You could have called the building in the Tokyo suburbs a birdcage. Whenever a man with dementia tried to leave his rental flat, empty cans and wind chimes strung from the doorknob would rattle an echoing warning down the hall. The man's tired-looking helper would then appear to block his way and stop him from wandering onto the streets.
The nursing company charged with the man's care gathered elderly people with dementia in the same buildings, drawing its fees from the clients' public assistance and nursing care support payments. In order to turn a profit, the firm did not spend much money on the helpers charged with the residents' care. The residents had no nearby relatives they could lean on, and their savings were meager, meaning there was no way they could afford a place in a proper nursing home. It is in sad conditions like these that elder care services that can only be described as inferior thrive.
Even when a dementia patient lives with family, should he or she be effectively imprisoned in his or her room? In 2007, a 91-year-old man with dementia was hit and killed by a train in Obu, Aichi Prefecture. He apparently left his house in a short interlude when his family wasn't watching over him. Both the local district and high court then ordered the man's family to pay the train's operator, Central Japan Railway Co., compensation for the service delay caused by the accident. On March 1, observers will be keeping a close eye on the Supreme Court as it decides whether to uphold these decisions.
Meanwhile, there are also sad cases of family members, driven to exhaustion by the requirements of 24-hour care, murdering their charges. In November last year, a 47-year-old woman in Fukaya, Saitama Prefecture, was arrested on suspicion of killing her 81-year-old mother.
The suspect's mother had dementia, and she had been caring for her for about 10 years. Her 74-year-old father and the family breadwinner became unable to work due to ill health. The father proposed a family suicide to his daughter. So she loaded her parents into a car and drove into the Tone River. The daughter was known in her neighborhood for her commitment to family, and one has to wonder what she was thinking as she turned the steering wheel for the final plunge into the water -- one that she would survive but her parents would not.
Of course, courts will hand down their decisions based on the law. But that we should look at this case and at the death of the Obu man at the same time tells us something about the unchanging state of social welfare in Japan. ("Yoroku," a front-page column in the Mainichi Shimbun)