The rapidly-growing home care co-operative Kōreikyō combines features of consumer and worker co-operatives of, by and for over 30,000 seniors throughout Japan. In the Kōreikyō model, the active elderly provide home care services to the frail elderly. Caregivers and care-receivers are alike members. The task of personal care of the elderly in Japan is traditionally assigned to daughters-in-law typically aged 35 to 55. While still almost entirely female, Kōreikyō home care workers are older (55 and over). The features of Kōreikyō that make it a co-operative – democratic control of work conditions, opportunity for personal initiative, participation in organisation policy making – make it especially attractive to such women. The complexity of Kōreikyō’s organisation goes well beyond the market model of a simple instrumental nexus in which an activity once embedded in family practice becomes commodified and then professionalised. That Kōreikyō practices do present a significant shift from traditional, market and even other co-operative solutions to home helper services does not seem a drawback to members either as caregivers or care recipients. Kōreikyō home helper services grew rapidly during the period of greatest opportunity for home helpers, the three years following the inauguration of Japan’s Long Term Care Insurance programme (kaigo hoken) in 2000.