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From the outside, Kotoen was indistinguishable from the other buildings in its vicinity. “Is this it?” my husband asked me, looking at their signboard.
We were in Tokyo to visit Kotoen, Japan’s first fully integrated intergenerational facility run by the Sugi family.
We first heard about Kotoen from Dr Thang Leng Leng, a Professor and Researcher at National University of Singapore (NUS) who did her anthropological research at the facility. At first, we were intrigued but frankly also a little curious. A single centre that actually brings together all three vulnerable groups—the elderly, young children, and the intellectually disabled, under one roof. Was this possible? We decided to make a trip to Japan to see for ourselves.
Once we stepped inside, we were greeted with squeals and chatter from the little ones. It was 9.30am and intergenerational exercise has just begun. Music blasts from the speakers and the children begin to move their bodies, while the seniors sit facing them, clapping their hands to the beat. “Are you Mariel?” greets Yuichi-san, “Welcome to Kotoen!”
Kotoen houses 7 different care businesses under one roof, including a children’s day care, senior’s nursing home, dementia day care, day care for the mentally disabled. While each space was specially tailored to the needs of the respective communities, there was movement between spaces. Seniors from the nursing home would come down to the childcare for intergenerational morning exercise or to use the kids pool, or kids would visit the nursing home to cheer up seniors on their death beds.
We were brought around by Yuichi Sugi, who 47, the director of the centre. Yuichi studied Mathematics in the U.S. and has a Master’s Degree in Forensic Science. He returned to Japan due to health reasons and helped to run his family’s care business, which started in 1962 as a nursing home. The intergenerational component has been running for at least 30 years. His twin brother runs one of their other centres.
Extensive literature have lauded the benefits of intergenerational bonding, noting that it improves the psycho-social wellness of seniors and increases the emotional quotient of children as they learn to interact across difference. But we don’t need to quote researchers on this. Just look at how babies instantly light up the faces of the elderly during Chinese New Year celebrations or even in the lifts. As a mother of a toddler, I have seen grumpy aunties in my neighbourhood smile from ear to ear when they play with my daughter.
Yuichi says that in his daily work, the impact of the children on the senior’s wellbeing is evident every single day. “Especially for those with Alzheimer’s, they cannot tell you, but you can see it on their faces.” He also related to us a story, “Seeing children also helped to delay the death of the elderly. We had a patient in our nursing home who was very sick and already on her death bed. The children decided that they wanted to visit her. After their visit, she stayed alive for a while before she finally passed away.”
There is a beautiful symbiotic relationship here. However, Yuichi also said that sadly the Covid-19 pandemic had changed the interactions between the young and old. Before the pandemic, he says there used to be a lot more mingling between the two groups. The elderly would also be more active and leave their premises for walks around the neighbourhood. However now they are more sedentary and for safety reasons, don’t have as much physical contact with the children.
Yuichi brought us for a tour around Kotoen. We visited their physiotherapy centre, their day care centre for seniors, as well as their day care centre for adults with mental disabilities. He explained the landscape of care in Japan. Childcare fees are 100% subsidised by the government while elderly care is subsidised by 90%. One of their centres which serves elderly with higher needs is run by an insurance company. I was very awestruck by these statistics, at least compared to Singapore. Early childhood care here is mostly privatised and while subsidised by the government, will probably never hit 100% subsidy-rate. Subsidies for eldercare is based on means testing.
Most people know of Kotoen as an intergenerational facility. What we saw during our visit, however, was that beyond serving the young and the old, Kotoen also takes into their care adults with intellectual disabilities. We visited their cosy space on the second floor. It was decorated with colourful origami and on the wall was a showcase of their calligraphic artworks.
Yuichi-san brought us to an island of work desks next to a large whiteboard with a schedule written on it in Japanese. “Some of the adults here work with us,” Yuichi explains. “For the higher functioning adults, we pay them to do different tasks such as changing sheets, cleaning, and simple administrative tasks on the computer. You can see here that this woman with autism here will be helping out with some cleaning tasks in the morning.”
The centre was empty when we visited early at 10am. The 8-9 clients arrived slightly later after being picked up by their centre's shuttle, strolled out of the elevator, then dispersed into different parts of the centre. One of them wore earmuffs. “This group,” Yuichi told us, “They’re my favourite.”
We decided to pop by the dementia day care as I mentioned Yuichi that we were planning to start a senior day care centre in Singapore.
The dementia day care centre was simply but delightfully designed, with lots of natural light streaming in from the windows. (There was, in fact, a lot of natural light in the whole building.) There were about 10-12 seniors around the table doing different activities like solving puzzles, reading newspapers, and one elderly was sitting looking at a picture of her son.
My toddler loved the spaciousness of the room and started running around and making friends with the seniors. “Anata no namae wa nanidesu ka? (What is your name?)” asks one of the elderly woman. “Faye-chan!” Faye-chan was a hit. She ran around and played with the seniors whom all loved her and wanted to cuddle her.
One of Kotoen’s care staff came over to us and offered my husband and I genmai-cha. It was delicious. Bennet and I talked about how nice it was to offer a non-water beverage for seniors.
I asked Yuichi if Kotoen takes in seniors with dementia who display aggressive behaviours. I explained that in Singapore, most centres would screen for behavioural patterns and not take in those with violent tendencies, for the safety of their other clients. That’s when he looked at me and said, “Of course. If no one else will take them, we will.” He said that they will just employ different strategies such as distracting them. Their staff are trained to manage difficult behaviours.
To end our visit, Yuichi brought us back to the day care centre for those with intellectual disabilities. The room was now transformed into a vibrant, carnival-like centre. Seniors from the dementia day care and the nursing home were all gathered with children from the nursery as well as the adults with intellectual disability, to play games together.
We watched as they took turns to toss the rings onto a cardboard board. The elderly spectators would laugh and cheer the kids or the adults with ID on, and everyone looked like they were having a good time. As I stood there and watched the children, the seniors, and the adults with ID mingle and cheer each other on, I could not help but pinch myself. Was this real? I’ve never seen anything like this, and especially not happening on a daily basis.
This was the village I had always dreamed of and here it was, unfolding before my eyes in a nondescript building in Edogawa City, Tokyo.
Sensorially and emotionally, the whole experience was a lot to take in and process.
muein’s vision is one of unity and integration, within the self and with the community, especially those on the fringes of society.
It was therefore completely surreal to see a model of this dream actually taking place in reality, in that little building.
Yuichi told us that they are planning an overnight intergenerational trip to the sea soon. “It’s going to be a big headache,” he said with a laugh.
We thanked him for their time - and apologised for the many, many questions of ours he patiently and generously entertained.
Prof Thang told us that Japan is 30 years ahead of Singapore. My hope is that we can grow our own village like this in Singapore, that we can learn from our neighbours and yet find our own way of creating an inclusive village in our local context.
