Dementia is a condition that requires skillful care.

An 84-year-old female resident of a group nursing-care home in Kahoku, Ishikawa Prefecture, suffered an agonizing death after a part-time staffer working the night shift exposed her face and body to hot air blasting from a kerosene heater. The woman, who suffered from severe senile dementia, died of shock.

What a sad end for a person who had lived so long. Many people in this country must have felt deep indignation and anxiety over the woman's death, and no doubt wondered if a similar tragedy could also befall them in their sunset years.

The suspect, a 28-year-old man, joined the group home to acquire the necessary skills to care for his grandmother, who requires nursing care. He worked three night shifts a week in his endeavor to obtain a license as a second-class home-care giver. He demonstrated a strong commitment to his job and made clear he hoped to work day shifts, too, according to people at the home.

Why this earnest young man committed such a violent crime against an elderly and helpless person remains a mystery. He reportedly told police investigators that he lost control of himself because of a gap between his ideas and the reality. As yet, though, nothing is clear about this case.

The facility where the tragedy occurred is one of a growing number of nursing-care homes for the elderly that have sprung up in recent years to provide care in an environment that resembles an ordinary house.

In this type of situation where constant care is offered, staff members often become familiar to the patients, and this can produce astonishing results in people with dementia. In fact, this type of facility is now regarded as one of the best approaches available for treating people with this condition.

A new public nursing care insurance system introduced in 2000 covers services at group homes. Since then, the number of such homes has soared. There are now more than 6,000 group homes nationwide.

Despite the cozy environment, a group home needs staffers with exceptional skills. Dementia patients often panic or become violent when they are treated in a way they don't like. Staff members are particularly effective when they can offer sympathetic care. This can help ease the anxiety in patients about their deteriorating mental faculties as well as their frustration at being unable to articulate their thoughts and feelings. Such quality care can help stop people becoming delusional or wandering off aimlessly.

Supplying such care demands a great deal of expertise and a deep understanding of human being.

In Denmark, which has an advanced welfare system for the elderly, expert coordinators well versed in the problem of dementia make rounds of group homes to provide counseling and advice for staffers.

The night-shift-only worker in this murder case was also attending a course for second-class helper certification. He must have encountered a variety of difficult situations while taking care of the residents. We wonder if the home had any system that allowed for exchanges of information about patients and mutual consultation among the staff.

Starting this spring, municipal governments will monitor and supervise the management of group homes. Their first task should be to provide training programs to help staffers acquire expert skills and knowledge. Many patient abuse cases involving workers at care facilities are due to insufficient knowledge about dementia.

Local residents also need to develop a deeper understanding of this chronic disorder and help protect group homes as common assets of their communities through personal involvement.

The city of Omuta in Fukuoka Prefecture offers a learning program for citizens to encourage community support to old people with dementia. Elementary and junior high schools in the city also teach students about this unfortunate condition through various programs and by using picture books.

Getting people interested in this problem will lead to better care for patients fighting the disease.

--The Asahi Shimbun, Feb. 16(IHT/Asahi: February 17,2005)