After a career as a middle-school teacher and principal, the retired Shōhei Higashi begins showing signs of dementia in his seventies. Eight linked stories trace the challenges he, his wife, and their three daughters face over the next ten years, until he passes away on New Year’s Eve. According to Ministry of Health, Labour and Welfare data, the number of dementia patients in Japan is expected to exceed seven million by 2025, affecting one in five individuals over the age of 65. A growing number of patients and their families are choosing home care, and in a culture where domestic matters continue to be considered the province of women, the greatest part of the burden falls on wives and daughters. This work offers a vivid portrayal of some of the realities Japan will face as the average age of its population continues to climb.
The collection opens with a story in which Shōhei begins wandering, and his three daughters buy him a mobile phone equipped with GPS for his birthday. Shōhei is slowly but surely losing his cognitive functions and has difficulty following conversations. He constantly says he wants to go home, no matter where he may be. His responses often make no sense, and he wants nothing to do with caregivers other than his wife, but when addressed as “Sensei” he sits up straight and, to his grandson’s amazement, holds forth with his vast knowledge of kanji (Chinese characters) still intact.
Each of the daughters has her own life and concerns, as well as her own way of relating to her parents and contributing to her father’s care. Mari, the eldest, is married to a biologist who obtains a research appointment in the United States, so she moves to the West Coast with her husband and two sons. Second daughter Nana also has a husband and son to keep her busy, but she is the dependable one. Fumi, the youngest, is doing well as a culinary coordinator but remains unmarried in her mid-thirties. Their mother Yōko is determined to do everything she can for Shōhei in their home, right down to the end. But then crisis strikes the family as Yōko has to undergo surgery for a detached retina, and Shōhei not only suffers a femoral fracture but comes down with a fever. They have reached the limits of one elderly person caring for another with nothing but the help of visiting aides dispatched by the municipal health department.
Advances in modern medicine have made long slow declines in cognitive function at the end of life increasingly common. How are families to relate with their loved ones as they gradually lose their identities to their debilities? This work interweaves an unflinching look at the troubling realities of such situations with a sympathetic eye for those who find themselves caught up in them.