Good Death

“Good Death” is a photo project about the aging population and palliative care in Nagano, Japan. The prefecture has the longest life expectancy in Japan, which makes the 2nd in the world. In comparison, the birth rate has been falling to the lowest level in history and it predicted that its workforce will be 20% smaller in the next 20 years. Most young people leave their town to metropolitan areas after high school and causing a lack of caregivers. As one of the only photographers who grew up in Nagano working internationally, this project will focus on three themes include death, reminiscence, and resurgence by covering palliative care and disposers who help patients to clean up their own belongings in ahead of their death. The project documents an entire stream of death from the patient’s preparation to the family’s aftercare both mentally and materially.

In the city of over 50% of its population is older than 65 years old, medical care for the elderly is crucial. In need of hospice, the demand for palliative care is very high in depopulating Nagano. This project will focus on Aiwa Hospice, the only hospice in Nagano-city, prefecture’s capital. Aiwa hospice provides palliative care to 400 - 450 patients a year for the last month of their lives. By riding along with domiciliary visits, I will examine the patients' and families' preparation for the expected death.

“Kodokushi” is a Japanese word means lonely death refers to the people dying alone and remaining undiscovered for a long time. Social isolation of the elderly is common in Nagano since their children move out from prefecture in seek of better opportunities. By following the disposers who clean belongings of departed people, the project questions the necessity of medical care after they were left behind the isolation of Nagano.

“Good Death” is the photo story that questions the dignity of death in Nagano by focusing on two types of death. By covering Aiwa hospice and disposers of Kodokushi, both sides show the reality of the aging society, but one document patients and families who expect the loss of beloved ones, and another document the struggle of finding medical care at their last days and memories they left in their empty room.

© Yuki Iwamura - Image from the Good Death photography project
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During the week of the Obon Festival, people burn dried Japanese white birch to make a small bonfire called "Mukaebi" to guide spirits upon their return back home. On August 13th, 2019 in Nagano, Japan. Obon Festival is the three-day Buddhist custom to honor the spirits of one's ancestors in Japan.

© Yuki Iwamura - Image from the Good Death photography project
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Yoshiko Ochiai was diagnosed with Parkinson’s disease 7 years ago after she lost her husband with cancer. Even though the symptoms of the disease was alleviated by the medicine, she still lives alone with many daily struggles. On August 19th, 2019 in Nagano, Japan.

© Yuki Iwamura - The bed frame of the cancer patient is lit by the sunlight on November 20th, 2019 at Aiwa Hospice in Nagano, Japan.
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The bed frame of the cancer patient is lit by the sunlight on November 20th, 2019 at Aiwa Hospice in Nagano, Japan.

© Yuki Iwamura - Image from the Good Death photography project
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Makoto Hirakata, vice-president of Aiwa Hospice talks to his patient during the round check on November 16th, 2019 at Aiwa Hospice in Nagano, Japan.

© Yuki Iwamura - Image from the Good Death photography project
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Nurses and Doctors surround the table for their morning conference to check every patients' condition. Aiwa Hospice holds 40 stage-4 cancer patients with 6 doctors and 25 nurses. On November 19th, 2019 at Aiwa Hospice in Nagano, Japan.

© Yuki Iwamura - Doctors and nurses participate ward rounds every on November 20th, 2019 at Aiwa Hospice in Nagano, Japan.
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Doctors and nurses participate ward rounds every on November 20th, 2019 at Aiwa Hospice in Nagano, Japan.

© Yuki Iwamura - Image from the Good Death photography project
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Makoto Hirakata, vice-president of Aiwa Hospice talks to his bedridden patient during the round check on November 16th, 2019 at Aiwa Hospice in Nagano, Japan.

© Yuki Iwamura - Image from the Good Death photography project
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All the doctors and nurses of Aiwa Hospice participate ward rounds every morning and evening. They usually visit all the ward asking patients’ conditions. On August 25th, 2019 at Aiwa Hospice in Nagano, Japan.

© Yuki Iwamura - Image from the Good Death photography project
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Family of Shigeyuki Yoshida, 75, and doctors and nurses of Aiwa Hospice hold farewell ceremony for Shigeyuki who past away earlier that day after fighting for cancer at the hospice for 8 days.

© Yuki Iwamura - Image from the Good Death photography project
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The undertaker from the funeral home covers the body of Yasutaro Koyama, 89, at his farewell party on November 29th, 2019 at Aiwa Hospice in Nagano, Japan. Yasutaro hospitalized for cancer on November 27th, 2019 after receiving treatment from the hospice remotely at his house for a year.

© Yuki Iwamura - Image from the Good Death photography project
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The patient's baggage left on the chair in the empty room after his death on November 29th, 2019 at Aiwa Hospice in Nagano, Japan.

© Yuki Iwamura - Image from the Good Death photography project
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Aiwa Hospice in Nagano, Japan hosts around 400-450 cancer patients a year who left a last month of their lives. When their patients pass away, they host farewell party with the family at the church inside of the hospice. On August 13th, 2019 at Aiwa Hospice in Nagano, Japan.

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