Last week, a 47-year-old woman was arrested for killing her 81-year-old mother and “assisting” in the suicide of her 74-year-old father. The woman had been found on the banks of the Tone River in Saitama Prefecture, into which she and her parents had driven in order to drown themselves.
Actually, the mother did not necessarily have that intention because she suffered from dementia. The woman told police she had been taking care of her mother full-time, and that after her father fell ill and could no longer work delivering newspapers, they decided to die. A neighbor told Asahi Shimbun that the woman was a devoted daughter.
The welfare ministry projects that there will be about 7 million people with dementia in Japan by 2025. There were 4.62 million in 2012. The Saitama family may not be typical in terms of their fate, but they are typical in that they couldn’t afford the kind of care they thought they should provide for a loved one whose cognitive faculties were gone. The government offers welfare assistance to those who qualify, and home nursing care up to a point, but it isn’t always enough. Prime Minister Shinzo Abe has proposed improved services to eliminate the need for people to quit their jobs so they can take care of ailing parents.
Nevertheless, the standard thinking is that families should take care of their elderly members, and dementia is the scariest possibility for people who expect to do so, since it implies constant supervision. Horror stories like the one related above exacerbate the creeping sense of despair these people feel.
But the subject has taken on a more hopeful tone. NHK recently ran a two-part special, “Dementia Revolution,” which showed that the condition is not always a bottomless black hole. The first part reported on research that found its effects can be mitigated. There’s a condition called MCI (mild cognitive impairment) that leads to dementia 50 percent of the time, but doctors have also found that at least 10 percent of MCI cases are reversible. The trick is regular exercise, better diet and stimulating activities — in other words, a healthier lifestyle than the one the individual was leading before diagnosis, which hardly sounds surprising but is nonetheless encouraging.
Then there are stories of people who are making the best of their situations. Actor Keisuke Sunagawa published a bestselling memoir about his wife, actress Nobuyo Oyama, who supplied the voice for the cartoon robot cat Doraemon for decades. Sunagawa chronicles her degeneration, and describes his difficulties in deciding to make her condition public and reduce her medication. Though the book offers detailed insight into successful ways of caring for a person with dementia, part of that success has to do with Sunagawa’s material circumstances. Like many people, he thinks institutionalizing his wife will make her condition worse, so he cares for her at home. But he has help from Oyama’s manager and the couple’s housekeeper, a luxury most people can’t afford.
According to several recent documentaries, the solution is a change in attitude toward the afflicted individual. Yukio Tanaka’s “On the Road” takes a lighter approach. The director was asked by a 56-year-old woman to film her elderly mother, Aseyo, after she was diagnosed with dementia and came to live with her. Aseyo was constantly angry at imagined slights and often left the daughter’s house, determined to walk all the way to her family home in Fukuoka. The daughter recorded these incidents in a blog and was able to extract humor from them, which Tanaka captures in his film.
A similar vein is tapped by Shinichi Ise’s “My Wife’s Illness,” a portrait of pediatrician Koichi Ishimoto and his wife, Yayoi, who suffers from youthful dementia — both are 63. Ise deliberately avoids showing Yayoi in a distressed state, and after filming for a while, he found her “charming,” despite her diminished capabilities. Though the film leaves out much about the reality of caring for someone with dementia, it shows how conjugal love survives under such circumstances. Even as Yayoi’s condition worsens, the couple’s affection for each other is palpable.
Probably the most acclaimed film in this subgenre is Katsumi Sakaguchi’s “Walking With My Mother,” which records his own difficulties in addressing his mother’s dementia, which was brought on by acute depression over the deaths of her daughter and husband. Sakaguchi started filming as a means of dealing with his own helplessness in the face of his mother’s mood swings. Eventually, her sister in Kyushu talks her into moving back to their hometown, and the viewer sees a marked improvement in both her outlook and her cognitive functions after she does. In the end, she asks her son to release the film publicly. “Now I realize she just wanted people to understand her feelings,” Sakiguchi told the Asahi Shimbun.
The theme of these films is that even when someone loses cognitive functions they still retain what makes them unique as a human being. Usually people have too much emotional investment in the process of caring for a loved one with dementia, and part two of the NHK special cited local-government programs that help families better understand their afflicted members. Professionals look at the patients objectively and coach relatives in how to approach the problem: Don’t scold; allow the person to express themselves; see that they aren’t isolated from society.
But before that, they have to seek help. Shouldering the burden alone can lead to despair, as illustrated by the Saitama family. It can also lead to total resignation. On Nov. 18 it was reported that 34 residents of a nursing home, also in Saitama Prefecture, had been found tied to their beds or wheelchairs. According to the law, facilities can only take such action after receiving consent from families, and while it isn’t clear if permission had been sought, it was obvious what sort of solution these patients’ families had chosen.