The recent killing by an 84-year-old man of his wife after more than 50 years of marriage has shaken Taiwan. I think the key to understanding why the elderly Mr Wang (王) did what he did are the fact that he had played the role of family caregiver for more than a decade, and to understand the treatment of such family caregivers under existing policies.
The daily lives of family caregiver’s involve attending to the needs of family members, often to the extent that they gradually forget about themselves. Many can recite a list of their loved one’s favorite foods, but have no answer when asked what they like themselves. Even when they fall ill, they might do nothing about it.
In Mr Wang’s eyes, he was the only person available to care for his wife and she was entirely dependent on him. This attitude is quite common among people who care for others in their own homes.
Unfortunately, the state has not responded to this reality by taking a more proactive approach to family caregivers in its long-term care policies.
Family caregivers are often taken for granted as a resource when long-term care needs are being assessed. The assumption is that if someone has a family, that means there is someone to look after them. Based on this reasoning, Taiwan’s existing long-term care system does not provide for separate assessment of family caregivers’ own needs, so those needs remain hidden.
In Mr Wang’s case it was taken for granted that he, as his wife’s spouse, would be her caregiver. It was assumed that, once she was out of hospital, he would look after her and that was the end of the matter. Never mind the fact that he was in his 80s and had had to look after her for 10 long years — the hospital still did not consider him as requiring guidance or apparently consider that his wife’s case should be turned over to a community-based long-term care management center, to follow up and provide help where necessary.
Another problem is that existing long-term care policies place numerous limitations on family caregivers’ access to services. Families that employ a foreign migrant caregiver cannot apply to the state for home-based care. Family caregivers applying for special care allowances are only eligible if they are from low-income households or are unemployed adults, and those who get the subsidy are then not eligible for either home-based or day care services. Those who use home-based care services are not eligible to use day care. The result of all these restrictions is that, as things stand, family caregivers do not have access to full, flexible and reliable supplementary services that could relieve them of some of the burden of care.
If family caregivers are determined to apply for assistance from the state, they have the following choices. Taiwanese family caregivers who have one or more severely disabled family members can only depend on foreign migrant caregivers and they can’t give them any time off, because they are not entitled to apply for any kind of supplementary service. Another option is to apply for a NT$5,000 monthly care allowance and take the 365-days-a-year job of caring for their family members upon themselves. The third option is to use one, and one only, of the available services, while still having to do everything else on their own. Faced with all these obstacles, most family caregivers choose to take on the burden of care themselves. When state policy is so inadequate for family caregivers, how can we condemn Mr Wang for the drastic action he took to end the present and foreseeable suffering of his wife, after caring for her on his own for so many years until finally he lost all hope?
Society should ensure that caregivers do not end up destitute because of the care they give. Adequate support for caregivers is a public duty, not something that individuals or families should bear on their own, but the reality in Taiwan today is that society does not give family caregivers the support they deserve.
Mr Wang was just one of countless people in Taiwan traveling the long and lonely road of caring for their family members. Taiwanese society as a whole is failing to perform its civic duty to give proper support to home caregivers and it is that ethical failure that finally drove Mr Wang to make the most painful decision of his life.
Frank Wang is an associate professor at National Chengchi University’s Graduate Institute of Social Work.
TRANSLATED BY JULIAN CLEGG
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