Japanese facilities are reluctant to accept new residents without a personal reference because of concerns about who will pay any outstanding bills and make funeral arrangements when a resident dies, according to a government survey of 2,387 facilities.

95.9% of facilities said they ask for a third person to sign a contract when someone enters an aged care facility, while 30.7% won’t accept someone without such a signature.

Respondents said these guarantors should act as emergency contacts, claim the body and belongings, sign any paperwork and guarantee payments.

What then for elderly residents without family to vouch for them or a guarantor?