Exhausted from caring for his ailing wife, a 73-year-old man hanged himself at his home near Tokyo last week in a tragedy that has become almost commonplace in the world's most "elderly" country. The man's 72-year-old wife, afflicted with Parkinson's disease, was found still alive with a plastic bag over her head.
Japan has the world's highest number of elderly people as a proportion of total population. About 21 percent of its 127 million population is aged over 65.
Recognising the changing needs of its people, Japan has introduced nursing services for the elderly funded by a levy on the over-40s. The measure has won praise.
But experts say the government needs to do more, including assisting families of the elderly overcome the exhaustion, frustration and isolation of caring for their loved ones, which can lead to depression and occasionally murder or suicide.
There are no official figures on the number of these incidents although police records show that 10,894 people over the age of 60 committed suicide last year. The most common reason was believed to be poor health.
A government study published this year found 30 percent of carers over the age of 65 had thought of committing suicide. Despair can also strike younger people.
A Kyoto court room was reduced to tears in April when 54-year-old Yasuharu Katagiri spoke of his deep affection for his 86-year-old mother, whom he admitted strangling with a towel before he attempted suicide.
"If I am born again, I want to be born to the same mother," he told the court on the first day of his trial, where evidence detailed his struggle to earn a living while caring for his wheelchair-bound mother, who suffered from senile dementia.
When he realised he could not pay the next month's rent on his apartment, Katagiri, brought up to hide his problems from others, decided he and his mother had no choice but to die.
He received a suspended jail sentence in July. More than 2.7 million Japanese require elderly care services in their homes. That figure is set to rise as the population ages over the next few years because of low birth rates and one of the highest life expectancies in the world.
On average, Japanese women live until the age of 85 and Japanese men live until the age of 78. That's about four to five years more than contemporaries in the United States.
As the population ages, the social problems related to an aging society are expected to grow, including murders and suicides, unless the government steps in to better address the problem, the most pressing of which is depression, experts say.
Voluntary worker Fumiko Makino believes Japan's education and culture are partly to blame for the difficulties faced by the families of the elderly and infirm.
For Japanese women, marriage traditionally meant becoming the servant of their husband's family. Care of their elderly relatives-in-law was seen as part of their housework duties.
Putting an elderly person in a home is often frowned upon as a form of abandonment, while the custom of the eldest son inheriting all the family property means the burden of nursing care often falls exclusively on his wife.
"The government is doing nothing for the carers," said Professor Takashi Hosaka of Tokai University. He has spearheaded projects such as training care-givers to identify depression and group counselling sessions for carers, which has been clinically proven to reduce their stress levels.
Some care-givers take advantage of local services and voluntary networks to make life easier. Hiromichi Takeuchi, a 62-year-old retired marketing planner lives in a quiet residential area of Tokyo with his 93-year-old mother, Iyo, a cheerful, neatly turned-out woman who has Alzheimer's disease and is unable to walk.
Hiromichi has faced problems - Iyo recently fell from her wheelchair and broke her arm while he was on the telephone. But by combining daycare services, a home helper and joining a local carers' group, he has arranged his mother's timetable so that he only needs to care for her alone one day a week. "It's important to give yourself a bit of leeway. It's the people who try too hard who trip up," he said.
Avoiding isolation is crucial, experts agree. Makino became aware of the loneliness suffered by those caring for the elderly when she was assisting the victims of the 1995 earthquake in the western city of Kobe.
"When we visited the homes of people caring for the elderly, it was as if they could finally let out all the worries that had been building up inside them," Makino said. "It's as if they live in a sealed capsule. They don't have the opportunity to talk to anyone outside, which leads to all sorts of problems," Makino explained. "That's when frightening things can happen," she added.
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