The Supreme Court ruling this week on the liability of the family of a 91-year-old dementia patient fatally hit by a train after wandering onto the railway tracks in 2007 should lead us once again to think who should bear — and how society should share — the burden of caring for the expanding ranks of the elderly requiring nursing in this rapidly aging country.
The man in Obu, Aichi Prefecture, who was suffering from a severe case of Alzheimer’s disease, disappeared from his home while his 85-year-old wife was taking a brief nap. He took a train and got off at the next station, wandered onto the tracks by opening the fence at the end of the platform, and was hit and killed by a train. The railway sued the man’s wife and his son for ¥7.2 million in compensation to cover the cost of dealing with the accident, including the expense of providing alternate transportation for passengers.
Lower courts ordered the family members to pay the damages, on the grounds that they bore the responsibility of keeping watch over the man, who had repeatedly wandered away from home. In a landmark ruling Tuesday, the Supreme Court relieved both the widow and the son of their duties to pay the compensation, saying their liability should not be determined by family ties alone but require a comprehensive judgment on whether it was practically possible for the relatives to watch over the man’s actions. Along with the son, who had been living away from the parents for more than 20 years, the wife — who lived with the man in the house — cannot be deemed to have been capable of supervising the husband’s behavior since her own failing health required nursing care, the top court said.
Under the Civil Code, people who lack accountability for their actions such as small children and the mentally disabled cannot be held liable for damages for the consequences of their actions, including losses caused to others. People responsible for supervising such persons, such as parents of the children, are instead held liable for the damages, although they are spared if it’s deemed they have fulfilled their supervisory duties. When small children cause accidents that result in harming others, their parents’ responsibility comes into focus. Tuesday’s ruling was the first Supreme Court judgment on the responsibilities of families taking care of dementia patients for damage caused by the patients.
The circumstances that surrounded the family of the deceased man hardly seem extraordinary in Japan’s fast-aging population, where dementia is an increasingly common ailment among elderly residents. A Health, Labor and Welfare Ministry estimate shows the number of people aged 65 or older will hit 36.57 million in 2025, and 1 out of 5 of them, or 6.75 million to 7.3 million, will suffer from senile dementia — compared with 5.2 million today. Around 10,000 dementia patients are reported missing by their families each year. Accidents like the one befalling the Aichi Prefecture man are not rare.
As the number of the elderly requiring nursing care increases, availability of care facilities — including those that accommodate seniors suffering from dementia — remains limited, and many people care for their ailing relatives in their homes. Roughly 100,000 workers a year are believed to quit their jobs to provide care for their relatives — a problem that prompted the government to set new targets for expanding the capacity of nursing care services. In many cases, it is similarly aged spouses or other relatives who provide care for the elderly. In 51.2 percent of households that had a member requiring nursing care, both the recipient and care provider were 65 or older, according to a 2013 health ministry survey. The problem will become more serious as the number of households consisting only of aged couples — or of elderly persons living alone — is set to increase.
Lower court rulings that ordered the wife to pay millions of yen for the consequence of her husband’s action must have posed a nagging question to families taking care of their ailing relatives with dementia at home. Would they need to keep watch over the patients all the time, or would they have to lock up the patients to prevent them from wandering out when they’re not watching? Requiring families to keep a 24-hour watch will make it effectively impossible for people to care for dementia patients at home. Even the top court ruling does not set clear criteria on what circumstances would spare families from taking responsibility for the actions of their relatives, saying that decision will rest with a comprehensive judgment on each case. But one thing at least seems certain — that it’s impractical to leave the burden entirely in the hands of the families.