David Winter bashed his elderly father's head more than 40 times with a flashlight and stabbed him at least a dozen times with a letter opener.
His father, Lawrence, had Alzheimer's and Winter was his sole caregiver.
The odd hours Lawrence Winter would roam around the house, due to the body clock changes that occur in Alzheimer's, became too much for his son to handle.
David Winter awoke on March 30, 2011, at 6:30 a.m. and found his father making tomato soup. After putting his father back to bed, he snapped.
Winter, who has a developmental disability, did not have a criminal record and told a judge at sentencing that he loved his father and misses him every day.
"I'm not an evil person," Winter said, according to the Bismarck Tribune. "I just had more than I could handle."
Although Winter's case is extreme, an estimated 44 million caregivers in the United States face a tremendous burden that often times causes them to crack when they least expect it. Somewhere between 30 percent to 40 percent of dementia caregivers suffer from depression and emotional stress, according to a 2003 study in the Journal of Internal Medicine.
"The stress of caring for someone 24 hours a day would drive people to do things they would never do," said Marlo Sollitto, an editor at Aging Care, an online support community for caregivers. "We've seen posts from people who say, 'Help, I can't do this anymore.' We have heard people say 'I want to kill my mother'. "
Other times, it's just screaming at a loved one.
"[Caregivers] can feel like they're at the end of their rope sometimes," she said.
Winter's case underscores the need for people caring for a loved one to reach out for help, said Krista Headland, a spokesperson for the Alzheimer's Association in North Dakota.
"Without a support system, caregivers can become very stressed and isolated and that can obviously lead to bigger problems," she said. "[Winter's cases] is very unfortunate, but hopefully this has increased awareness about the importance of support systems ."
Winter was sentenced to 18 years in prison Tuesday for his admitted role in his father's death.
Proscutor Pam Nesvig asked for the court to suspend sometime off of the recommended 60 year prison sentence. She said she took several factors into consideration including his mental state and lack of a criminal record.
"But the end result here was a homicide," Nesvig said. "And it was a brutal homicide."
Travis Finck, Winter's public defender said his client had been struggling to get help for his father and simply couldn't do it alone.
"He just couldn't find a place to help him," Finck said. "He had no family and the bureacracy you have to peel your way through to get anything done isn't something that happens overnight."
Winter had taken his father to the hospital twice in the days before he killed him.
"He was surprised they sent him home, " Finck said.
And for now, Winter told a judge he is seeking forgiveness and misses his father "everyday".
"I will always regret that it happened," he said.