Stress can make caregivers ‘snap’ violently, experts say
Published: Wednesday, February 15, 2012 at 6:16 p.m. last Modified: Wednesday, February 15, 2012 at 6:16 p.m.
SARASOTA COUNTY – as more Americans live with and care for elderly parents or family members, the stress is sometimes leading to violence.
Last March, David Winter of Bismarck, N.D., the sole caregiver for his father with Alzheimer’s disease, admitted to bashing his father’s head more than 40 times with a flashlight and stabbing him a dozen times with a letter opener. “I’m not an evil person,” Winter told a judge, “I just had more than I could handle.”
In 2009, Robert Yurkanin Jr. of Fort Lauderdale pleaded guilty to manslaughter for attempting to drown his 84-year-old father in the ocean; his father later died. Yurkanin Jr. said he was distressed after caring for his father for five years.
On Friday night in Sarasota, a combination of stress, anguish and financial problems may have been too much for 58-year-old Thomas Moak, an unemployed limo driver living with his aging parents and 60-year-old sister.
Moak later told detectives that “the living situation” had become “very volatile.” an argument that night between his mother and sister led to his mother threatening to kick him and his sister out of the house in the 4100 block of Tonga Drive, he told them.
“Mr. Moak asked his sister to leave the house multiple times and she refused,” an arrest report states. “Mr. Moak stated he could not handle the problems any longer and went to his bedroom to retrieve his rifle from underneath his bed.”
Moak shot and killed his sister, Renee O’Connor, 60, on the back lanai. Then he went into their bedroom and killed his parents, 82-year-old Thomas Edison Moak and 84-year-old Isabelle Moak.
Moak’s other sister, Cheryl Thompson, told 911 dispatchers that her brother called her after the shootings, told her what he had done and said he planned to kill himself as well.
Deputies intervened, arresting Moak on three counts of first-degree murder; Moak remains on suicide watch at the county jail.
A neighbor contacted after the killings described the younger Thomas Moak as a nice man who had spoken of being “stressed out” caring for his parents; Moak also told the neighbor he was “struggling” because he was out of work.
Such acts of violence by adults living with their aging or infirm parents remain a rarity.
Most caregivers are evidently coping, likely because they get assistance from family, friends or professionals such as home health aides.
“Most of the time this doesn’t happen,” said Sandra Reynolds, a gerontologist at the University of South Florida School of Aging Studies, referring to the killings at the Moak home.
Yet, in some cases, “the unrelenting nature” of feeling responsible for others, perhaps 24 hours a day every day, can become too much, Reynolds said — especially if someone is already having troubles being responsible for himself.
In court records filed this week, Moak declared himself indigent. He reported that he had no income and $25,000 in debts.
In 2010, Ford Motor Credit Co. won a $9,940 judgment against Moak for his failure to make payments on a 2005 Focus. A judge ruled that interest would accumulate at 6 percent a year if the debt remained unpaid.
Moak, who was not represented by an attorney in that civil case, told the court he was then earning less than $700 a month as a janitor and kitchen worker at an Elks Lodge and could not pay increasing expenses that included prescriptions and outstanding doctor and hospital bills.
From there, Moak’s difficulties appeared to worsen.
On the night of the murders, sheriff’s officials say, Moak “snapped.”
An estimated 65.7 million Americans are unpaid caregivers living with a relative, according to a 2009 survey by the National Alliance for Caregiving and AARP.
Many of them live with aging parents because of their own financial plight, which may add to the pressure.
As Florida pulls out of the recession, its population is growing again, the U.S. Census Bureau says. yet the number of households is still declining.
Economists believe that means more adults are sharing homes, often with their parents, because they cannot afford to live on their own.
Seeing warning signs
Experts on aging say there are typically warning signs when a caregiver is becoming overwhelmed and that, in most communities, help is available if the person will ask.
Symptoms of such stress may include “sleeplessness, loss of weight, withdrawal from usual patterns of activity,” Dr. Walter M. Bortz II, a clinical associate professor at Stanford University who specializes in aging issues, said.
Those caring for others who are aging and losing some of their abilities must “deal from strength,” Bortz said. If they start becoming emotionally or physically “fragile,” too, they will quickly be unable to cope.
Typically, a caregiver assumes more duties than before, such as managing the household finances and becoming their loved one’s chauffeur, cook and bathroom attendant.
Financial worries just add to the burden, Bortz noted. “There are only so many inches on their backs to carry other people.”
Those experiencing such stress may “drop out of sight” and stop doing their usual activities, such as socializing with friends, said Susan Siegel, a psychologist with Jewish Family & Children Service of Sarasota-Manatee. “They become isolated.”
Asking for help
Such situations can become especially acute in retirement meccas such as Sarasota, Manatee and Charlotte counties, where many elderly residents live far from relatives.
On the phone, a spouse or an adult child living with an elderly or disabled person often assures distant relatives that all is well. when those relatives eventually visit, however, they discover conditions to be different than what they were told, said Pamela Baron, director of senior services at JFCS.
“The critical thing is that families communicate with each other,” Reynolds said. often one person “feels they are doing everything and getting no help.”
The situation worsens if they do not start delegating responsibility, Bortz said.
“They can have less tolerance, less patience,” Siegel said. “They can lose their temper and feel horrible about it. If that’s your predominant mood, you need help. you need a break.”
People caring for an elder or other relative who is becoming less able-bodied may feel guilty if they ask for help, feeling they are failing in their responsibility as a family member.
Trained counselors can assure them that their guilt is misplaced, Siegel said.
Experts say that makes it crucial for people under mounting stress to get assistance before they reach a breaking point.
When friends and neighbors offer help, the caregiver often declines, said Andria Keil Bilan, vice president of development at JFCS. “Those offers of help will only come for so long. If they repeatedly say ‘no,’ the offers of help will stop.”
Other assistance, much of it free, is available — especially from local nonprofits such as JFCS and the Senior Friendship Centers.
Those services include counseling, support groups, respite care, home visits as well as connections to assistance offered by other agencies, such as hospices, hospitals or the Veterans Administration.
Getting help with a stressful family situation should not be regarded as a weakness or failure, Siegel said. “You need a team. You’re still the captain of the team.”
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