Woman's win of nursing home money a rarity in aging

TOKYO (AP) -- When her stay at the glamorous Grancreer residence turned into a nightmare of disrupted sleep and difficulties with the staff, retired harpist Yumi Makino opted out, and after a two-year legal battle got her deposit money back in a rare victory over a big real estate company.

Makino's experience reflects the challenges faced by many older Japanese in finding suitable care and accommodations in "super-aging" Japan. Many assisted-living facilities demand hefty up-front payments on top of the usual rent and other fees -- payments that are customary in Japan although they've been banned in other wealthy nations.

A resident who gets fed up usually has no option but to just forfeit the money. But Makino, a 66-year-old widow, fought on and eventually got all 12 million yen ($113,000) of her money back.

There are no official data, but the National Consumer Affairs Center of Japan, a government-backed agency, reports growing problems with residents of assisted living facilities who decide to leave but have a hard time getting those big one-time payments back.

"The reasons for such payments have always been unclear," said Kosei Ogawa, Makino's lawyer. "It serves as an expression of gratitude."

Makino says she was unhappy with how staff at Grancreer treated her. But the strongest factor behind her win was a malfunctioning emergency alarm that kept going off at night, disturbing her rest. The management of Grancreer refused to fix it despite repeated requests, dismissing her as senile, she said.

"Why do we have to be treated as inferior when we are paying all this money?" said Makino, who spent much of her career on the move, including stays in Colombia and Mexico. "The appearance may be that of a gorgeous hotel, but the staff's behavior was low grade."

Tokyu Land Corp., which runs Grancreer and other similar facilities around Tokyo, refused comment on the case.

Five million of Japan's 35 million people 65 and older are estimated to live in special-care facilities, according to the health ministry. Given the shrinking size of families as the birthrate declines, the need for group homes, hospices and assisted living accommodations is skyrocketing.

Shigenobu Ueoka, a consultant who advises families about nursing homes, says most facilities tend to focus more on pleasing government bureaucrats, who dole out aid, than about satisfying their customers.

Monitoring of quality and safety tends to be inadequate, with the worst facilities charging residents for food and adult diapers on top of regular fees, or restricting family members' visits as a nuisance, said Ueoka, who has visited hundreds of homes in Japan, and dozens in Europe and the U.S.

He says the system's troubles are partly related to Japan's relatively generous support for its elderly, which limits the burden for those qualifying for government help to only 10-20 percent of the total costs. The rest is covered by the government, with the level of aid depending on an individual's health and income.

Typically, a resident might pay just 50,000 yen ($470) out of the total 400,000 yen ($3,700) monthly cost for food, housing and care.

Facilities with a good reputation aren't cheap. "The best homes never have to advertise," and they have long waiting lists, Ueoka said.

Silver Villa Koyama, a home in Tokyo, which Ueoka has ranked as among the best, charges 8.3 million yen ($78,000) for those who are aged 94 or older. For those 75 years or older, the upfront payment is 23 million yen ($215,000), with an additional monthly fee of 145,800 yen ($1,360).

Makino's win over Tokyu Land Corp. was the equivalent of an out-of-court settlement in the West.

The one-time insurance-like payment that she managed to get back, called an "ichijikin," is standard in Japan -- renters often have to pay a similar fee, called a "reikin," for a new or renewed lease. Such onerous payments are honorariums of sorts that symbolize an expression of gratitude toward one's higher-ups.

The government is phasing out such payments, but many places still demand them.

Still physically active and busy with her hobbies of knitting and Western-style calligraphy, Makino opted to move back into an apartment.

Many older Japanese stay in their own homes well into their 80s and sometimes beyond, getting relatively generous, government-subsidized help with cleaning, cooking and deliveries.

Makino's solution was to sign up for daily lunch deliveries from a nearby convenience store, not because she needs the lunch, she said, but to minimize the risk of dying alone and being found weeks later -- a common and realistic concern among many who live alone. For dinner, to save trouble, she just has chocolate.

She has no children but adopted a huge black and white stray cat for company. She says she's enjoying her peaceful life, but sort of misses her legal battle.

"It was fun," Makino said. "How to pass your time is the biggest challenge of growing old."

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