Sun, Jan 27, 2019 page6

• Government must heed caregivers

  • By Chen Chen-fen 陳正芬
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  On Jan. 11, a man surnamed Wu (吳) was found dead hanging from the Old Steel Bridge in Kaohsiung’s Dashu District (大樹). His 80-year-old father was found dead inside a nearby vehicle. Initial investigations turned up a suicide note Wu had left in his room that said: “I took Father away and I take all responsibility.”

  This was the first tragedy involving a caregiver this year. The public nature of the incident, which would usually play out in private, requires deliberation.

  On Dec. 27, 2010, 84-year-old Wang Ching-hsi (王敬熙) killed his wife, who had Parkinson’s disease, by hammering a screwdriver in to her forehead, shocking the nation.

  During his first arraignment in April the following year, Wang reportedly said it was the state that had forced him to kill his wife. At the end of the year, he died at the Taipei Detention Center after an illness.

  In 2012, the Taiwan Association of Family Caregivers held its first news conference addressing caregiver tragedies, calling the public’s attention to three trends — aging caregivers, an increase in the number of male caregivers and the increased demands of the role.

  The association urged the government to increase funding for social services to allow caregivers at least one day off per week and to curb such tragedies.

  However, caregiver-related tragedies have not stopped. There were seven incidents in 2013, nine in 2014, seven in 2015 and 14 in 2016.

  On Aug. 8, 2016, a 78-year-old woman who was caring for her disabled and ill husband, killed him by stabbing him 14 times one day after he was discharged from hospital. Only 14 days later, a disabled 88-year-old man murdered his 69-year-old wife with a hammer during the night and then committed suicide. His wife and son had planned to send him to a care facility because they were unable to look after him.

  From June, 2016 to June the following year, there was almost one caregiver-related tragedy per month.

  Such incidents have not diminished, even though the past five years has seen an increase in the number of caregivers calling the association’s help line and saying that they were having thoughts of suicide, as well as an increase in the number of caregivers transferred to centers for the prevention of domestic violence or to other agencies after exhibiting tendencies toward domestic violence.

  On Nov. 14 last year, a 38-year-old man gave his father a 10-fold insulin overdose because his application for long-term care services was rejected and the family finances had deteriorated.

  Asked by reporters why he killed his father, the man said without an expression on his face that it was “a social tragedy.”

  On Dec. 7 last year, the association invited two former caregivers to its annual conference to speak about their experiences. Both said they had had suicidal thoughts and when they called help lines, social workers would often say: “Please do not become the first caregiver-related tragedy of the year.”

  On Dec. 19, Chinese-language magazine Mirror Media published a story titled: “It is tragic to grow old together: the story of an old caregiver caring for an old person.”

  The reporter interviewed an 84-year-old caregiver and came to the conclusion that “for elderly people, taking care of another elderly person is more frightening than living alone.”

  This suggests that since the Wang case eight years ago, the issue has evolved from an incident that shocked the nation into a social construct.

  A review of domestic and foreign research showed that abuse and suicide among elderly people has become an important topic, receiving a lot of attention in developed countries that have aging societies.

  The percentage of elderly people who report abuse varies greatly, from an estimated 2.6 percent in the UK and 4 percent in Canada, to 18.4 percent in Israel and 29.3 percent in Spain. Physical abuse accounts for the majority of cases.

  Many studies have indicated that drastic increases in abuse rates are highly correlated with overburdened caregivers.

  Researchers have suggested that such cases should be clarified by examining the care situation, including interactions between abuser and victim, and changes in the victim’s degree of disability and social circumstances.

  Similar studies in Japan, where killings by caregivers have become more frequent in the past few years, are beginning to affect society, reminding people that it is important to provide opportunities for carergivers to release their pressure before they become violent due to stress related to their work.

  Since 2009, 74 care receivers killed their caregivers, with studies showing that factors included difficulty calling for outside help due to physical or mental conditions — or being turned down when asking for help — or the caregiver did not meet their expectations.

  However, when caregivers encounter rejection or ineffective assistance when seeking help for the first time, they might be put off further action.

  It is important to develop ways to assist caregivers and those in care who are exhausting each other and help them accept state services to prevent tragedies. This is especially important with demographic changes. Last year, elderly people accounted for 14 percent of the population, making Taiwan an aged society.

  The discussion about social security networks must stop neglecting two key issues: How to make carers aware that they must seek help before the situation deteriorates, and how the social welfare system should receive and respond to distress calls.

  Chen Chen-fen is a professor in the Department of Social Welfare at Chinese Culture University and president of the Social Welfare Association of Taiwan.

  Translated by Chang Ho-ming
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