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In 2024, the average number of people aged 65 and older in Japan amounted to approximately **** per household. Figures have been stabilized in recent years. 

The current situation of long-term care in Japan

Japan launched long-term care insurance (LTCI) in 2000, a mandatory program funded by all citizens over 40. While contributions are based on individual income, the LTCI’s benefits are equal for everyone. They are exclusively provided to individuals aged 65 and over in need of long-term care, or to people aged 40 and over who suffer from aging-related diseases, such as cerebrovascular disease. Japanese municipalities are responsible for licensing service providers and setting premiums. At the same time, the Japanese healthcare system has struggled to respond to the continuously growing share of citizens aged 65 and older. The system faces persistent problems, such as low capacities of intensive and long-term care facilities for the elderly, a health worker shortage, and understaffed facilities.

Health workers and foreign nurses in Japan

The Ministry of Health, Labor and Welfare (MHLW) in Japan predicts a severe shortage of health workers despite a steadily increasing number of certified care workers over the past decade. This is partially attributable to low wages and harsh working conditions. As a countermeasure, the country has begun expanding its labor market to other Asian countries and started Economic Partnership Agreements (EPA) with Indonesia, the Philippines, and Vietnam in 2008 and 2009. Those applicants are required to pass a state examination within their four years of residency that are permitted to become a licensed caretaker in Japan. With the exam being held entirely in Japanese, an immense disparity in passing rates between Japanese and foreign examinees became apparent. It can be considered one indicator as to why the majority of foreign nurses who had come to Japan in 2008 have since returned to their home countries.