When Takuya Shiota’s cleaning agency was called to a small apartment in Tokyo, the elderly resident had been lying dead on the floor for over three weeks.

The resident, who is over 70 years old, was only discovered when her landlord tried to collect unpaid rent.

She had no family or friends to look after her.

She lived and died in loneliness.

The sultry Tokyo summer was in full swing and the sight was so gruesome that Mr. Shiota had to cut the floorboards out of the floor where the woman was found.

“The smell in the room was so strong,” he remembers.

“We treated the liquid and then cut out the soil and disinfected it.”

The work of Mr. Shiota and his colleague Kyohei Kudo is unpleasant but vital.

Japan has long struggled with the problem of so-called “isolated deaths”: people who die without a support network and remain undetected for long periods of time.

In a notorious case more than two decades ago, an elderly man was discovered three years after his death.

His rent and utilities were automatically deducted from his bank account and when it was finally empty, the authorities began investigating.

This year, the Japanese government published an official count of individual deaths for the first time.

In the first three months alone, almost 22,000 people died and remained undetected for a long period of time.

Most of them are older people.

This means that about 88,000 people are expected to die a lonely death in Japan this year.

And this crisis will only get worse: Japan has the oldest society in the world; more than one in ten people here is older than 80 years.

However, it is not just a problem of the ageing population.

For many, the lonely deaths in Japan are a reflection of a society that has lost its sense of community. Neighbours no longer care about each other and many residents prefer to isolate themselves.

“The number of inquiries is increasing significantly,” said Mr Shiota.

“We handle around 100 cases a year, especially in summer. That’s peak season.”

Aging residents in a dwindling boomtown

In Yokohama, a city just a short train ride from Tokyo, lies the Kotobuki district.

It is a densely populated suburb where outsiders from all over Japan came to escape their old lives and find work in the big city.

Many apartments are tiny – often smaller than five square metres – and have shared facilities such as kitchen and bathroom.

During Japan’s boom years in the 1980s, it was a thriving, bustling place.

Today, residents are predominantly older and often suffer from a variety of health problems, including alcoholism and mental illness.

Here, Osamu Yamanaka was the first to conduct regular health checks at home.

“People were found dead in their rooms, some even down to their skeletons,” he said.

“I was young and thought it was unforgivable.”

Every week, Dr. Yamanaka visits his lonely patients to perform a series of tests.

Some are in the final phase of their lives.

Dr. Yamanaka discusses their treatment options, but many refuse medical intervention.

They have given up. And Dr. Yamanaka respects their decision. But he will continue to keep an eye on them.

“If I didn’t do that, there would be an awful lot of lonely deaths,” he says.

These visits are about enabling important human contacts.

“I belong to the lower class,” says 74-year-old patient Yasuo Inayama.

“There are not many people who are willing to negotiate with people from the lowest levels of society. But he is willing to come to me. I appreciate that.”

Throughout Japan, elderly residents with health problems may be entitled to varying levels of home care.

Compared to Dr. Yamanaka’s early days, this service is much more accessible today.

Dr. Yamanaka says the workload is manageable and the problems of Japan’s ageing population do not worry him.

However, he believes that there is only so much that the medical profession can do to solve the dilemma of individual deaths.

Sometimes people don’t know how to get help.

Others have chosen to isolate themselves from their families and society at large.

Not all lonely deaths affect older people.

In these cases, it is up to the community to provide support.

“If they don’t maintain social contact with their neighbors, they will end up dying alone,” says Dr. Yamanaka.

“It’s very difficult to prevent this.”

Community building to prevent lonely deaths

It is a challenge that 81-year-old Yoshiko Sato has accepted.

Their huge apartment complex was once full of families.

But today it is home to nearly 400 elderly residents who live alone.

Just over two decades ago, she founded the community campaign Zero Lonely Deaths after a number of people died alone, including a good friend of hers.

“Every year, four out of five people die alone,” she said.

“People around me began to ask why such a good friend of ours died so lonely and alone.”

A group of volunteers began conducting routine checks on the neighborhood’s elderly residents.

The group also contacted authorities to be informed of suspicious activities.

For example, you will be called by the energy supplier if there is a sudden and prolonged drop in electricity consumption in a registered apartment.

“After five years, we could say that there were no more lonely deaths,” Ms Sato said.

The program has evolved to do much more than just prevent individual deaths.

In addition, it saves lives and restores a sense of community.

In one case, a sleeping man was rescued after an incense candle fell over and ignited a pillow.

In another case, an elderly diabetic man was found immobilized and taken to the hospital.

“In our complex, everyone comes together,” explains elderly resident Shigeko Maeda proudly.

During one of her regular visits, Ms. Sato brings fresh vegetables and receives a freshly cooked lunch in return.

“I look forward to cooking with the vegetables I get from her,” says elderly resident Akiko Yoshida.

“This is what makes my life worth living.”

Money is needed to keep initiatives running

Although Yoshiko Sato’s program was a success, she is worried about the future.

Community initiatives like yours are dissolving despite their importance.

“A community has to be built by each individual, which is not currently possible in Japan,” she says.

“People get selfish and say they don’t need to join a residents’ association or they don’t need a residents’ association.”

Cleaner Takuya Shiota also shares this concern.

Both are calling on the government to provide financial support to community groups.

“In Japan, there is a lack of interaction between people and local communities, which is quite normal,” says Shiota.

“There is data to show that loneliness is the biggest factor in shortening life expectancy.