CAREGIVERS WHO DON'T CARE A DAMN

This video caused a furore in Singapore when it was first screened on Channel 8 news Thursday night. After conducting an investigation of the nursing home in question, the Ministry of Health (MOH) has issued an order for the home to stop admitting new residents.

Outraged citizens have expressed shock and disgust at the abusive treatment meted out to the 75-year old woman in the video. According to the news report, the woman was made to sit naked for 30 minutes under the full blast of a ceiling fan, and then flung onto her bed. When she groaned, one of the caregivers slapped her on the mouth.

Since the news broke, people with elderly parents at the home have come forward to relate similar incidents. Obviously this is not an isolated case.

Close-circuit cameras at a nursing home to monitor the staff and ensure all's well. (Source: Straits Times 11 June)

Elderly folks can be cranky, obstinate and verbally abusive. It takes a lot of patience to look after them, more so if they are mentally or physically unable to take care of themselves. You have to feed them, bathe them, change their diapers, accompany them to the toilet, give them their medicine and make sure they do not hurt themselves. Not everyone has what it takes to be a caregiver. When caregivers are overworked, the stress can translate into mistreatment of the very people they are supposed to look after.

This is not meant to defend errant caregivers, but rather, to place the onus on nursing home operators to ensure better supervision of their staff. For one, they should adopt MOH's guidelines on staff-resident ratio to ensure that the staff are not overworked and taking it out on the residents. This ratio varies depending on the category of residents:

Category One: physically and mentally independent residents who require less attention. Ratio of staff to residents is 1:30.

Category Two: semi-mobile residents who require some assistance with daily activities. Ratio is 1:8.

Category Three: wheelchair bound or bedridden residents who may have mental sickness. Ratio is 1:4.

Category Four: fully dependent residents who have mental or behavourial problems and are unable to cope with daily living on their own. Ratio is 1:2.

Lunch time at one of the better managed nursing homes I have visited.

I have visited enough nursing homes in the past weeks to know that many of the staff are overworked and underpaid. At one home for the aged in Petaling Jaya, I saw how one of the caregivers was feeding an elderly woman. The latter was still chewing the food when the next spoonful was shoved into her mouth. It's a wonder she didn't throw up. That particular caregiver was in a hurry as she had several other residents to feed. At another home, wheelchair-bound residents were left in front of the TV set where they would sit and stare blankly at the screen for hours. There was no programme of activities to occupy them.

One of the many privately-run homes in Petaling Jaya.

So before you register your loved one in a nursing home, do all the necessary checks. You can't rely solely on the information contained in promotional brochures or websites. Or even what the staff tells you. Drop in unannounced for a surprise visit, say, during meal time. You will have a better picture of how the residents there are treated and how well the place is managed. Be prepared for some depressing sights.

SHE AIN'T HEAVY, SHE'S MY MOTHER

My 85-year old mother is in relatively good health and able to move around with the aid of a walking stick. But her memory is fading. There will come a time when she will need more care.

With my siblings all busy with their own lives, I know I will end up as my mom's sole caregiver by default. It is a role I have taken on for the past 15 years. So I won't be in unfamiliar territory. The only difference is my stress level will probably shoot up, and I will have to make changes in my lifestyle. Will I be up to the task?

Dr Lee Wei Ling's article "Who cares for the caregivers?" published recently in The Straits Times must have resonated with many women who have to look after an ailing elderly parent.


Source: Straits Times 30 Jan, 2011


I quote an excerpt from a letter a reader wrote in response to Dr Lee's article. Dr Lee heads the National Neuroscience Institute of Singapore, and is the daughter of Lee Kuan Yew, former Singapore PM.

"The emotional and psychological stress of the caregiver takes its toll and very quickly the caregiver becomes very tired and drained. There are no support groups, as far as I know, where caregivers can share common experiences and frustrations so the caregiver in Singapore has to rely on the listening ear of good friends and relatives who have the time to spare.



I live this frustration every day despite having a dedicated maid to take care of all my 91-year-old mother's needs. I worry when my mother doesn't eat right. I worry when she complains of aches and pains. I worry when she becomes sullen and depressed, which is most of the time.


I tell myself I shouldn't care if she eats her meals or not, but I do. I don't get any smiles or thank yous from her and most times I feel she is unappreciative of whatever I do. All I get are scowls and frowns and complaints that the food I cook (I do all the cooking) is not done right.


So how do you stay motivated to do this every day? How does the caregiver block all negative thoughts?"


File photo

If caregiving can extract a high physical, mental and emotional toll on a filial daughter, it must be 10 times more so for a son. Click here to read Matthew N's scathing article about how looking after his 64-year old mother is driving him nuts. He calls her a 'drama queen', a 'sympathy junkie' and much worse - too profane to quote here.

I am glad none of these labels fit my mom. She may be difficult at times, but she's the only mother I have.

For my personal tips on caregiving, do click here to read my article "Caring For An Elderly Parent" which was published in the Singapore Women's Weekly, Nov 2009 edition.

SIMULATING BEING OLD

Source: Straits Times

Would caregivers for the elderly do a better job if they could experience the daily challenges that their patients or loved ones go through?

The Tsao Foundation of Singapore believes so. The voluntary welfare organization has been running workshops to train staff of the SingHealth group to better understand the daily challenges faced by the elderly in carrying out simple tasks. So far 400 of the 20,000 employees have attended the workshops in batches.

My mom's daily calendar on the left, and my wallet-size 2010 calendar on the right. As we age, we need larger text to enhance readability.

Given that about one in 11 Singaporeans today is aged 65 and above, and one in five by 2030, this initiative is timely.

Workshop participants don partially blurred glasses to experience what it is like to perform tasks like reading labels on medicine bottles, or buttoning up a shirt with their fingers bandaged and unable to bend.

If you have missed this year's programme, make sure you sign up for it in 2011. 

Malaysian Healthy Ageing Society conducts a comprehensive training programme for caregivers for the elderly. If you are looking after an elderly parent or relative, you will find the 2-day programme extremely helpful.

TRAINING THE CAREGIVERS OF THE ELDERLY

My mother will be 83 in October. Except for a couple of age-related problems, she is in relatively good health and physically independent. Still, a time will come when she will no longer be able to do things for herself. Would I be sufficiently equipped with the know-how to look after her? As her sole caregiver, I was delighted when I found out that the Malaysian Healthy Ageing Society (MHAS) and The Faculty of Medicine and Health Sciences of Universiti Putra Malaysia (UPM) would be jointly conducting a series of talks to help train caregivers of the elderly.

Particpants came from all over the country.

I immediately signed up for both the basic and the advanced programmes. Thanks to Abbott Nutrition who sponsored the event, the fee was only RM40 for each programme.

Ms Sivaneswari Pillay sharing her experiences as a caregiver during the Q & A session. The other panelists were pharmacist Pn Syahida Embi and consultant cardiologist Dr Wong Teck Wee who spoke on Medical Warning Signs.

MHAS did an excellent job of putting together a panel of medical professionals and healthcare specialists to share their expertise on topics ranging from medication and caring for patients with diabetes, stroke, or depression and chronic problems like constipation, incontinence and poor nutrition, to basic resuscitation and first aid. Participants were taught how to clean wounds, including bed sores, and the proper way to move a patient. There were talks on bone loss, memory loss and hearing loss, as well as sessions on alternative therapy and how to deal with family conflicts.

Consultant geriatrician Dr Yau Weng Keong gave tips on how to manage pain in the elderly.

Consultant physician and geriatrician, Dr Rajbans Singh, enlightened participants on the role of supplements while Ms Theresa Commadeur demonstrated the technique of tapping to relieve stress.

The organizers slotted in as many topics as time would allow. There were topics as diverse as skin and foot care, beauty and grooming for the elderly, and stress management for the caregivers to tips on how to choose a good nursing home. The President of MHAS, Assoc Prof Dr Nathan Vytialingam spoke on intimacy in the elderly and preparing for death, while organizing chairman, Ms Ranuga Devy, who is an advocate and solicitor, counselled participants on the importance of estate planning. The latter drew quite a bit of interest from the participants as it was an opportunity for them to seek free legal advice!

MHAS president and consultant occupational therapist Assoc Prof Dr Nathan (top) and Organizing Chairman Ms Ranuga Devy.

At times, it was a case of information overload as participants tried to absorb as much as they could. There was plenty that I picked up which was immediately applicable to my role as a caregiver. The four days of training definitely gave me a better understanding of my mother’s current and future needs. I am now in a better position too to prepare for my own old age.

The “Train the caregivers of the elderly” (TCE) programme moves on to Penang on 16-17 May, then back to Kuala Lumpur on 4-5 July, 8-9 August, and ends in Johor Bahru on 26-27 September. Members get a 50% discount on the fee, so it makes sense to sign up for membership. Says MHAS president, Assoc Prof Dr Nathan, “Membership is open to all Malaysians aged 18 years and above. Our mission is to promote an integrative approach to healthy ageing for all.”

For more about MHAS and the TCE programme, contact 603 2070 5600 or visit their website at http://www.healthyageing.org