions about end-of-life care ahead of time with wishes to family), has increased annually but only had 0.5% of the population older than 65 years.
  • Japanese people had difficulty talking about end-of-life care and planning their death because of their distant family relationships.
  • But according to a research, some of the elderly participant want end-of-life planning although they have some barriers such as resistance to fill out what they want when they die.
  • Planning for death business in Japan is considered a cultural taboo according to Bloomberg, but now in recent years when aging is such a preoccupation in Japan, the cultural taboos against planning for death started peeling away.
  • The taboo started to peel away because some disasters such as the 2011 tsunami disaster which has reckoned with mortality and the hit "Departures" Japanese movie about death that won an Academy Award.
  • People think that this business is expensive such that one had to pay a lot for the funeral in the exchange of feeling gratitude toward it.
  • Japanese are not usually aware that this business is overpriced. It is because many operators' up-selling was at standard practice. Even half of the price can still make a profit.
  • A data from the National Consumers Affairs Center shows that as Japan's mortality count has climbed, complaints against the services of the funeral homes has jumped to 724 in 2015, from 83 in 1996. The most common reasons are the excessive billing and unexplained costs.

JAPANESE PREFERENCE FOR THEIR END-OF-LIFE journey AND THEIR WISHES

  • According to a research, many elderly talked about their ideal way of dying called “pokkuri” death, a dying without suffering from disease nor bothering their family.
  • Other people wanted natural death surrounded by their family at home and surrounded with love.
  • Some have wishes to be independent just before death without making their family busy with their needs. This is because they have an independent life history as a background.
  • Japanese people spend their lives on tatami mats, a straw flooring in most traditional Japanese rooms. So there is a saying or a culture that they want to die on tatami mats. Having said that some has this wish, tatami mats can be a business because they can have it in their coffin when they are sent off.
  • A business for dying is a big chunk of money because Japanese has a term for preparing for death, called “shukatsu,” a big play where they say and wish what they will be, as well as what condition will it be when they die.
  • Another trend called "Kodokushi" or "dying alone" is becoming a growing trend in aging Japan because many people are giving up getting a partner and instead choose solitary life.
  • The government had no exact number of people dying alone who stay unnoticed for days and weeks but most of the experts estimate it at 30,000 per year.

TYPES OF GROWING BUSINESSES FOR THE end-of-life planning

  • Japanese government estimates 1.68 million will die in 2038, that is why business opportunities for the dying has a potential in Japan.
  • At Endex or Life Ending Industry Expo, more than 200 companies were trying to get the money from end-of-life business that in 2018 was valued at a whopping $41 billion.
  • Some of the businesses are the usual coffins and tombstones, with the latest-model hearses.
  • Another type is Buddhist monks touting and coffee retailers as a gift for funeral attendees, which is a custom in Japan.
  • Other businesses are coffin builders, family altar makers, morticians and others featured in the Endex Show, a place where they show off their product and exchange useful information while promoting the latest products or services.
  • Artisan, a business where funeral directors place the body in coffins and apply make up, is also featured in this show. Here, they show off how they wrap the body in kimono and make sure the left flap goes over the right.
  • The Space Memorial are also there as an unusual merchant, they offer $22,000 for a "Space Explorer" package in which the dead's ashes are sent into deep space using a rocket.

CLEANING UP APARTMENTS IS ONE OF THE GROWING END-OF-LIFE PLANNING BUSINESS

  • A Kodokushi, a way of dying alone is now a growing trend in Japan.
  • A company that cleans the "lonely deaths" said that this kind of death happens to four out of 10 people in Japan.
  • Usually, the elderly is taken care by the family, but now the culture has changed because the number of single people is growing and the size of families are getting smaller.
  • In the last decades, the single occupant households more than doubled to 14.5% of the total population, mostly are men in their 50s and women in their 80s and older.
  • One in every four Japanese men in their 50s has never been married and some research said that the figure is estimated to rise up to 1 in every 3 in 2030.
  • This business in cleaning up apartments is growing because Japanese has a problem in turning to their family instead of their neighbors.
  • A government study stated that 15% of the Japanese people living alone reported to have only one conversation a week with their peers, compared to 5% in Sweden, 6% in the US, and 8% in Germany.
  • The NLI Research Institute estimated 30,000 people die each year alone, making the apartment cleaning one of the growing businesses in Japan.

Sources
Sources

From Part 01
Quotes
  • "The Japan Dignity Death Association registers and manages “Living Will” (pre-order instructions in terminal care), which falls into a condition that is unlikely to be cured, and refuses treatment for longevity when death is imminent."
  • " If you present your doctor with a living virus signed by each person, you will often not receive life-long treatment. There are many people who are well on their way to achieve a natural and natural death rather than being "lived" by a respirator or stomach fist, but those who have a disease and want a natural death sign Cases are also increasing"
Quotes
  • "There are "regular members" and "life members" as members. Membership is exactly the same, but there are differences in how the dues are paid. Regular members pay membership fees each year, but lifetime members pay collectively."
Quotes
  • "Suspicion of doctor's compliance with advance directives” and “Worry that asking for an advance directive will be mistaken as encouraging a family member to die.”"
  • "Dependency on others about decision making regarding treatment,” and “Difficulty talking about end‐of‐life care caused by distant family relationships."
Quotes
  • "only 3.3 percent of the respondents said they knew a lot about the system and 75.5 percent said they did not know about it at all."
Quotes
  • "A total of 49% were aware of the concept of a living will and 8% had actually written a living will. "
From Part 02
Quotes
  • "In Japan, there is no law supporting advance directives, and format has not been determined. A “Living Will” of the Japan Society for Dying with Dignity4 is a typical one, but not widespread. The number of members registered in the Japan Society for Dying with Dignity has increased annually since 1990, only 113 600 people are currently registered. This number accounts for only 0.5% of the population older than 65 years"
  • "Many participants talked about their ideal way of dying. Some wished for “pokkuri” death, which refers to dying immediately without suffering from disease nor bothering their family. Others wished for a natural death surrounded by their family at home. "
Quotes
  • "Yet now, with aging such a preoccupation in Japan, the cultural taboos against planning for death -- and working in the trade -- are peeling away. The 2011 tsunami disaster factored in the national reckoning with mortality. And the hit Japanese movie, “Departures,” which won an Academy Award in 2009 for best foreign language film, made a powerful case that undertakers are doing important work helping people deal with loss. "
Quotes
  • "In a country with many more deaths than births each year, Japanese companies are looking to maximize the amount of money people spend on shuffling off their mortal coil, from preparing “ending notes” and choosing coffins to arranging to have their ashes blasted into space or turned into diamonds."
Quotes
  • "Kodokushi is a growing problem in Japan, where 27.7 per cent of the population is aged over 65 and many people are giving up trying to find partners in middle age, opting instead for a solitary existence"
Quotes
  • "The 3-day expo is a gathering of all "End Of Life' related businesses, including coffin builders, family altar makers, morticians and others; they show off their wares, exchange information and promote their latest products and/or services. "
  • "The Japan Stone Show, for tombstone makers and suppliers is held concurrently. By 2024, 1 out of 3, Japanese will be over 65 and by 2039, there won't be enough crematoriums--death is a growing business in rapidly aging Japan."
Quotes
  • "“I’d say this is a four out of 10,” says Akira Fujita, leader of the crew from Next, a company that specialises in cleaning up after “lonely deaths” – where people lie dead in their apartments for long periods before being discovered. "
  • "Every country has cases where elderly people die alone, but none experiences it quite like Japan, home to the world’s fastest-ageing population. More than a quarter of the population is over 65, a figure set to rise to 40 per cent by 2050."
  • "Lonely death statistics are hard to come by – the central government doesn’t collect them – but regional figures show a sharp increase over the past decade. NLI Research Institute, a Tokyo think tank, estimates that about 30,000 people nationwide die this way each year."