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The story
A news story using Shimokitayama, a village in Nara Prefecture, as a case study on the crisis facing rural elder care was picked up on 5ch’s News Speed+ board. As both the population needing care and the workers providing it dwindle, experts reportedly describe rural care as being in a “fighting retreat.” The thread mixed worries about a reversion to the era when families had to shoulder caregiving themselves, with conflicted reactions to the trend of concentrating elderly people in upscale urban facilities. Calls to improve pay and conditions for caregivers—who face low wages and irregular shifts—ran alongside warnings that raising wages would make facilities financially unviable, sparking a broader debate about a structural problem that simple “labor shortage” framing can’t fully explain.
Rural elder care is in a critical state. A severe shortage of workers is being compounded by a shrinking pool of people who need care.
A quarter century has passed since Japan’s long-term care insurance system launched with the goal of “socializing caregiving,” but some experts now describe rural elder care as a “fighting retreat.”
Take Shimokitayama, a village at the southern tip of Nara Prefecture. Its population, which stood at 1,212 in the 2005 census, has fallen by 40% to 701 as of 2025. According to 2023 projections by the National Institute of Population and Social Security Research, it’s expected to shrink further to just 451 by 2040.
Source: mainichi.jp / Original article here
What people said
We're heading back to an era where children look after their own parents, and only children will be forced to choose between their parents and their own life.
get dumped in a nursing home by relatives with money to burn.
What started as a business
now has small operators going under.
Users and families are idiots.
Owners are scum.
Caregivers get irregular shifts and low pay.
Caregivers are at each other's throats, tearing each other down.
That's just my impression—I don't even work in care.
Isn't that exactly why they're talking about mandatory retirement at 45?
Re: #36
Abe praising Goodwill's care-services company (Goodwill Group, a staffing firm later hit by scandal) 20 years ago was the beginning of the end.
There's a chance we're heading back to obasuteyama days—literally abandoning the elderly (from the old legend of carrying elders into the mountains to die)…
Maybe if you're a decent parent you'll get looked after lol
That only applies to the rare case, like a farming family whose kid actually took over the farm.
Most rural areas are places where the kids moved to the city for work and only the old folks are left behind.
There's nobody willing to do the job. At this rate the whole care industry is going to collapse.
I'm dead serious. Whether it's you, your friends, or your relatives—please try to steer people toward the care industry.
Then the answer becomes 'pay them well'—but then nobody can afford to live in the facility in the first place.
No idea if "I don't want to deal with wiping some old person's ass" would actually work as a deterrent against crime, though.
Even in that prison, there are more and more inmates who might as well be senile old men.
1. Public transit disappears. Once you can't drive anymore, you can't function.
2. Electricity, gas, and water bills skyrocket.
3. Roads and other infrastructure become impossible to maintain.
4. Even if you request home care, nobody comes.
5. A bear stops by every day to check whether the homeowner is still alive.
Just get the bear to work as the caregiver then, problem solved.
That's why you live in a decent standalone house in a reasonably central spot within a "compact city."
Speaking as someone whose family has actually used care services—
>4. Even if you request home care, nobody comes.
Believe it or not, that's actually a bigger problem in the city center.
Home-visit nurses genuinely struggle without visitor parking.
They'll ask you, "Is there somewhere I can park? Even a kei car? Not even a COMS microcar?"
A modern-day obasuteyama (the mountain where the elderly were once left to die).
Eventually a generation that can't afford the move-in fees will show up, and that's when it all falls apart.
Even where facilities exist, they can't find any caregivers to staff them…
Ice Age generation here (Japan's "Employment Ice Age"—those who job-hunted during the long 1990s–2000s recession).
Got rejected by 100 different nursing homes.
Couldn't even get an interview.
Whatever I went through job-hunting back then just keeps following me for life.
Any sane member of the Ice Age generation wouldn't touch caregiving work.
Maybe not so much in the old days, but dealing with the baby boomers now would drive you insane lol
In the end, the ones who never even try to get into a nursing home turn out to be the winners.
Are there even enough young people left to hold up that inverted pyramid?
All I can picture is a future where you apply for a nursing home, get put on a waitlist, and just never get in.
The Ice Age generation's pension won't kick in until age 85.
Full out-of-pocket medical costs, too.
And of course welfare ("namapo") will be abolished by then.
Only option left is supplements and the gym to extend your healthy lifespan.
Pretty seriously, it looks like things will be adjusted so the Ice Age-to-Yutori generations only ever get back 10-20% of what they paid in before they hit the average life expectancy.
For Gen Z and beyond, with the birthrate dropping even further, it might not even be a question of how much pension you get, but whether you get any at all…
The Ice Age generation will be rolling in it come retirement thanks to the new NISA (Japan's tax-free investment scheme), right? lol
Ice Age generation people who didn't even pay into the pension and won't get the full amount
will get screened out by the facility right from the start, so all that's left is decomposing at home.
And even if you're lucky enough to get in, if you're a loner nobody visits you, so you're still a loner no matter where you end up.
It's hopeless.
Your place is rented too, so you'll get kicked out of that as well lol
Someone who's always been a loner is one thing, but it might actually be worse to have family out there who just never bother to visit.
You can probably make friends once you're in a facility.
Beats the daily grind of shuffling between a run-down apartment and the discount stickers at the supermarket.
At care-industry corporations, it's only the executives and board members outside the frontline who are getting fat off it.
Okay then, let's double the consumption tax and double the long-term care insurance premiums.
I think most employers would rather shut down the business than raise frontline wages.
Background and Key Points of This Discussion
It’s been a quarter century since Japan’s long-term care insurance system began, yet Shimokitayama’s population has dropped 40%, from 1,212 in 2005 to 701 in 2025, and is projected to fall further to 451 by 2040. What makes rural elder care so difficult isn’t simply a shortage of caregivers—it’s that the number of people needing care is shrinking too. The thread saw calls to “raise wages” clash directly with warnings that “raising wages will bankrupt the facilities,” pointing to a structural problem that better pay alone can’t fix. Some also described the trend of gathering rural elderly into upscale urban facilities as a “modern-day obasuteyama” (the legendary mountain where the elderly were once abandoned), while others pointed to the risks of rural living itself—lack of transportation, crumbling infrastructure, and no home-care visits—making this a debate with no simple answer between urban concentration and sustaining rural life. There was also anxiety expressed about the outlook for pensions and medical costs once the Employment Ice Age generation reaches old age.
*This article is compiled from excerpts and a summary of the 5ch (News Speed+) thread “Rural Elder Care Is Now a “Fighting Retreat” as Population Decline Threatens Services.”
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