Gaia Series 101: I want to make my "last wish" come true

From bespoke travel to home-centred care, Japan reimagines how the elderly spend their final days.

In a country where nearly 30 per cent of the population is aged 65 and above, Japan faces the urgent challenge of caring for its elderly. But in Tonami, Toyama Prefecture, a quiet revolution is unfolding – one that reimagines not only elder care, but life’s final chapter. 

This week’s episode follows Ryosuke Sakamoto, the founder of JEPTO, a travel service designed for senior citizens with health or mobility concerns. Through his work, he offers more than tours; he delivers seniors dignity and moments of deep human connection.

The episode opens at the Tonami Tulip Fair, where three million tulips of 300 varieties bloom across the fields in spectacular colour. Among the visitors is a group of elderly guests from Aichi Prefecture, all from the same daycare centre. Most require assistance walking, but this does not stop them from climbing the 26-metre-tall Tulip Tower, guided step by step by carers and their own determination. “You’re halfway there!” someone encourages. “Think of the delicious meal ahead.”

Their journey is not just physical. At the top, they marvel at the tulip art below – a mosaic in the form of Tonami’s mascot, Tuli-kun. One elderly woman chuckles, “My legs are still shaking,” prompting another to joke, “I’ve only got five or six years left to live,” to which a third responds wryly, “Still five years? I’m already done.” The laughter that is shared by the seniors, all in their 80s, is tinged with both humour and honesty. It reveals how these seniors face ageing not with fear, but with resilience and wit.

Behind this trip is Mr Ryosuke Sakamoto, who not only runs the daycare centre but also leads the tour. A licensed physical therapist, Mr Sakamoto provides more than supervision; he gives physical and emotional support. “I can come, thanks to all the support,” says one participant. “I can’t do a normal trip anymore.”

The episode then shifts to the Mercure Toyama Tonami Resort and Spa, where the group stays for a night. Facilities here are elderly-friendly, with walkers and pushcarts available. Dinner features local seafood such as sweet shrimp and yellowtail from Toyama Bay. Though the trip – which includes two meals – costs ¥115,500 (S$1,000), demand is so high that tours regularly sell out.

“Many people want to travel but assume they can’t anymore,” Mr Sakamoto explains. “I think we can support what the guests want to do. That’s what inspired me to start this.” 

The seed for JEPTO was planted years earlier, when Mr Sakamoto, then 27 years old, was still working as a physical therapist. One patient, Mr Takashi Yamamoto, had spent so long in rehabilitation that he lost his will to live. Sakamoto gently asked what he wanted to do if he could walk again. Yamamoto’s response was simple: “I want to soak in an open-air hot spring.” That wish became reality, and when they finally visited one together, Yamamoto cried – not from pain, but from joy. “He never showed that kind of joy during rehab,” Sakamoto recalls. “That moment with Mr Yamamoto was what sparked my journey.”

Mr Sakamoto is also president of P-BASE, a daycare service in Toyota City, Aichi Prefecture. With four branches serving around 850 clients, its aim is to maintain health and prevent further decline. “People exercise so they can go on trips,” he says. “The effort they put in leads to something to look forward to.”

And for one family, that “something” is deeply personal.

Michiko Onoda wants to fulfil her 99-year-old mother Yoshimi’s wish: to visit the grave of her late husband, Shizuo, and enjoy her favourite childhood snack, gohei-mochi. Yoshimi has been in a wheelchair since breaking her leg three years ago. Dementia has advanced, and going out has become nearly impossible.

Mr Sakamoto takes on the challenge. He visits the steep cemetery to assess logistics and works with his team to design a custom tour. They rehearse how to manoeuvre Yoshimi’s wheelchair up the steps using towels and ropes. “If we pull firmly, it should work,” he says. “Three people should be enough.”

On the day of the trip, nine family members – spanning four generations – accompany Yoshimi. A truck blocks the path, but after Mr Sakamoto negotiates with the workers, it’s moved immediately. The family proceeds, pushing and lifting her wheelchair with loving care. “We made it,” her grandson Toru says, placing her in front of the grave. “Mrs Yoshimi, here we are. This is your husband’s grave.” She replies softly, “Thank you.”
Later, the family shares a meal at a local inn. Gohei-mochi is served. Though she had lost interest in food recently, Yoshimi takes a hearty bite. “She still has all her teeth,” her daughter notes. “She can eat just fine.”

Yoshimi even enters a hot spring bath with help from her great-grandchild. “She often looked down, but today, she smiled,” her grandchild says. “Hearing Grandma say ‘thank you’ made me truly happy.”

Another request soon reaches Mr Sakamoto. This time from Hiroyuki Shikata, 64, who has ALS (amyotrophic lateral sclerosis), a rare and progressive neurological disease. His mobility is limited and time is of the essence. What he wants is simple but symbolic: to visit the Expo once more. Twenty years ago, he and his wife Rumiko took their young sons to the Aichi Expo countless times. “He had an annual pass,” she recalls.

On 21 May, Mr Sakamoto takes the Shikatas by car to the Osaka-Kansai Expo. It is their first outing in six months. “You’re so impatient,” Rumiko says teasingly in the car. “You used to walk so fast.” He responds with a smile, “Slow is better, right?”

At the Expo’s Japan Pavilion, Mr Shikata touches a Mars rock, marvelling at its smooth texture. “It’s different,” he says. At the US Pavilion, he relives the Moon landing through an immersive space experience. “It felt like I really went there,” he says. “That footage was incredible.”

A new goal is born: to travel again with his wife. “I hope we can keep spending our days filled with laughter,” she says. “If we get another chance, I’d love to go somewhere together again.”

In Tokyo’s Itabashi Ward, the episode turns to a groundbreaking facility with an unusually hopeful name – “Let’s Go Home Hospital.” Here, the focus is not on prolonging hospitalisation, but on rehabilitation with the aim of helping patients safely return to their homes. “Only 20 per cent get to die at home,” says hospital director Dr Shinta Mizuno. “We want to change that to ‘I made it back.’” The hospital also provides support for home care, bridging the gap between acute treatment and daily life – a model that recognises the importance of dignity, independence and comfort in a patient’s final chapter.

That mission is poignantly realised in the story of Tokio Tsuruishi, 76. After battling lung cancer and pneumonia, he is admitted to “Let’s Go Home Hospital” for rehabilitation. He regains strength, walks with assistance, and even eats again with newly adjusted dentures. But when his condition suddenly deteriorates, the family is faced with a choice: another hospital transfer or a return home. His wife Mayumi makes the decision he had long hoped for. “You’ll go home from Let’s Go Home Hospital to your real home,” she tells him. Surrounded by neighbours, family, and memories, Mr Tsuruishi returns home – if only for a few precious hours – and passes away peacefully.

This episode of Japan Hour is a reminder that in the twilight of life, people don’t stop dreaming. Whether it’s standing at a spouse’s grave, sharing a nostalgic bite of gohei-mochi, or going home to spend one’s last few hours, there is purpose and dignity to be attained. And with people like Mr Sakamoto and Dr Mizuno helping to make those wishes come true, these final chapters can still hold meaning, joy, and even laughter.