The subjective perception of vulnerability differs from one society to another according to customs, values, and resource affluence. Tolerance for pain, poverty, and loneliness varies because of different cultural prescriptions, social definitions, and relative sense of deprivation. The degree to which this vulnerability is anticipated as an inevitable process of old age is fundamental to the way societies prepare for – and ultimately deliver – social support for the elderly. In Japan, this anticipation is far more prevalent than in the United States; the assumption that everybody will need help – the preparation for an eventuality rather than a possibility – creates a greater willingness on the part of givers to commit the time, energy, and resources necessary to help, as they themselves stand to benefit from this arrangement in their own later lives.

The perception of help also differs from one society to another according to access and desirability. Cultural assumptions and norms that shape social ties – transcending individual cases of need – produce smaller, focused support networks in Japan. The mutual helping arrangements forged by obligation and affinity are explicit in these small units and have important consequences for the security and independence of the elderly in Japan.

How an individual attains security and independence in old age, however, is not an abstract but a concrete issue that affects the quality of financial, physical, and emotional well-being.