In Korea’s rest homes, the care can be deadly

In late March this year, an elderly woman was found dead on a mountain in South Jeolla province. A police investigation found that the woman was an 81-year-old identified as a Ms. Choi, who was living in an elderly care facility about 3 kilometers (nearly 2 miles) from where her body was found. She had suffered from Alzheimer’s disease, but was physically fit. The officer in charge of the case said no one saw her leave the care facility, and no one expected her to die so far from where she lived.
“Our facility is suited for elderly people who are relatively healthy, and it’s difficult for us to care for Alzheimer’s patients like Ms. Choi,” an official at the care facility said. “She should have been relocated to a professional facility.”
Such is the reality of elderly care facilities in Korea ― deaths due to neglectful management, inappropriate treatment, and in some cases, serious infringements of the residents’ human rights.
The Korean government recently announced that in order to meet the demands of an aging society, it would pursue an elderly care guarantee system for all senior citizens by 2011.
In order to do so, the government pledged to add every year 100 new facilities for the elderly. Yet the 358 elderly care facilities currently in operation are far from being properly run.
The death certificate of an 81-year-old woman, identified as Ms. Chang, stated that she died last November due to suffocation caused by an inappropriate ingestion of food. But Ms. Chang’s daughter did not know the exact reason for her mother’s death, because the care facility officials where her mother was residing would not tell her.
“I thought my mother died a natural death, because the caregivers told me that she was at death’s door for several days before she passed away,” she said.
Ms. Chang had died after trying to eat a piece of custard bread, which blocked her airway and caused her to suffocate.
The staff, however, could do nothing. “Because one employee is in charge of five to six patients, we sometimes don’t have the capacity to take care of all of them at once,” one caregiver said.
The hospital that undertook the autopsy also stated that Ms. Chang died from natural causes, but since the death was caused by suffocation due to food intake, the cause should have been classified as accidental.
In analyzing the deaths of 3,290 persons who lived in elderly care facilities around the country over the past 10 years, about 45 percent, or 1,466 persons, were stated as having died of infirmity, Alzheimer’s disease or heart failure. Yet these factors are not cited as causes of death in the National Statistical Office or in international disease categories.
There have been many cases in which elderly residents of care facilities died in safety-related accidents or committed suicide, but no autopsy was undertaken. Some cases found evidence of malnutrition or dehydration from neglect, but the deaths were treated as ordinary.
An in-depth analysis by the JoongAng Ilbo of the causes of death showed that at least three persons died of malnutrition and 20 died of gastritis, or digestive diseases.
“The process by which care facilities determine the cause of death is so ineptly dealt with and is such a mess, it shows that the government’s elderly policy is full of holes,” said Professor Choi Joong-myung of Kyung Hee University medical school.
In July 2002, a 78-year-old man identified as Mr. Lee stepped outside of his elderly care facility to smoke a cigarette when he was run over and killed. The driver fled the scene. When staff members at the care facility found Mr. Lee, he was already dead.
“The elderly want to take a stroll around town from time to time, but that puts them at risk of car accidents,” one care facility official said. “There are just not enough people to look after each and every one of the residents.”
One elderly woman residing in a care facility in Gyeonggi Province died at the age of 90, five years ago, when she slipped and fell, hurting her back.
Professor Lim Chun-sik of Hallim University said the number of elderly people that one employee of a public care facility must tend to is five times what it is in the United States.
In the United States, if an elderly resident dies of malnutrition or dehydration, or develops bed sores, the authorities look into the matter to ascertain whether the death was caused by neglect on the part of the employees.
Any employee who does not feed an elderly resident or who contributes to their death by other means can be charged with criminal neglect, a serious crime.
The Ministry of Health and Welfare or local and provincial governments do not even compile basic statistics about the nation’s care facilities, such as the number of deaths of elderly residents.
“We will prepare related regulations after researching the conditions at the care facilities,” said Kim Won-jong, director of the ministry’s elderly care team.
A fact-finding team from the National Human Rights Commission recently visited an elderly facility in Incheon and was shocked to discover the remains of 221 residents stacked and neglected in a cupboard behind the funeral hall. The corpses were those who had died over the past 15 years and who had no family members to provide a funeral.
An officer of the commission said it was shocking to find that the care facility had taken such little care for the management of remains, but the facility managers responded by saying that while it was a mistake not to have cared for the remains, “We didn’t bury the bodies in case the relatives showed up.”
Yet the process for what should be the most formal of rituals remains slapdash, with no rules and nobody to care. There are no specific regulations on how to treat the remains of elderly people who die at care facilities but who have no known relatives. Most care facilities run by local governments place the dead in public vaults or cremate them, and later bury them in the mountains.

by Special Reporting Team