Tuesday, October 30, 2012


This transcript below comes from a talk Dr Richard Teo Keng Siang gave to a group of dental students in Singapore on 24 November 2011, eight months after he was diagnosed with stage 4 lung cancer. He had an important message to share with them, and with all of us too. Please read and pass it on to your children and your friends if you think it will benefit them.

Hi good morning to all of you. My voice is a bit hoarse from the chemotherapy, so please bear with me. I thought I'll just introduce myself. My name is Richard, I’m a friend of Danny’s, who invited me here.

I’d just begin to say that I’m a typical product of today’s society. Before this, I was talking about how the media influences us etc. So I’m a typical product of what the media portrays. From young, I’ve always been under the influence and impression that to be happy, is to be successful. And to be successful, is to be wealthy. So I led my life according to this motto.

Coming from a poor average family, back in those days, I was highly competitive, whether in sports, studies, leadership. I wanted it all. I’ve been there, done that. But at the end of the day, it’s still about money.

So in my recent last years, I was a trainee in ophthalmology, but I was getting impatient, cos I had friends of mine who were going out into private practise, making tonnes of money. And there I was, stuck in a traineeship. So I said, ‘Enough, it’s getting too long.’ At that time, there was a surge in protégés of aesthetic medicine. I’m sure you’re aware, aesthetic medicine had peaked over the last few years, and I saw good money in there. So much so that I said, ‘Forget about ophthalmology, I’m gonna do aesthetic medicine.’ So that’s what I did.

The truth is, nobody makes heroes out of the average GP in the neighbourhood. They don't. They make heroes out of rich celebrities, politicians, rich and famous people. So I wanted to be one of these. I dived straight into aesthetic medicine. People were not willing to pay when I was doing locum back in those days. Anything more than $30, they would complain that “Wah, this lo kun (doctor) jing qwee (very expensive)”. They made noise and they were not happy. But the same people were willing to pay $10 000 for a liposuction. So I said, ‘Well, let’s stop healing the sick, I’m gonna become a beautician; a medically-trained beautician.’

And that was what I did – liposuction, breast augmentation, eyelid surgeries, you name it, we do it. It was very good money. My clinic, when we started off, waiting time was 1 week; 1 month; became 2 months; became 3 months. There was so much demand that people were literally queuing up to have aesthetic work done on them. Vain women – easy life!

So the clinic grew. I was so overwhelmed, from 1 doctor, I employed 2, then 3, then 4 doctors, and carried on. Nothing is ever enough. I wanted more and more and more. So much so that we set up shop in Indonesia to lure all the Indonesian tai tai’s. We set up shop, set up a team of people there, to get more Indonesian patients to come in.

So, things were doing well. I’m there, my time has arrived. 

Around some time in February last year, I said, ‘OK, I have so much spare cash, it’s time to get my first Ferrari. So there I was, getting ready for the deposit. ‘OK! There comes my first Ferrari!’ I was looking for land, to share with some of my friends. I have a banker friend who makes $5 million a year. So I thought, ‘Come, let’s come together. Let’s buy some land and build our houses.’

I was at my prime, getting ready to enjoy. At the same time, my friend Danny had a revival. They were going back to church, some of my close friends. They told me, ‘Richard, come, join us, come back to church.’

I have been a Christian for 20 years; I was baptised 20 years ago, but it was because it was fashionable to be a Christian then. All my friends were becoming Christians then. It was fashionable! I wanted to be baptised, so that when I filled in a form, I could put there “Christian” – feels good. In truth, I had never had a bible; I don’t know what the bible is all about.

I went to church for a while, after some time, I got tired. I said it’s time to go to NUS, stop going to church. I had a lot more things to pursue in NUS – girls, studies, sports etc. After all, I had achieved all these things without God today, so who needs God? I myself can achieve anything I want.

In my arrogance, I told them, “You know what? You go tell your pastor to change your sermon to 2pm. I will consider coming to church.” Such arrogance! And I said 1 statement in addition to that – till date, I don’t know I’ve regretted saying that – I told Danny and my friends, “If God really wanted me to come back to church, He will give me a sign.”. Lo and behold, 3 weeks later, I was back at church.

In March 2011, out of the blues – I was still running around, ‘cause I’m a gym freak and I always go to the gym training, running, swimming 6 days a week. I had some backache, and that’s all I had, but it was persistent. And so I went for an MRI to exclude prolapsed disc. And the day before I had my scan, I was still in the gym, lifting heavy weights, doing my squats. And the next day, they found that half my spine had bone marrow replacement. I said, “Woah, sorry, what’s that?” 

We had a PET scan the next day, and they diagnosed that I had terminal lung cancer, stage 4B. It had spread to the brain, half the spine, whole of my lungs were filled with tumour, liver, adrenals…

I said, “Can’t be, I was just at the gym last night, what’s going on?” I’m sure you know how it feels – though I’m not sure if you know how it feels. One moment I was there at the peak, the next day, this news came and I was totally devastated. My whole world just turned upside down. 

I couldn’t accept it. I have a hundred relatives on both sides, my mom and my dad. 100 of them. And not a single one has cancer. To me, in my mind, I have good genes, I’m not supposed to be having this! Some of my relatives are heavy chain smokers. Why am I having lung cancer? I was in denial.

So the next day, I was still in a state of denial, still unable to accept what was going on. There I was lying in an operating theatre in a hospital, for a needle biopsy (for histology). There I was, just completed the biopsy, and lying in the operating theatre. The nurses and doctors had left; told me I had to wait for 15 minutes to do a check X-ray to make sure there’s no pneumothorax (a complication).

And there I was, lying on the operating table, staring blankly at the ceiling in a cold, quiet operating theatre. Suddenly I just heard an inner voice; it was not like coming from outside. It was inside. This small inner voice that I had never felt before. And it said very specifically, it said, “This has to happen to you, at your prime, because it’s the only way you can understand.”

I said, “Woah, why did that come from?” You know, when you speak to yourself, you’d say, “OK, what time should I leave this place? Where shall I have dinner after this?” You’d speak from a first person point of view. You don’t say, “Where should YOU go after this?” Whereas the voice that came spoke as a third party. It said, “This has to happen to YOU, at YOUR prime, because this is the only way YOU can understand.” At that time, my emotions just overflowed and I broke down and cried, alone there. And I knew then, subsequently, what it means to understand that why this is the only way.

Because I had been so proud of myself, my whole life, I needed nobody else. I was gifted with things that I could do, why do I need anybody else? I was just so full of myself that there was no other way I could have turned back to God.

In fact, if I were diagnosed with stage 1 or 2, I would have been looking around busily for the best cardiothoracic surgeon, remove a section of the lobe (do a lobectomy), do preventive chemotherapy…The chances of it being cured is extremely high. Who needs God? But I had stage 4B. No man can help, only God can.

A series of events happened after that. I wasn’t sold after that, because of the inner voice, I became believing, prayers, all that. No I wasn’t. To me, it was just ‘maybe there was a voice; or maybe that was just me talking to myself.’ I didn’t buy the story.

What happened next was that I was being prepared for chemotherapy. I started off with a whole brain radiation therapy first; takes about 2 -3 weeks. In the meantime they prepared me for chemotherapy, supplements etc. One of the things they used for chemo was a thing called Zometa. Zometa - they use it to strengthen the bones; once the bone marrow (replacement) is cured of cancer cells, it becomes hollow, so we need Zometa to strengthen the bone to prevent compression fractures. 

One of the side effects of Zometa is that it can cause osteonecrosis (bone death) of the jaw, and I had to have my wisdom teeth removed. Years ago, I had my upper wisdom teeth removed, cos it was giving me trouble. The lower ones didn’t give me trouble so I said, “Forget it, just leave it.” So of course, Danny volunteered to remove it for me.

So there I was, lying there in a dental chair, asking myself, suffering all the side effects of radiotherapy, and now I have to go through wisdom tooth surgery. As if I’ve not had enough to suffer! So I asked Danny, “Eh, bro, is there any other way? Can I not go though this?” He said, “Yes, you can pray.” 

I said, “What’s there to lose? Ok lah, pray lah!” And so we prayed. And we did an X-ray after that. Everything was all there, all the appliances and everything. And lo and behold, the Xray showed that there was no wisdom teeth in the lower jaw. I know most people have 4 wisdom teeth, maybe some have none, but to be missing one or 2, as I understand – I’m not too sure, as I understand – is not that common.

Still I was, “Nah, I don’t care about that.” To me, as long as I didn’t have to take out the tooth, I was happy. At that point, I still wasn’t sold on prayers. Maybe it was just a coincidence – for whatever it’s worth.

I continued meeting my oncologist, asking him, “How long do I have?” I asked him. He said, not more than 6 months. I said, “Even with chemotherapy?” About 3 – 4 months, he said. 

I couldn’t grasp that. It was difficult to come to terms. And even as I went through radiotherapy, I was struggling everyday, especially when I wake up, hoping that it’s just a nightmare; when I wake up, it’s all over.

As I was struggling, day after day, I went into depression, which is the typical denial, depression blah blah blah that you go through. But for 1 reason, I don’t know why, there was this specific day that I was supposed to meet my oncologist. At about 2pm, I felt this sudden surge of peace, comfort, and in fact, a little happiness. It was just overflowing. For no rhyme or reason, it just came about 2pm, as I was getting ready, dressing up to meet my oncologist. So much so that I whats-apped all my friends that, “Bros, I just feel so good suddenly! I don’t know why, it just came!”

And it was only days, or was it weeks after, that Danny revealed to me that he had fasted for 2 days for me, and he was bargaining with God, and fasted for 2 days, and he ended his fast at that exact same point, about 2pm thereabouts, that this surge of sensation came to me for no rhyme or reason. And I didn’t know that he was fasting for me. And when he ended the fast, I felt that sensation!

Whoa, things were getting a bit too coincidental. I was starting to buy a bit of the story, but still I wasn’t sold. As days passed by, I completed my radiotherapy, about 2 weeks plus. Getting ready for chemo, so they let me rest for a few days.

See, the mortality rate of lung cancer : Lung cancer has the highest mortality rate. If you add up breast, colorectal (colon) cancer, and prostate cancer (the top few cancers in Singapore for men and women), if you add up the mortality rate of these 3, it still doesn’t add up to lung cancer. Simply because, you understand, you can remove the prostate, the colon, the breast, but you cannot remove your lungs.

But there’s about 10% of lung cancer patients who do pretty well for some reasons, because they have this specific mutation; we call it the EGFR mutation. And it happens, only 90% of the time, in Asian ladies who never smoked in their lives. Me, first of all, I’m male. 2ndly, I’m a social smoker. I take one a day after dinner; weekends, when my friends offer me, I take it as well. I’m a light smoker, not a social smoker. But still, my oncologist was still not hopeful for me to have this mutation. 

The chances of it happening for me was maybe 3-4% for me to get it. That’s why I was being primed to go for chemo. But through all the intense prayers, friends like Danny, people that I don’t even know, it turned out that, during my waiting for chemo, the results came back that I was EGFR positive. I was like, “Woah, good news!” Cos now I don’t have to undergo chemo at that time, because there’s this oral tablet that you can use to control this disease.

Just to share with you some idea – this is a CT scan – thorax – of my lungs, before treatment. 

Every single dot there is a tumour. You can see all the mets (metastasis) there. This is just one single plane. Literally I had it in both lungs, and I had literally tens of thousands of tumour. That’s why the oncologist told me, even with chemo, at most 3-4 months.

But because of this mutation, they have this oral medication. This is what happened after 2 months of treatment. As you can see over here; this is what God can do. And that’s why I’m still here having this opportunity to share with you. As you can see over here, the difference between before and after treatment.

At that point, I said, “Well, it’s to be expected, isn’t it? The medicine is good.” I’m still not buying the story. Well, the guys prayed for me and the tumour markers started to come down. 90% of the tumours were wiped out, and the tumour markers came down to more than 90% over the next few months.

But still, you know, once you have the clinical knowledge, you know the statistics. One year survival, two year survival; having all this knowledge is not a good thing. Cos you live with the knowledge that even with all this, the cancer cells are so unstable, they keep mutating. They will overcome and become resistant to the drugs, and eventually you’re gonna run out of medication.

So living with this knowledge is a huge mental struggle, a huge mental torture. Cancer is not just about a physical struggle, it’s a huge mental torture. How do you live with no hope? How do you live with not being able to plan for the next few years? The oncologist tells you to bear with it for the next 1 – 2 months. So it’s a lot of struggles as I went through: March, then April. April was my lowest point, in deep depression, struggling even as I was recovering.

And one of those days, I was there in bed, struggling in the afternoon, asking God, “Why? Why do I have to go through this suffering? Why do I have to endure this hardship, this struggle? Why me?” 

As I fell asleep, in my dreamy state, a vision just came, that says Hebrews 12:7-8.

Now mind you, at this time, I had not read the bible. I have no clue what’s Hebrews, I don’t even know how many chapters there are. Totally clueless.

But it says Hebrews 12:7-8, very specifically.

I didn’t think too much of it. I just continued sleeping. Then I woke up, and I said, “What’s there to lose? I’d just check it out lah!” Danny had bought me a bible; it’s still quite new. I said, “It’s ok, just try.” So I flipped to the Old Testament. Hebrews to me sounds like something ancient, so it should be in the Old Testament right? So I flipped through the Old Testament. No Hebrews there. I was so disappointed.

Then I said, “Maybe New Testament, let’s have a look!”. WOW – New Testament, there’s Hebrew’s!! It says Hebrews 12:7-8. It says, “Endure hardship as discipline as God is treating you as His children.”

I said, “WAH!! Where did that come from?” I was getting goose pimples all over my body. I said, “This can’t be, right?” I mean, what’s the chance of somebody, who has never read the bible, to have a vision of a chapter of a specific verse, that answers my question directly?

I think God called to me directly as I was there sleeping, struggling with it, asking God, “Why do I have to suffer? Why do I have to suffer this?” And God says “Endure hardship as discipline as God is treating you as His child.”

At this point, the chance of that happening is even lesser than my EGFR being positive. There’s just no way; there’s so many millions of thousands of verses in the bible, how can I just conjure up something like that?

So at that point, I was sold I said, “YOU WIN! YOU WIN!!”

Ok , I was convinced. And so from that day onwards, I started believing in my God. And the last time I heard that inner voice was the end of April. And that inner voice, same thing, in the afternoon, as I was sleeping (this time I wasn’t struggling, just going to sleep). In a dreamy state I just heard Him say, “Help others in hardship.”

It was more like a command, rather than a statement. And that’s when I embarked on this journey, helping others in hardship. And I realised that hardship is not just about being poor. In fact, I think a lot of poor people are probably happier than a lot of us here. They are so easily contented with whatever they have, they’re probably pretty happy.

Hardship can happen to rich people; it can be physical hardship, mental hardship, social, etc. And also over the last few months, I started to understand what this true joy is about. In the past, I substituted true joy with the pursuing of wealth. I thought true joy is about pursuing wealth. Why? Cos let me put it to you this way, in my death bed, I found no joy whatsoever in whatever objects I had – my Ferrari, thinking of the land I was going to buy to build my bungalow etc, having a successful business.

It brought me ZERO comfort, ZERO joy, nothing at all. Do you think I can hold onto this piece of metal and it’s going to give true joy? Nah, it’s not going to happen. 

True joy comes from interaction with other people. And at a lot of times, it is a short term pride, the past. When you pursue your wealth, Chinese New Year is the best time to do it. Drive my Ferrari, show off to my relatives, show off to my friends, do my rounds, and then you thought that was true joy? You really think that those guys who sold you your Ferrari, they share their joy with you? And your relatives, wow, they share this joy with you? In truth, what you have done is just to illicit envy, jealousy, and even hatred. They are not sharing the joy with you, and what I have is that short-term pride that wow, I have something you don’t have! And I thought that was joy!

So what we have is basically a short-term pride at the expense of somebody else. And that wasn’t true joy. And I found no joy at all on my deathbed, thinking of my Ferrari – to hold on to it, sayang it?!?

True joy I discovered comes from interaction. Over the last few months I was so down. Interaction with my loved ones, my friends, my brothers in Christ, my sisters in Christ, and only then was I able to be motivated, able to be uplifted. To share your sorrow, to share your happiness – that’s true joy.

And you know what makes you smile? True joy comes from helping others in hardship, and because I’ve gone through this, I know what hardship entails. In fact, there’re some cancer patients who tell me a lot of times, people come up to them and tell them, “Stay positive. Stay positive.” Yah, right. You come in my shoes and you try to stay positive! You don’t know what you’re talking about!

But I have the licence. So I’ve been going out to meet other fellow cancer patients, to share with them, encourage them. And I know, because I’ve been through it, and it’s easier for me to talk to them.

And most importantly, I think true joy comes from knowing God. Not knowing about God – I mean, you can read the bible and know about God – but knowing God personally; getting a relationship with God. I think that’s the most important. That’s what I’ve learnt.

So if I were to sum it up, I’d say that the earlier we sort out the priorities in our lives, the better it is. Don’t be like me – I had no other way. I had to learn it through the hard way. I had to come back to God to thank Him for this opportunity because I’ve had 3 major accidents in my past – car accidents. You know, these sports car accidents – I was always speeding , but somehow I always came out alive, even with the car almost being overturned. And I wouldn’t have had a chance. Who knows, I don’t know where else I’d be going to! Even though I was baptised it was just a show, but the fact that this has happened, it gave me a chance to come back to God.

Few things I’d learnt though:
1. Trust in the Lord your God with all your heart – this is so important.
2. Is to love and serve others, not just ourselves.

There is nothing wrong with being rich or wealthy. I think it’s absolutely alright, cos God has blessed. So many people are blessed with good wealth, but the trouble is I think a lot of us can’t handle it. The more we have, the more we want. I’ve gone through it, the deeper the hole we dig, the more we get sucked into it, so much so that we worship wealth and lose focus. Instead of worshipping God, we worship wealth. It’s just a human instinct. It’s just so difficult to get out of it.

We are all professionals, and when we go into private practise, we start to build up our wealth – inevitably. So my thought are, when you start to build up wealth and when the opportunity comes, do remember that all these things don’t belong to us. We don’t really own it nor have rights to this wealth. It’s actually God’s gift to us. Remember that it’s more important to further His Kingdom rather than to further ourselves.

Anyway I think that I’ve gone through it, and I know that wealth without God is empty. It is more important that you fill up the wealth, as you build it up subsequently, as professionals and all, you need to fill it up with the wealth of God.

I think that’s about it. It’s good to share. Thanks.

Rest in peace, Dr Teo.
The above transcript came from Heaven Address, an online memorial. To view a video of Dr Teo sharing his thoughts on life, wealth, success and happiness, please click here.

Sunday, October 28, 2012


Nudity has been in the news of late. Recently the buzz was about young couple Alvin Tan, 24, and Vivian Lee, 23. They posed nude photos of themselves on their blog Sumptuous Erotica. While Alvin said his parents were pretty 'cool' about the whole episode, Vivian's parents went ballistic. In an interview posted on Youtube, the couple expressed no regrets over what they did and said they enjoyed being in the limelight.

Public reaction was clearly split in the middle. The young generation mostly supported the couple. "It's their body and they can do anything they like with it. It's no big deal." The older generation, on the other hand,  heaped condemnation upon the couple. "Shame on them!"

Photo: China Daily
The latest nudity case to hit the headlines involves Wang Xuzhong, 84. Now this is where it gets interesting. This time it's the young generation who are appalled that an old man like Wang would take off all his clothes for a fee. Wang does part-time nude posing for art students in universities in Chengdu, China.

Wang's children have disowned their father. Although they still bring him clean clothes and food weekly, his elder son has changed the lock of his house to keep his father from visiting him. Wang, a widower, lives alone and survives on a monthly pension of 800 yuan (RM400). The 1400 yuan (RM676) he earns from posing nude goes a long way towards supplementing his small pension.

Photo: People Daily
Apparently, earning a side income as a nude model is catching on among older people in China. It is easy money for them. All they have to do is sit for about an hour and be paid 120 yuan (RM58) for it. Besides, they consider nude modeling an honest job, more honorable than committing crime for money. The only problem is, they have to hide their part-time job from their children to avoid bringing dishonor to the family.

So here we have two opposing reactions to nudity. It is obvious that age has a lot to do with it. When you are young and you have a body that is to die for, flaunt it. That seems to be the message of the young. When you are elderly and you have a body that has fallen victim to gravity, with body parts dangling south, you had best keep it under wraps. Unless you have a body like Tsutomu Tosuka's, then by all means, exhibit it. In 2009 at the age of 74, he won first place in the above 70 age category in the Japan Masters Bodybuilding Competition.

Believe it or not, these men are aged 70+. Goes to show what
discipline and training can do for your body whatever your age.

Once upon a time in Bali, women went about their daily chores with their breasts exposed. It was a natural thing to do, just like these women below waiting to dance for Prince William and Princess Kate during their visit to the Solomon Islands in September. Nobody would bat an eyelid, or look away in embarrassment. In Japan, everyone steps into a public hot bath stark naked, and no one cares two hoots whether your body is a work of art or a personal trainer's nightmare. At the other extreme, there are cultures where the women are covered from head to toe to shield their body and protect their modesty from lustful eyes.

Photo from Getty Images

Should there be some code of decency that society should observe regarding nudity? Is a nude body a joy to behold whatever the age or shape, or is it a shame, a horror to shut your eyes to? Should nudity be made punishable by law? The answer to all these questions is probably "It depends." On what?

Anyone who walks around naked in public would end up being hauled to the police station or to the loony house. That probably sums up how society views nudity today.

PETA: Going naked for a good cause

Have we become such prudes that we appreciate nudity only as an art form in statues, sculptures and paintings?

Saturday, October 27, 2012


A bit late to watch this for Queen Elizabeth's Diamond Jubilee celebrations, but better late than to miss this video showing the transformation of the Queen over the  years from birth to the present day. Amazing!

Ah, we were all young and beautiful/handsome once. And for some, wild and rebellious too! Those were the carefree days of youth. But the golden years can be just as carefree - if we want them to be.

Here's another video that I find truly inspiring.

Thursday, October 25, 2012


Student discount card
Early in September the government launched the 1Malaysia Student Discount Card (KADS1M). To date, close to a million full-time students from public and private universities have been issued with the card.

Last week the government announced that the card would be extended to part-time students as well as students studying overseas. 2,633 retail outlets are participating in the KADS1M, with more to come on board. With the card, students can enjoy discounts on a wide range of items, including food, books, stationery, sports equipment, clothing, medical check-ups, optometry, hotel accommodation, beauty products and IT products.

This is good news. Helping students cope with the rising cost of living is indirectly helping parents save on financial support for their children in university. The government deserves credit for this although the timing is such that critics of the ruling party are bound to link this laudable initiative to an attempt to buy votes for the coming General Election.

Students get discounts on all the above items with their KADS1M. Shouldn't senior citizens, especially those in the lower and middle income bracket, have their own discount card too? 

My question to the government is this. When will senior citizens get a discount card similar to KADS1M? At the moment the only government-backed concession card they have is the Rabbit senior citizens card. With this card, they are entitled to a 50% discount for travel on RapidKL buses, monorail, Putra LRT and the Ampang Line.

In Australia, for example, seniors cards are issued to citizens aged 60 and above "in recognition of the contribution that they have made - and continue to make - to the Australian community", as stated on the website. Now that is appreciation!

The card entitles senior Australians to discounts on purchases for travel, electrical goods, pharmaceuticals, computers, magazines, restaurants meals, and a whole host of products and services, including yoga classes.

In Malaysia, some restaurants, pharmacies and retail outlets do offer senior discounts, but more often than not, these discounts are subject to a list of terms and conditions. Oftentimes these discounts are so minuscule it does make one wonder about the sincerity of the issuing vendors. For instance, seniors get only RM1 off movie tickets at GSC cinemas for weekday shows before 6pm. The Kuala Lumpur Performing Arts Centre (KLPAC) used to have discounted tickets for seniors, but have since withdrawn the concession 'as seniors can afford to pay regular prices'. Not all of them can.

Wouldn't it be great to have a seniors discount card for Malaysians aged 60 and above? Then I wouldn't have to carry with me a dozen plastic cards. I just have to bring along one seniors card for a day's outing in the city. Plus my credit card, of course.

Still time to sign up for Guardian's Golden Privilege card for 
senior citizens and use it for these purchases.
When you don't have a steady stream of income, every ringgit counts. For retirees, a seniors card would certainly go a long way to help offset price increases and stretch their savings.

Wednesday, October 24, 2012


I came across the above in the New Straits Times a while back. It got me thinking. If it costs RM317,000 to raise a child from the day he was born to the day he celebrates his 17th birthday, how much would it cost to care for an elderly parent, say, from the age of 70 to 87?

I doubt any study has been done on this here. From what I've heard, most financial planners don't even advise their clients to allocate a certain sum to cover the cost of looking after their elderly parents, or paying for their healthcare and medical expenses. Bear in mind the aged have no health or medical insurance.

The bookend generations - the very young and the very old - have much in common. Both are dependent on others to help them, so their needs are quite similar. Except for a few items, the above list of costs incurred in raising a child applies to caring for an aged parent too. At least we now have an idea of how much it will cost us to look after our parents.

The cost can easily double or triple if our parents require special nursing care. What happens when adult children can no longer afford to care for their parents?

According to a recent report in The Star, up to June this year, 157 patients above 60 were abandoned by their families at hospital. A total of 205 senior citizens were abandoned last year. 95% of those abandoned came from poor families. Statistics from the Fourth Malaysian Population and Family Survey conducted in 2004 by the National Population and Family Development Board show that about 675,000 elderly parents did not receive financial support from their children.

Isn't this shocking? But that's the reality of life. The family institution of past generations has disintegrated, no thanks to changing family dynamics and to an erosion of family values. While there are kind people who would adopt abandoned babies, who would want to 'adopt' abandoned old people? Babies are so much cuter and have their whole lives ahead of them. Old people are all wrinkled and nearing the end of their lives.

The Tong Sim Senior Citizens Home has been receiving generous donations of provisions since The Star (8 Oct) featured it in their cover story. What the home needs now is not food supplies but household items like washing detergent, garbage bags, adult diapers and toilet rolls.

I visited the Tong Sim Senior Citizens Home yesterday. I was there to deliver provisions purchased with proceeds from past seminars organized by Seniorsaloud. It is heart-breaking to see so many elderly folks who are there because they have nowhere else to go. It is through the kindness of Mr Cheong Loy that they have a roof over their head, albeit on the upper floor of Mr Cheong's funeral parlour.

As parents we don't want to be a burden to our adult children. The latter have their own young family to take care of. Unless we are blessed with good fortune, we need to continue working as long as we can, save as much as we can, and look after our health. That's our responsibility.

Remember, we may still be active and independent now, but a day will come when we too will be our parents' age. When we reach our 70s and can no longer work to support ourselves, who will look after us? Aside from financial support, we need assistance with ADL (activities of daily living). We can't take filial piety for granted, especially if we haven't laid the foundation for bonding with our children when they were growing up.

Time to take stock of our future, so as to be better prepared for a smooth and pleasant journey into the sunset years.

Sunday, October 21, 2012


How does one refer to folks who have lived past the retirement age and are moving on into their 70s, 80s and even 90s? This huge demographics defy labelling. To lump everyone born between 1900 and 1952 as 'senior citizens' is to over-generalize. Senior citizens are not all the same. Many people my age (I am 64) would object to being referred to euphemistically in Malaysia as 'warga emas' or 'golden citizens'. Call them 'elderly' and you can be sure of rubbing them the wrong way.

So we have terms like 'the young old', 'the middle old' and 'the old old', which are just as inadequate and clumsy. If we divide age into numerical units, we have the following age categories:

Helen Mirren - a sexygenarian at 67
between 60-69:  sexagenarian
between 70-79:  septuagenarian
between 80-89:  octogenarian
between 90-99:  nonagenaran
between 100-110: centenarian

But if numbers don't matter, and chronological age is not an accurate indicator of physiological age, what are we left with? How would you like to be referred to? 'Older people' seems to be the least disparaging and most neutral. With people now living much longer, there is a need to come up with new labels for the old (pun intended) that do not smack of ageism, and that is acceptable to all.

If this retired teacher can cycle all the way to London, what excuse do I have not to cycle round my apartment block to stay fit and healthy? (Photo grab from The Star)
Hats off to Eva Ho, 71. Pole dancing is not for me. I'm learning to dance Gangnam Style - much safer! (Photo grab from The Straits Times)

If the 60s is the new 40s, you can understand why labels like 'old', 'elderly', 'frail' no longer describe the active, independent and fun-loving baby boomers of today. By the time we reach our 70s, 80s and 90s, we will be re-defining the face of ageing.

With plenty of inspiring role models to show the way forward, growing older doesn't sound so dreadful after all. There is a world of difference between growing old and growing older. And it's a lot to do with how we look at ageing - positively or negatively, with anticipation or dread.

The Rolling Stones (from left) Charlie Watts, 71, Keith Richards, 68, Ron Wood, 65, and Mick Jagger, 69. They have just announced their concert dates for November and December 2012. Still going strong after 50 years.

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Friday, October 19, 2012


Alzheimer's purple ribbon 
It's been a week now since the National Caregivers' Seminar up in Genting (see previous post). I continue to receive email enquiries about the seminar and also about the daycare centres that were recommended. Some of you have written to me about the daily challenges you face as a caregiver. I thank you all for writing and for sharing. I am glad many of you have found the post informative and helpful.

Here are two videos I would like to share. The first video was screened during Dr Donald Yeo's presentation at the seminar. It features well-known psychologist Dr Richard Taylor who has dementia. He has made it his mission to change public perception of people who have dementia.

The second video is a BBC interview with singer-songwriter Glen Campbell and his wife Kim after he was diagnosed with AD in June last year. At 76 and battling Alzheimer's, it is incredible that Campbell still remembers his lyrics and guitar chords. Truly an inspiration. Click here for a Youtube video of clips from Campbell's goodbye tour in February 2012. Do view especially if you are a Campbell fan.

In Singapore, it is estimated that about 28,000 seniors aged 60 and above suffer from dementia. This number is expected to increase to 80,000 by 2030. A study called WiSE (Well-being of the Singapore Elderly) is currently underway, led by the Institute of Mental Health, to better understand dementia in order to provide early intervention and reduce the burden on caregivers.

Alzheimer's Disease is the most common form of dementia. There is currently no cure for AD. For this reason, it is often referred to as 'The Long Goodbye'.

Tuesday, October 16, 2012


Last weekend I attended the National Caregivers Seminar organized by the Alzheimer's Disease Foundation of Malaysia (ADFM). It was time well spent as I learned much and met with caregivers from Johor, Malacca, Penang and Ipoh. As any caregiver will tell you, knowing there are others who are facing the same challenges gives you the vital support to get through each day of care-giving.

For the record, here is a list of the doctors who spoke and their presentations:

  • Dr Lee Fatt Soon (General Hospital, KL) - "Managing Medical Conditions in Dementia"
  • Dr Donald Yeo Hong Huang (General Hospital, Singapore) - "Person-Centred Dementia Care - The Singapore Experience"
  • Dr Ho Bee Kiau (Health Clinic, Klang) - "Mentally Stimulating Activities Can Delay Dementia"
  • Dr Gemma KC Law Wong (Hongkong University, HK) - "Caring for Someone with Dementia in Home Environment"
  • Dr Lu-Ann Chong (UMMC, PJ) - "Prevention of Alzheimer's Disease - Healthy Brain Initiatives"
  • Dr Bharathi Vengadasalam (UPM, Serdang) - "Ain't Misbehaving: Understanding and Managing Difficult Behaviours"
  • Dr Tan Maw Pin (Universiti Malaya) - "Fall Risk Assessment on people with Dementia and Effective Preventive Measures"
  • Dr Esther Ebenezer (Royal College of Medicine, Ipoh) - "Caring for Someone with AD"
  • Mr Thillainathan Krishnan (Hospital Selayang, KL) - "Assisted Daily Living for Person with Dementia"
From left: Dr Gemma, Dr Lee and Dr Esther

Day 1 began on Friday evening with an interactive caregivers' dialogue with Dr Gemma and Dr Esther. Caregivers shared their experiences looking after their elderly loved ones, and nurse managers of care centres also shared creative ideas on how to handle difficult situations with AD clients.

Everyone who spoke had the same advice to share with caregivers:
  • Look after yourself. A stressed out caregiver is of little help to the person with AD
  • Take a break when you feel overwhelmed, and don't feel guilty about it.
  • Adopt a positive attitude and learn to accept little acts of 'misbehaviour'. 
  • Know you are not alone. Join an AD caregivers support group.
Strong support from caregivers, members of the medical and nursing fraternity as well as the public.

Some of the caregivers brought along their elderly parents. It was touching to see the loving care and patience shown by these caregivers. These acts of filial piety auger well for the future. Our children learn from us. They follow by example. How we treat our parents is an indication of how our children will treat us in our old age. 
Herbert Chong (right) shares the role of caregiver with his brother Chee Wah. Their father, Chong Kim Swee (left), 85, stays two weeks in rotation with each son. Shared responsibility helps to reduce the stress of care-giving.
Tan Suat Eng (right) with her mother Ng Siew Poh, 83. Mdm Ng lives with her youngest son on the first floor of a condo. Suat Eng is on the third floor so she gets to spend time with her mom daily. A very practical arrangement!
Caring for a parent with AD requires the cooperation  and support of the whole family. Care-giving is not only a drain on your financial resources but also on your energy. So when the whole family shares in looking after mom or dad, everyone benefits.

Here is a selection of slides that might be of interest to our viewers.

Scary figures. Knowledge precedes action. Governments need to intervene and be prepared for the dementia tsunami as the population ages. (Above slides from Dr  Lu-Ann Chong's presentation)
People with dementia have the same wish list as any of us. Why should we treat them differently? (Above slide from Dr Donald Yeo's presentation.)

Dr Bharathi's slides below highlight some of symptoms we should look out for, and offer practical advice on how to care for those with dementia.

All of us experience forgetfulness on a daily basis. Is this part of the ageing process? No, it isn't. It is only when forgetfulness affects our activities of daily living (ADL) that we should be concerned.

Occupational therapist Mr Thillainathan Krishnan explains ADL. Are our elderly parents able to perform all these activities independently?
Dr Tan points out that falls increase dependency on the caregiver, especially in using the stairs, toilets and showers.

Here is a list of registered Dementia daycare and residential care centres in Malaysia:

Nurse managers: (left) Jade Wong who manages the ADFM daycare centre in PJ, and (right) Angela Lee who runs the Dementia Homecare Centre in Telok Panglima Garang, Klang. Both have degrees in Nursing.

Dementia Care Centres:

Rumah Alzheimer's
6, Lorong 11/8E, Petaling Jaya, Selangor
Tel: 603-7956 2008 / 7958 3008

KL Daycare Centre
9A, Lorong Bukit Raja,
Taman Seputeh, Kuala Lumpur
Tel: 603-2260 3158

Dementia Homecare Centre
PT 715, Jalan Pandan 26,
Telok Panglima Garang, Selangor
Tel: 603-3122 6908 

ACE Daycare Centre
115-1, Jalan Mayang 3
Taman Peringgit Jaya, Malacca
Tel: 606-284 7886

JOBADA Activity Centre
43, Jalan Petri, Kampung Tarom, Johor Bahru
Tel: 607 - 222 4016

Dementia Daycare Centre
15, Jalan Foo Choong Nyit, Ipoh
Tel: 605-241 1691 or 019-571 2738 (April Loh)

ADFM Head Office
6, Lorong 11/8E, Petaling Jaya, Selangor
Tel: 603-7956 2008 / 7958 3008
Fax: 603-7960 8482

Saturday, October 13, 2012


Front page of the New Straits Times (13 Oct 2012)

Here we go again. Sigh. Clarification needed one more time.

In Malaysia, the term 'pensioners' refers to retired civil servants, and 'pension' refers to a sum of money that the government pays each month to those who have retired from government service at the age of 55 (now extended to 60).

Pensioners do not include people who have retired from private companies. So it is misleading to say that "retirees earning more now...thanks to improvements to the pension scheme". In fact, if you were to ask private sector retirees, most of them will tell you they have nothing much to smile about.

(Above: Obama is reaching out to the middle class in his re-election campaign.)

There is no private pension at the moment. What private sector employees get when they retire is a lump sum withdrawal of their EPF (Employees Provident Fund) savings. That's it. Period. This amount (or whatever is left if partial withdrawals have already been made for medical expenses, children's education, etc) has to sustain them for all 10-20 years of retirement. The middle class who are not eligible for welfare, subsidies and handouts, are finding it a challenge to cope with the escalating cost of living.

Enough said. Just read earlier post "Pensioners get the cake, retirees get the crumbs".

If you can't read the small print, click here to read the full article.

Let's crunch some numbers.

Based on the National Population Census 2010, we have a population of 28.3 million. Of this number, 2.25 million are aged 60 and above.

Our civil service is 1.42 million strong. The number of pensioners now stands at 662,000. That means we have a total of 2,082,000 citizens who are grateful to the government for taking good care of them and their families.

The remaining 168,000 are retirees, but not pensioners. Excluding those from the lower income group who are eligible for financial assistance, this leaves only a small number of retirees from the middle income group who are unhappy with the government. They feel they have been neglected. Is this number too insignificant for the government to be concerned about in the bigger scheme of things?

What do all these numbers mean? What do they translate into?

Well, draw your own conclusions.