Guilt. People caring for the demented see the person they loved disappear but not die. Sooner or later the thought surfaces: if only he/she would die. Then the guilt. They can't forgive themselves, so they beat themselves up by refusing help; it happens time and again. Sometimes they snap. Then it's a murder/manslaughter charge, and a judge saying "how could you be so cruel to this dear old person?" Sometimes they kill themselves as well or instead. Little tragedies that go through A&E every day, no-one notices. Sometimes I have been on duty when an Alzheimer case presents at Casualty for the third or the tenth or the fiftieth time, with "chest infection" or "constipation" or some such. Accompanied by a relative with drawn face. What it really means is, their carer is at the end of their tether and the GP can't help. So shuffle it off onto the Hospital for a forty-eight-hour respite. And sometimes, when the houseman has shot the patient up with antibiotics, or the crash team has bounced in and resuscitated, they go out proudly to the relatives and say "Good news! your husband/wife/parent is going to be all right!" And you can see the carers' faces drop.