Care Managers Average 55.1 Years, the Oldest of Any Role in Japanese Care — Exam Candidates Fell From 131,560 to 49,332 and Have Not Returned in Seven Years

Becoming a care manager in Japan means passing the practical training entrance examination. Line up the candidate numbers by year and there is a step in the middle.

Fiscal 2017, the 20th sitting: 131,560[1]. The following year, fiscal 2018, the 21st sitting: 49,332[2]. A fall of 62.5% in a single year.

The fall itself was to be expected once the requirements changed. What draws the eye is what came after. Recently: 56,494 in fiscal 2023, 53,699 in fiscal 2024 and 50,601 in fiscal 2025[3]. Seven years on the figure has not returned to six digits, and it has now fallen three sittings running.

Meanwhile the age of those in post is rising. According to the fiscal 2025 survey by the Care Work Foundation, care managers average 55.1 years[4], the highest of any role in the sector. The average across all respondents was 49.5, and the lowest, covering physiotherapists, occupational therapists and speech therapists, was 39.1. Within one industry, a gap of 16 years.

What changed in fiscal 2018?

The entry requirements. Until then, a person without a national qualification could sit the examination after a set period working in care. The ministry's tables for each sitting still carry a note to the effect that the figures for those in consultation and support roles include, up to the 20th sitting, people who qualified through care work. From the 21st, that route was gone.

The basis was a notice dated 12 February 2015. The amendment was settled then, and a transitional arrangement allowed the old requirements to apply through the 20th sitting. The step appears in fiscal 2018 because that arrangement expired.

The intent is legible. A role that writes care plans was asked for expertise in consultation and support. The pass rate at the 21st sitting immediately fell to 10.1%, with 4,990 passing against 28,233 the year before, a drop of more than 80%.

Pass rates have swung widely since. Fiscal 2024 ran 32.1% with 17,228 passing; fiscal 2025 ran 25.6% with 12,961[3]. Fewer candidates with a higher pass rate still yields more entrants, and the reverse holds too. The adjustment of numbers happens at the examination rather than at the requirements.

Narrowing the entrance to a qualification always carries a paired question: where does the shortfall get made up?

In this role, it has not been made up. Candidates have not recovered in seven years and have fallen three sittings running. Those in post average 55.1 years, the highest in the sector. The 16-year gap against therapists is not simply a matter of having many experienced people. The length of the period during which fewer people entered is showing up directly in the age distribution.

Age also means accumulated experience. The problem is that this accumulation leaves at once, on retirement. An average of 55.1 means a substantial share enters the retirement band within a decade. Whether a comparable cohort exists below to replace it is the question, and current candidate numbers do not supply one.

The requirement change carries a further property. Limiting eligibility to holders of national qualifications and people with consultation experience means the pool is drawn only from those who have already passed through another qualification system. That works while those systems have people to spare. Care workers, social workers and nurses do not. A narrow upstream cannot produce a wide downstream.

There is a further constraint on the fee side. In-home care support caps the number of cases a single care manager may handle. If headcount does not grow, neither does the total number of people who can be supported. Providers themselves are thinning, as 91 home-visit care failures against 45 in day services（このサイトの記事） described. Both the people who write the plans and the people who make the visits are getting scarcer.

Designing for the quality of a qualification and designing for the number of people needed are separate tasks. Move the first and leave the second, and the landing point is not enough high-quality people. The structure in which a system exists but does not reach people was examined in policy exclusion and non-take-up（このサイトの記事）; here, the people who would do the reaching are the ones missing.

Further Reading

• 『介護格差』 (Care Inequality)（外部サイト、新しいタブで開きます） (Yasuhiro Yuki, Iwanami Shoten). An account, drawn from practice, of what separates those who can obtain care services from those who cannot. Useful for tracing how a shrinking workforce lands on the people being served.

References

Results of the 28th Care Manager Practical Training Entrance Examination — Ministry of Health, Labour and Welfare (2026). Ministry of Health, Labour and Welfare

Results of the 21st Care Manager Practical Training Entrance Examination — Ministry of Health, Labour and Welfare (2018). Ministry of Health, Labour and Welfare

Results of the 20th Care Manager Practical Training Entrance Examination — Ministry of Health, Labour and Welfare (2017). Ministry of Health, Labour and Welfare

Fiscal 2025 Survey on Care Labour: Worker Survey, Results Report — Care Work Foundation (2026). Care Work Foundation

Results of the Care Manager Practical Training Entrance Examination — Ministry of Health, Labour and Welfare (2026). Ministry of Health, Labour and Welfare