In the past decade, frailty research has focused on refinement of biomedical tools and operationalisations, potentially introducing a reductionist approach. This article suggests that a new horizon in frailty lies in a more holistic approach to health and illness in old age. This would build on approaches that view healthy ageing in terms of functionality, in the sense of intrinsic capacity in interplay with social environment, whilst also emphasising positive attributes. Within this framework, frailty is conceptualised as originating as much in the social as in the biological domain; as co-existing with positive attributes and resilience, and as situated on a continuum with health and illness. Relatedly, social science-based studies involving interviews with, and observations of, frail, older people indicate that the social and biographical context in which frailty arises might be more impactful on the subsequent frailty trajectory than the health crisis which precipitates it. For these reasons, the article suggests that interpretive methodologies, derived from the social sciences and humanities, will be of particular use to the geriatrician in understanding health, illness and frailty from the perspective of the older person. These may be included in a toolkit with the purpose of identifying how biological and social factors jointly underpin the fluctuations of frailty and in designing interventions accordingly. Such an approach will bring clinical approaches closer to the views and experiences of older people who live with frailty, as well as to the holistic traditions of geriatric medicine itself.

Demographic and policy changes in Japan during the first decades of the twenty‐first century have resulted in significantly more people growing older and dying alone, especially in densely populated urban centers. As the national Long‐Term Care Insurance system continues to promote community‐based elder care despite weakened family and neighborhood bonds, the home has become an intensified space of care as well as a potential zone of abandonment. This article considers these divergent potentials of home and their implications for thinking about the material, ethical, and aesthetic limits of dwelling as embodied in the specter and spectacle of the lonely death (kodokushi). Such deaths and the empty houses they leave behind index other forms of loss emerging from intertwined histories of the family, welfare, and housing and construction policy. I argue that the connection between local experiences of aging and death and national policies can be found in mediating images and narratives of mourning, which seek to locate and make sense of the inability to dwell. Approaching unwitnessed deaths as specters at the limits of dwelling allows us to move beyond the shock of lonely death and draws our attention instead to the links between caring, mourning, and the home in an aged society.

Caring for an elderly person often requires constant attention, physically challenging tasks, and emotional strain, all of which accumulate over periods and manifest as fatigue. Despite the prevalence of descriptions of fatigue in carer narratives, and the massive clinical literature on 'carer burden' and 'exhaustion,' the significance of fatigue as a component of care rather than a mere by-product has not been fully explored. Drawing on Levinas' phenomenological theory of fatigue I argue that experiences of fatigue shape carer subjectivities as both vulnerable and enduring, qualities that are essential for inaugurating new ways of being toward and taking ethical responsibility for the cared-for. At the same time, fatigue can become tragic if not supported by social and cultural narratives that recognize it and give it value.

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In Japan, today, longevity has not meant a reduction in years of dependence. As a result, anticipation of a long life also brings the troubling anticipation of problems like chronic illness and loneliness. How do older adults facing such a future create hope? The purpose of this paper is threefold: (i) to propose a conceptualization of hope as "lunar aesthetics," that is, not as anticipation of achievement but as a process of loss and renewal; (ii) to link this process to aesthetic forms and ritual practices from my fieldwork with older adults in Kyoto; and (iii) to critically evaluate the ways current formal longterm care diverges from "lunar" hope. Drawing on Japanese associations between the moon, hope, and rituals memorializing the spirits of the dead, this paper argues that older adults engage with an alternative interpretation of hope based on transience and transcendence. Both of these offer hope to older adults by reorienting the temporal boundaries of personhood, to experience change (including decline and death) as an inherent aspect of becoming part of a larger narrative of linked generations or the natural state of life.