ISHINOMAKI, Miyagi Prefecture--Everything seemed fine and dandy for 60 residents living in a special nursing home for the elderly here in the Tohoku region when they emerged unscathed from the March 11 Great East Japan Earthquake and ensuing tsunami.
ISHINOMAKI, Miyagi Prefecture--Everything seemed fine and dandy for 60 residents living in a special nursing home for the elderly here in the Tohoku region when they emerged unscathed from the March 11 Great East Japan Earthquake and ensuing tsunami.
However, within two weeks following the disaster, 13 residents would be dead, compared to normal times, when one might die a month.
A look at what caused their deaths shows how a nursing home could become overwhelmed by food and power shortages and a lack of medical attention, despite the best efforts of its staff.
The nursing home, Isshin-en, stands on a hill about 10 kilometers from the coast, so its buildings were protected from the tsunami.
At the time of the March 11 quake, however, Isshin-en had only a three-day supply of food. It was forced to reduce the number of meals to two a day until companies could resume deliveries. As the electricity was also knocked out, heaters and sputum suction devices became unusable.
Outside, the temperatures dropped to below zero. To warm the rooms, the nursing home staff used kerosene stoves. They also had the residents wear more clothing than usual and stuffed cardboard into cracks to prevent cold winds from entering the building.
More than 80 percent of the 60 residents were at a level 4 or 5 on Japan's five-level scale for the seriousness of symptoms, which meant that they required much nursing care and many were bedridden. In addition, two-thirds of the 60 were suffering from dementia.
The staff was concerned that the physical conditions of the residents could begin to deteriorate rapidly. So, they moved all the residents into the dining hall so that they could immediately deal with any possible sudden change in their conditions.
According to a woman who was working as an adviser to the residents and knew what transpired at the facility, a 91-year-old male resident, who was on a bed placed in the dining hall, was found to have stopped breathing on the evening of March 13, two days after the powerful tremor.
The previous day, he had a high fever. However, his physical condition stabilized after receiving intravenous fluids from a part-time doctor who had visited the facility. His family member, who had visited him, left, saying, "I will come here again."
After that, however, he died, and the cause of death was suspected to be pneumonia. He was the first resident to die in the special nursing home after the March 11 disasters.
Then, early on March 16, a 95-year-old man, who had chronic heart disease, died. On March 17 and 19, four more residents passed away.
An 89-year-old woman, who died on March 17, had experienced the powerful earthquake when she was on her way back to the nursing home from a hospital. At that time, she told a staff member, "I don't want to live anymore." She looked as if she lost her spirit to live.
Ishinomaki Red Cross Hospital is located near the special nursing home, and had usually accepted an average of about 60 emergency patients a day. After the disasters, however, the number of emergency patients increased to several hundreds a day. Therefore, it was almost impossible for the residents of the nursing home to receive sufficient medical care at the hospital, even if they were taken there.
It was also difficult for nursing home staff to contact residents' family members. As telephone landlines had become unusable, the staff continued to try calling the cellphones of the family members. They also drove to visit the family members' houses or evacuation centers to find them.
In Isshin-en, the staff had built trustworthy relationships with their residents' family members by spending much time with them. They had also allowed the residents to pass away in the nursing home while their family members were looking on. However, sudden deaths that came after the March 11 earthquake were dealt with completely differently from conventional deaths.
On March 22 and 24, four more residents died. On March 25, another two residents passed away. One was a 92-year-old man, who was a caretaker in the local community. Before the earthquake, he enjoyed excursions with staff members of the nursing home by car. At that time, he told them that he wanted to go to a city government office he had often visited. The photo of his smiling face taken during that trip was selected for his funeral.
On March 28, another resident died.
Toshinori Nakamura, 44, an Osaka doctor, who was treating patients in their homes, lists three diseases or symptoms that may cause sudden deaths of elderly people at time of disasters: pneumonia, hypothermia and dehydration.
In Isshin-en, a part-time doctor was examining its residents. Though busy checking bodies found in areas affected by the disasters and treating patients at clinics, the doctor visited the special nursing home eight times during the period from the disasters to the end of March, more than double the number of visits during conventional times.
Meanwhile, no other doctors came to the nursing home to assist.
Though goods were delivered to the nursing home by the city government or public health centers, liquid meals and nutritional supplements that were needed by the residents were in short supply. The nursing home also suffered from a serious shortage of staff and needed supplies.
Apart from the residents, about 20 elderly people affected by the disasters were brought to Isshin-en by the end of March, forcing the staff to care for them as well.
In such dire conditions, 13 residents died in the two weeks following the March 11 quake.
Now, a system to prevent nursing homes from being isolated in the event of a natural disaster is needed to prevent a recurrence like Isshin-en in the future.