Obasuteyama In Japan institutional care can be traced to the late sixth century, when the aged, destitute and frail, without a family to care for them, were placed in poorhouses along with the sick, disabled, vagrants and orphans.1 ese were charitable facilities provided by the emperor, monks and philanthropists, inspired by Buddhism or Confucianism.2 ere were, however, very few, and specialized institutions did not appear until the 1870s.3 e rst charitable small almshouse exclusively for older people opened in 1895, but there was no o cial involvement in indoor (institutional) relief before the 1929 Poor Law.