I had already lived in Japan for six years before I ever set foot in a care facility. I thought that experience would make the transition easy. I was wrong. Nothing — not the language classes, not the years of working in Japan, not the research I had done — could have prepared me for what that first year of caregiving actually felt like.
Before I became a caregiver, I was a student in Japan.
My first job here was at Sagawa — the delivery company. It was 2018, I had just arrived, and my Japanese was basic at best. I remember the physical exhaustion of those early shifts, the way my body ached from work I had never done before, and the strange pride I felt receiving my first paycheck in a foreign country. That was the moment I truly understood what it meant to earn money yourself. Back home, I had relied on my parents. Here, every yen in my hand was mine — and I felt it.
Those student years taught me a lot about Japan. The rhythm of the country, the unspoken rules, the way people behave in the workplace. By the time I transitioned into caregiving, I had been in Japan for six years. I thought I was ready.
I was not ready.
The language barrier hit harder than I expected
I had reached a comfortable level of Japanese by the time I entered caregiving. I could hold conversations, understand daily life, navigate the city. What I did not know was that caregiving has its own language entirely.
The vocabulary used inside a care facility is different from anything used in everyday life. Medical terms, facility-specific phrases, kanji combinations I had never seen before. If you want to understand just how different caregiving Japanese is, I wrote about it in detail in Japanese vocabulary for caregiving in Japan — it goes deeper into the specific words and kanji you need to know before you start.
Every morning before work, we hold a meeting. The staff gathers, and we discuss each patient — their condition, their needs, what to watch for that day. In my first weeks, I sat in those meetings and understood maybe half of what was being said. I would nod, take notes, and then quietly piece together the rest on my own. It was frustrating in a way that is hard to describe. I knew I was capable. I just did not yet have the tools.
Now I understand everything. I can speak confidently in those meetings, contribute, ask the right questions. But that first year — I was always slightly behind, always catching up.
I did not expect it to be this physical
Before I entered caregiving, I had an image in my mind of what the job would look like. I imagined sitting beside patients, helping with small tasks, managing schedules. I thought it would be mostly mental work, with some light assistance.
That image lasted about three days.
Caregiving is one of the most physically demanding jobs I have ever done. You use your back constantly — lifting, supporting, repositioning. You use your hands, your legs, your entire body through every shift. The physical stress accumulates in a way that does not go away between shifts. It builds. I covered this honestly in my post on the physical demands of caregiving in Japan — if you are considering this career, that post is worth reading before you decide.
In my first year, I injured my back. I injured my hand. Both of those injuries have not fully healed — even now. I carry them with me every shift, every day. That is the reality of caregiving that nobody writes about clearly enough. The physical cost is real and it is permanent if you are not careful.
For relatively modest pay, your body takes significant damage. That is the honest truth, and anyone considering this career deserves to know it before they start.
The emotional pressure is a different kind of difficult
The physical exhaustion I could push through. The emotional pressure was harder.
Caregiving requires you to think clearly while your body is tired. You must follow precise schedules, complete every task on time, and never let fatigue compromise your focus. In my first months, I sometimes panicked. Not visibly — I kept it together on the surface — but internally I was running calculations constantly: what comes next, what did I forget, am I keeping up?
The hardest part is controlling your emotions when patients become difficult. Some patients say cruel things. They insult you. They push you away. And you cannot respond harshly. Speaking harshly to a patient, or acting with any aggression, is treated as a severe offense in Japanese caregiving. It can end your career. It can bring consequences for the entire facility. In serious cases, it can lead to legal action.
So you learn to absorb. To breathe. To respond with patience you may not feel in that moment. I wrote about this kind of pressure in caregiver burnout in Japan — because if you do not learn to manage it early, it will catch up with you.
Loneliness — and how I managed it
People often ask if I feel lonely living abroad. The honest answer is: sometimes, yes.
But I grew up away from home from a young age, so I had already built some resistance to it. When loneliness comes now, I know how to meet it. I walk in the park, in quiet places, with my thoughts. I replay good memories. I make a cup of tea, find something I enjoy watching, and let the feeling pass without fighting it too hard.
What I would caution against is the pattern I fell into in my earlier years — telling myself that working hard and sending money home was the same as staying connected to family. It is not.
There were years when I contacted my family once or twice a month. Eight years passed before I returned home. I convinced myself that money was the priority, that providing was the same as being present. It took time to understand how wrong that thinking was.
Your family does not only need your financial support. They need you. And while money is necessary — especially when you are building a future from scratch in a foreign country — it must never become the thing that replaces everything else.
The mistake I would undo
If I could go back to my first year of caregiving and change one thing, it would be how seriously I took kanji.
I thought I knew enough. I was wrong. The gap between general Japanese and caregiving Japanese is wide, and I underestimated it completely. I spent the first year playing catch-up when I could have prepared better before I even started.
My advice: if you are planning to enter caregiving in Japan, start studying caregiving vocabulary before your first shift. Learn the kanji used in care settings. Familiarise yourself with the kinds of patient names you will encounter. That preparation will not make the job easy — nothing does — but it will give you a head start that matters more than you can imagine.
What kept me going
When the first year became truly difficult — when the physical pain and the mental exhaustion and the language frustration all arrived at once — I thought of my family.
I work hard because I want to build something for them. Not just for who they are now, but for who they might need to be in the future. Life cannot be predicted. There are no guarantees. So while I am able, while I am here, while I am strong — I work.
But I have also learned that life is not only work. Life is like water. You have to learn how to shape it properly. The person who spends every year chasing money and forgets to live, forgets to call, forgets to visit — that person may arrive at the end with full savings and empty hands.
Be present. Be happy. Stay safe.
Wondering what the very first months of living in Japan look like? Read My First Year in Japan as a Foreigner — What I Learned.
Thinking about the physical side of this job? Read The Physical Demands of Caregiving in Japan — What Nobody Warns You About.
Still deciding if this career is right for you? Read Is Caregiving in Japan Worth It? My Honest Answer After 8 Years.
For more on how Japan’s care sector works from the outside: Foreign Elderly Care Workers in Japan — Unseen Japan
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