Family caregiving problems of suspected elderly neglect: A review of forensic autopsy cases in Japan

Abstract

Background. Elder abuse is a severe violation of human rights, and the most recent domestic violence issue to gain the attention of public and medical communities especially highly aged country like Japan.

Methods. To clarify family caregiving problems related to elder neglect in Japan, we reviewed 178 autopsies conducted between 2000 and 2003 at one centre.

Results. Of the 178 cases (134 males and 44 females), 53 involved people were 65 years old and over (30%). A careful investigation of these 53 autopsy reports (39 males and 14 females) allowed us to exclude obvious causes of death, such as traffic and other accidents, drowning, poisoning, alcoholism, and clear disease pathology. We were left with nine cases of suspected neglect (three males and six females). The mean age of victims was 82.1 years (range, 68–91). According to the autopsy reports, two were severely starved, two were putrefied or mummified, three had pressure sores, two had dementia and three would have had difficulty in performing the activities of daily living. Each victim had lived with one family member; their sons in five cases, and a grandson, brother, wife or husband in each case. The caregivers’ ages ranged from 27 to 76 years, and five were unemployed; in three cases, the family incomes were very low. Of the caregivers, two were depressed, one was an alcoholic and one had dementia.

Conclusions. This investigation indicated that elderly parents living with their sons are a high-risk group for neglect. A family support system is needed to target male caregivers who are likely isolated from social services. Autopsy cases provide valuable information for public health to prevent similar cases in future.

Keywords: Elder abuse, Elder neglect, Male caregivers, Family caregiving, Autopsy records,