Some Japanese words resist translation.
Take rōrō kaigo (老老介護). The character rō means “elderly”, and repeating it describes an elderly person caring for another elderly person, such as an 80-year-old husband looking after his equally frail wife on his own. That is the reality the word captures.
Then there is the darker ninnin kaigo (認認介護). Here, the repeated character refers to dementia (ninchi-shō in Japanese). The phrase describes a person with dementia caring for a spouse who also has dementia.
That these situations are common enough to have earned vernacular shorthand says a great deal about what Japan is up against. The elderly population keeps growing, but the supply of caregivers does not.
Also Read: iWOW’s US$11M placement tests investor appetite for Singapore’s ageing economy
Japanese media call it the “2025 Problem”: the year the postwar baby-boomer generation crossed the age of 75. Since then, the labour shortage has stopped being a headache for individual care homes and has become a looming crisis for the country’s social infrastructure.
For decades, caregiving has run on human hands, experience and compassion. The assumptions behind that model are now cracking. Technology is moving in to fill the gap, with physical AI and next-generation communications at the centre. As AI moves off the screen and starts interacting with real bodies in real rooms, the nature of care itself is set to change.
Why physical AI, and why Japan?
At first glance, “Japan” and “AI leader” don’t sit comfortably in the same sentence. The country is regularly ranked among the slowest AI adopters in the developed world. In generative AI use and software-led development, it is usually described as having missed the digital transformation wave.
So how could it lead in physical AI? Part of the answer is robotics. Japanese companies account for roughly 70 per cent of the global industrial robotics market. Giants such as FANUC, Yaskawa Electric and Kawasaki Heavy Industries have spent decades building the physical backbone of manufacturing worldwide.
Japan may have lagged in software, but it remains one of the world’s deepest pools of expertise in machines that work in the physical world. Physical AI plays directly to that strength.
The other part of the answer is urgency. The labour shortage is nearing the point where recruitment drives and pay rises alone can’t fix it. Across government, industry and the startup ecosystem, there is growing acceptance that caregiving as a social service may become unsustainable without technological help.
Also Read: Singapore’s robotics dominance is a warning sign dressed up as good news
That changes the usual debate. The argument here is not that physical AI will replace workers. It is that physical AI can fill roles that there simply aren’t enough people willing or able to do. Caregiving could become the first arena where Japan stages a meaningful comeback, through physical rather than purely digital innovation.
Why caregiving became so hard
The shortage is not simply a matter of the profession being unpopular. It is structural and long-running. Heavy physical demands, relatively low wages and high turnover feed a vicious cycle. The caregiving workforce is itself ageing, and too few young people are joining it.
Demand, meanwhile, keeps climbing. Both home-based and institutional care are expanding, and the need for dementia support, night-time monitoring and specialised assistance is becoming more complex.
Japan’s Ministry of Health, Labour and Welfare estimates that the country could be short of approximately 690,000 caregivers by the 2040s.
Physical AI moves into care facilities
Until recently, AI in caregiving was mostly about handling information, such as documentation support and analytics on monitoring-camera footage. Now robotic arms, autonomous mobility and remote operation are converging to push AI into the physical side of the job.
Patient transfers, mobility assistance, night patrols, dish collection, laundry and restocking supplies are all becoming tasks that AI-powered robots can perform.
What care robots actually need to do
Care robots need capabilities fundamentally different from those of their factory-floor cousins.
Every care recipient differs in physical condition, cognitive state and daily habits. Some use canes, while others rely on wheelchairs. Even a task as simple as delivering a meal tray changes with the circumstances.
So caregiving-focused physical AI has to do three things:
- adapt to constantly changing environments
- interact safely with the human body, using precise force control
- run reliably on its own for long periods, including overnight
The challenge is less about automation and more about building intelligence that can work alongside people.
The network behind the robot
Physical AI does not work in isolation. Care robots, monitoring sensors, staff smartphones and remote management systems all have to stay connected in real time for the system to function. Low-latency networks, private 5G, edge AI and IoT sensors form the foundation that keeps care robots running in real-world environments.
The same is true in logistics and supply chains. The robot gets the attention, but the communications and data infrastructure behind the scenes decides whether the system succeeds.
The Japanese companies to watch
Enactic
Tokyo-based startup Enactic builds physical AI solutions for caregiving environments.
Its humanoid care assistant robot, Ena, does not perform direct physical caregiving. Instead, it handles the peripheral chores that caregivers usually juggle on top of their main duties, including laundry, dish collection and restocking supplies. The aim is to free staff for human-centred work: personal care, emotional support and meaningful time with residents.
As of April 2026, Enactic had signed MOUs with more than 80 caregiving organisations across Japan. It planned to begin pilot testing in care facilities in the summer of 2026. The company has also been recognised through its participation in Amazon’s advanced AI development programmes.
CYBERDYNE
CYBERDYNE was founded in Tsukuba, Ibaraki Prefecture, and has offices in Tokyo. It is best known for HAL (Hybrid Assistive Limb), a wearable robotic exoskeleton.
HAL reads bioelectrical signals from the user’s nervous system and provides muscular assistance in response. It is used for gait rehabilitation and patient-transfer support.
What sets HAL apart is that it responds to the user’s intention to move, rather than simply applying mechanical force. That makes it useful as a rehabilitation tool as well as an assistive device.
In care homes and hospitals, transfer-assistance technology is also expected to reduce the physical strain on caregivers, particularly lower-back injuries. Some rehabilitation hospitals and care facilities have already adopted HAL, making it one of the earliest examples of physical AI in healthcare and eldercare.
ugo
Tokyo-based ugo develops and deploys a series of robots, also called ugo, that combine autonomous navigation with remote operation.
The company’s core idea is a hybrid approach. Instead of pursuing full automation, ugo designs its systems around flexible collaboration between humans and machines. Its robots patrol predefined routes on their own, and human operators step in remotely when a detailed task or an unusual situation needs attention.
In care facilities, that means night patrols and monitoring. The platform also connects to sensors and cameras for data collection and analysis.
Through its Robot-as-a-Service (RaaS) platform, ugo lets operators manage multiple robots across multiple sites from one place, which makes adoption easier. The company has also worked with major organisations such as Tokyo Gas and leading security firms, extending its technology beyond caregiving into broader social infrastructure.
Also Read: Why patient intake is becoming healthcare’s most important AI use case
Care is becoming an infrastructure business
Caregiving has long been a labour-intensive industry. The amount of care available was set by the number of people available to provide it.
In the future, it may look more like an infrastructure industry, powered by robotics, AI, communications networks and edge computing. Connectivity systems, robot-management platforms and shared data networks could become the invisible backbone of care delivery.
The real value won’t lie in the robots themselves. It will lie in the data generated on the ground and the intelligence built from it. Can the knowledge of experienced caregivers, including their instincts, their individual approaches and their hard-won best practices, be captured, learned from and passed on? That question may decide who leads this industry.
Two questions sit at the centre of it all. Can we protect the dignity of older adults even when there aren’t enough people to care for them? And can caregivers do meaningful work without burning out?
Physical AI is beginning to offer answers to both. Autonomous mobility, remote operation, edge AI and private 5G, combined and deployed in real care environments, are laying the foundation for a new kind of caregiving infrastructure.
—
This article was originally published by Black Box, a global media outlet that reports on the Japanese startup scene.
The post When the carer has dementia too: Japan turns to physical AI to rescue eldercare appeared first on e27.