When Takuya Shiota's cleaning agency was called to a small Tokyo apartment, its elderly resident had been lying dead on the floor for more than three weeks.
The occupant, aged in her 70s, was only discovered when her landlord tried to claim unpaid rent.
She had no family and no friends checking on her.
She lived, and died, in solitude.
With Tokyo's humid summer in full force, the scene was so ghastly, Mr Shiota had to cut out the floorboards where the woman was found.
"The smell in the room was so strong," he recalls.
"We treated the fluid and then cut out the floor and disinfected it."
The work of Mr Shiota and his colleague Kyohei Kudo is unpleasant, but vital.
Japan has long grappled with what's known as "solitary deaths", where people living without a support network die and remain undiscovered for prolonged periods.
In one infamous case, more than two decades ago, an elderly man was discovered three years after death.
His rent and utilities were automatically deducted from his bank account, and when it was finally depleted, authorities came to investigate.
This year, the Japanese government revealed its first official tally of solitary deaths.
In the first three months, almost 22,000 people died alone and were undiscovered for a prolonged period.
Most are elderly.
This means about 88,000 people are expected to die solitary deaths in Japan this year.
It's a crisis that is only going to worsen — Japan has the world's oldest society, with more than one in 10 people older than 80.
But it's not just an aging-population problem.
For many, Japan's solitary deaths reflect a society that has lost a sense of community; neighbours no longer look out for one another, while many residents choose to isolate themselves.
"The number of requests is increasing considerably," Mr Shiota said.
"We do roughly more than 100 cases a year, especially in the summer. It's the busy season."
Aging residents in dwindling boom town
In Yokohama, a city only a short train ride from Tokyo, is the district of Kotobuki.
It's a densely packed suburb where misfits came from all over Japan to escape their old life and find work in the big city.
Many apartments are tiny – often smaller than five square metres — with shared facilities like kitchens and bathrooms.
During Japan's boom years of the 1980s, it was a thriving, bustling place.
Now, the residents are mostly elderly and often with a litany of health problems, including alcoholism and poor mental health.
It was here that Osamu Yamanaka pioneered at-home, scheduled health checks.
"There were people who had been found dead in their room, even skeletal," he said.
"I was young, and I thought it was unforgivable."
Every week, Dr Yamanaka visits his lonely patients to conduct a series of tests.
Some are in the final phases of life.
Dr Yamanaka discusses their treatment options, but many refuse medical intervention.
They've given up. And Dr Yamanaka respects their decision. But he'll keep checking on them.
"If I wasn't doing it, there would be an awful lot of lonely deaths," he says.
These visits are about providing important human contact.
"I'm such a low-class person," patient Yasuo Inayama, 74, says.
"There aren't many people who are willing to deal with people from the lowest strata of society. But he is willing to come to me. I appreciate it."
Across Japan, elderly residents suffering health problems may be eligible for varying levels of at-home care.
It's a service that is now much more accessible compared with when Dr Yamanaka started.
Dr Yamanaka says the workload is manageable and he doesn't worry about Japan's aging population woes.
But he says there is only so much the medical profession can do to tackle the solitary deaths dilemma.
Sometimes people don't know how to reach out for help.
Others have chosen to cut themselves off from family and society more broadly.
Not all solitary deaths are elderly people.
In these cases, it's up to the community to try to provide support.
"If they do not socialise with their neighbours, they will end up with solitary death," Dr Yamanaka says.
"It is very difficult to prevent it."
Building community to prevent solitary deaths
It's a challenge Yoshiko Sato, 81, has accepted.
Her huge apartment complex was once filled with families.
But now, it's home to almost 400 elderly residents who live alone.
Just over two decades ago, she established the Zero Lonely Deaths community campaign, after a spate of solitary deaths, which included a dear friend of hers.
"Every year, four of five people were dying alone," she said.
"People around me started to ask why such a good friend of ours was dying so lonely and alone."
A group of volunteers started to conduct routine checks on the neighbourhood's elderly residents.
The group also linked up with agencies to be alerted to suspicious activity.
For example, the power company calls them if there is a sudden and prolonged drop in power usage at a registered apartment.
"After five years, we were able to say that there were no more lonely deaths," Ms Sato said.
The program has evolved into much more than simply preventing solitary deaths.
It's also saving lives and restoring a sense of community.
In one case, a sleeping man was saved after an incense candle fell over and ignited a pillow.
In another, an elderly diabetic man was found immobile and rushed to hospital.
"In our complex, everyone is coming together," elderly resident Shigeko Maeda explains, proudly.
For one of her regular visits, Ms Sato brings fresh vegetables, and in return gets a freshly cooked lunch.
"I look forward to cooking with the vegetables I receive from her," elderly resident Akiko Yoshida says.
"That's what makes my life worth living."
Money needed to keep initiatives going
While Yoshiko Sato's program has been a success, she worries for the future.
Community initiatives like hers are dissolving, despite their importance.
"A community has to be built up by everyone, but that is not possible in Japan at the moment," she says.
"People are becoming selfish, saying that they don't have to join a residents' association, or that they don't need to have a residents' association."
It's a concern cleaner Takuya Shiota shares.
Both are calling on the government to provide financial support to community groups.
"There is a lack of interaction in Japan between people and local communities, it is very common," Mr Shiota says.
"There is data that loneliness is the biggest factor in shortening life expectancy.
"Japan is a society of depression."
