This thesis examines twentieth-century residential care for the elderly in England and Japan, and particularly local authority provision in Norfolk and in Gifu Prefecture. It focuses upon actual developments, decentring conventional single guiding policy-led or ideological-based narratives in favour of multi-faceted compositions. It considers any improvements in relation to policy goals at different organisational levels: central government, local authorities and specific institutions. It also explores how perceptions and attitudes towards institutionalisation and old people’s homes, commonly carrying the legacy and stigma associated with the corresponding Poor Law workhouse and almshouse provision and the Obasuteyama legend in Japan, have changed over time.

A historical framework and tiered studies at national, regional and local levels in both countries are utilised, beginning with national surveys, encompassing central legislation, governmental policies and objectives, quantitative data and qualitative care concerns, and assessing national performance. Subsequent chapters investigate how respective national goals were assimilated by local authorities and then delivered by specific institutions, acknowledging important specific contexts. Case studies use official and other documentation, in considering the impact of central legislation and policy objectives, but reveal diversity and regionally-specific interpretations and practice; while institutional studies explore grassroots services and the life experiences of residents, enlivened by interview materials.

Key research findings are discussed briefly in a comparative and international context in the conclusion, addressing both common and particular experiences, obstacles and achievements. Hopefully this multi-layered approach adds a fresh perspective to some conventional understandings and widespread assumptions, helping to inform the discourse on forms of long-term care for the elderly, increasingly pertinent in ageing societies such as England and Japan.