Avoiding Kodokushi As We Age

It seems like everybody wants to live forever these days. As long as they are healthy, financially independent, residing in their own home, and surrounded by loved ones. This is not realistic, especially as the number of older adults continues to climb. 

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America Is Entering a New Era of Aging

By 2030, one in five Americans will be 65 or older, representing roughly 70 million people, according to the U.S. Census Bureau. By contrast, in 1963 when President Kennedy first established the month of May as Older Americans Month, only 17 million Americans had celebrated a 65^th birthday.

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The demographic shift, a first for the U.S., will impact every single one of us. How we work, how we care for each other, and how we live.

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The Growing Pressure on Families and Senior Care

Those in the sandwich generation, a population that has swelled from 45 million in 2015 to 63 million in 2025, are already feeling the squeeze at work as 7 in 10 are employed while caring for older family members. In response, larger employers are offering more flexible schedules and benefits to caregivers. Those not as fortunate are stringing together jobs and staggered hours to carry the burden.

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Getting help is not always possible. The persistent staffing shortage in senior care communities shows no signs of abating. Harvard Public Health projects 4.6 million unfulfilled home care and senior care jobs by 2032. And a 2024 survey from the American Health Care Association and National Center for Assisted Living reports 46% of nursing homes had to limit new admissions.

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It is no surprise that more of today’s older Americans are living alone. Harvard University experts estimate that by 2038, the majority of those age 80 and older, approximately 10 million people, will be living alone.  

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What Japan Can Teach Us About Kodokushi

A keen observer of Japanese culture and lifestyle will see the parallels between what the U.S. is undergoing and what transformed Japan starting in the 1970’s. By 2007, Japan became the first country to qualify as a super-aged society with a 21% elderly population.

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With this milestone came challenges that upended society, notably kodokushi. This term refers to a person dying alone and not being discovered for some time. It led the Japanese government to assemble task forces and encourage more welfare checks on neighbors. Landlords took a more active role looking after older tenants. 

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In the U.S. this becomes acute in apartment buildings where the risk and associated costs of cleaning up biohazardous materials and replacing carpets and other non-porous materials are not often fully covered by insurance. Neighbors can resist paying rent until the apartment is clean and smells have dissipated. 

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Why Today’s Age Tech Falls Short

Inspired by boomers and investors alike, these converging factors have ushered in a wave of age tech innovation. Some have been true breakthroughs while others are well intentioned, albeit goofy or obtrusive technologies built on assumptions of how older people behave. Few are based on realistic scenarios.

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If we don’t want cameras on our every moves today, why would we invite them to monitor our older selves? The “I’ve fallen and I can’t get up” trope relies on the older adult being able to press a button for help. And while the idea of wearing a smart device is great for fitness tracking now, it’s not something I anticipate doing in my 80s even though I know it increases the risks of kodokushi.

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The New England Journal of Medicine reports that mortality reaches 67% when a person in medical distress is found after 72 hours, compared to 12% if discovered within the first hour. Yet being tethered to a device or watched through a camera lens is not how any of us envision our golden years. 

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A More Human Approach to Aging in Place

Instead of older adults and their sandwich generation children living in anticipation of a medical event, why not benchmark the flexibility of older adults today through non-invasive monitoring of everyday activities. It is possible by sensing body temperature and interpreting subtle changes in activity, responsiveness, and walking speed before it impacts mobility. Many are surprised to learn that frailty is preventable if identified early. Detecting frailty signs early can potentially reduce that 12% and save on the associated costs of care and modified living environments.

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Preparing for Longevity Before a Crisis

Flagging potential health risks is well trodden from a clinical and prescriptive perspective. Yet it is often relegated to a doctor’s office visit triggered by pain or in response to being asked the right question. Or it relies on invasive technologies at home.

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Aging is nothing new. How we plan and prepare for is changing thanks to research and technologies that provide insights and improvements to support longevity. We can learn from countries like Japan, France and Italy that have already figured out how to accommodate demographic shifts like the one the U.S. is facing. Or we can do nothing and wait to be discovered late in life.