More families grapple with hardships of dementia
They were in their 70s, happily married for 50 years, when suddenly she had a stroke overnight and came down with vascular dementia.
She was hospitalized at a nursing home and cared for with affection by the nurses, Kim and their two children, but her memories slipped away fast.
Not only could she not recognize them, she turned into someone the family could not recognize as their once-caring and loving mother and wife. Whenever they visited, she would spit out expletives at them.
“She never used swear words before,” Kim had testified before the court in 2015. “It was like she had turned into a completely different person.”
Kim and the nurses tied her to the bed whenever they fed her, because she would start yelling and fighting back. But Kim would never leave her sight, changing her diapers and feeding her to keep her alive.
Vascular dementia leads to a decline in brain functions, due to blocked or reduced blood flow to the brain, which often results in memory losses and a declining ability to communicate, focus and reason. Alzheimer’s disease is another well-known type of dementia. Dementia patients also often suffer incontinence.
One day in 2015, as Kim lay sleepless on a guest bed at the nursing home, he decided to end his and his wife’s lives, for the sake of their children. They were paying 1.2 million won ($1,037) a month to keep their mother alive.
He brought his wife home and wrote a will to the children.
“We are only sorry that we don’t have money to leave behind for you,” he wrote.
He choked his wife to death in her sleep and drank a bottle of pesticide. But the next thing he knew, he was lying on a hospital bed. He was sentenced to three years in prison that year.
Kim’s case is not unique in Korea. The Ministry of Health and Welfare said in 2016 that there are 680,000 dementia patients over 65. With the quickly aging population here, the ministry projected there may be 840,000 dementia patients over 65 by 2020, 1 million by 2024 and 2 million in 2050.
Unfortunately, the number of dementia patients murdered by their spouses is also on the rise. In January, an 84-year-old man surnamed Ko, a dementia patient, murdered his wife, also suffering from dementia, in their home in Bupyeong District, Incheon, by hitting her with a heavy object. They were married for 60 years, with four sons and five daughters.
Ko’s wife had suffered brain damage and doctors diagnosed her with dementia four years ago. Ko took care of his wife at home, feeding her and changing her diapers. But a year ago, he showed symptoms of dementia, too, as he started having issues communicating his thoughts and experienced memory loss. A caregiver was hired during the day. Their children did not live with them.
“I cannot remember what happened that night,” Ko told authorities. He is currently undergoing psychiatric evaluation at a detention center.
A dementia patient in his 70s was murdered by his wife in Daegu last month, too.
Experts and the JoongAng Ilbo, an affiliate of the Korea JoongAng Daily, analyzed 18 such cases in the past six years. About 72 percent of the murders were committed by the husband. According to the Health Ministry, there were more female patients of dementia than male, with 71.3 percent of dementia patients here being women. In the cases, the spouses became caregivers for an average of 5.7 years.
“In analyzing their reasons for killing their spouses, it seems many did so because they felt they were a burden to their children,” said Han Il-woo, director of the neurology department at Hyoja Geriatric Hospital in Yongin, Gyeonggi. “It is imperative that society takes measures to respond and share the burden, instead of letting the spouses take care of their ill partners.”
An 80-year-old surnamed Kim, husband to a dementia patient, said he was attacked by his wife in their living room as he was exiting the kitchen, just having finished doing the dishes. He told authorities that they got into a scuffle and he strangled her to death without realizing what he was doing.
“I didn’t want to let the children know their mother was ill,” he told authorities. “Because then it’s just an extra burden for them.”
“When the husband or wife of a dementia patient becomes the main caregiver, and often the sole caregiver of the family because they don’t want to let their children know, they often suffer depression,” Han said. “This is why many caregivers end up killing their spouses and commiting suicide.”
“Families need to talk to each other and share their burdens,” said Jeong Jee-hyang, director of the neurology department at Ewha Womans University Medical Center in western Seoul. “If the father is taking care of a wife with dementia, the children must call their father every day and comfort him, or he may fall into depression.”
But in a family with a dementia patient, sharing the burden equally does not always work out well.
Two daughters are taking care of their mother, who came down with a stroke last year and vascular dementia, in Incheon. The mother lives with the younger daughter, 43, while the older daughter lives in vicinity and visits every day. They battle their mother every meal time, as she throws a tantrum whenever they try to feed her.
And oftentimes, the stress imposed on the relatives taking care of dementia patients at home leads to physical abuse of the patients. According to the Health Ministry, 72.2 percent of the 1,030 cases of abuse of dementia patients occurred at home, at the hands of family members.
“There are educational and training programs for relatives of high-blood pressure or diabetes patients,” Jeong said. “But there is not a single program to train the relatives of dementia patients at hospitals.”
She added, “The programs will help many who are deciding how to take care of their relatives with dementia, as they learn more about how the disease is likely to progress and the difficulties involved in caring for the patients.”
Experts suggested the government provide public nursing homes for dementia patients, similar to public child care centers.
“There needs to be a systemic expansion of nursing homes focused on giving care for dementia patients,” Han said. “We need to help both the patients and their families find a stable way to provide care for their suffering families.”
BY LEE DONG-HYUN, KIM HYUN-YE AND CHOI MO-RAN [firstname.lastname@example.org]