The Care Journal : The realities of giving care to the elderly

Caregiver Support

The realities of giving care to the elderly

Mr Lawrence Wong faced a dilemma.

His grandmother, Mdm Yeo Kim Kio who lived with him and his mother, was diagnosed with colorectal cancer. Both Mr Wong and his mother were holding full-time jobs: his mother worked in an office on weekdays, while Mr Wong held a job that required him to work shifts. Who was going to take care of his grandmother?

“We didn’t really know where to turn to for help. So we tried to care for her ourselves at home,” recalled Mr Wong. “Even though there were days when I could tend to her needs as I work shifts, we could not be there for her all the time. So, she would be home alone most of the day, and my mum or I would rush home after work to bring food home for her.”

Several months into this arrangement, Mr Wong and his mother had to make a painful decision. “As my grandmother got weaker, we thought it was best for her to be in a nursing home. She would be cared for at all times,” he said. “But I felt I had abandoned her.  The first time I visited her in the nursing home was bittersweet - I was happy to see her, but sad to leave her in an unfamiliar environment.”

Shuttling between home, work and visiting his grandmother in the nursing home was also draining. “I would usually only leave when she falls asleep because I could see she felt sad each time we left,” he said.

The struggles of caring for an elderly

Mr Wong’s experience is one that many families face each day. A national study conducted by then-Ministry of Community, Youth and Sports in 2012 showed that juggling caregiving of elderly parents or grandparents is a responsibility that most Singaporeans - 98% of them - take on.  These family member caregivers often struggled to care for the elderly while juggling work, their own family and children. Some may not know where to find additional resources in their community, or may find them too expensive to afford.

Caregiving can be especially tough if the caregiver is also elderly.

Mr Tan Rui Fa, 73 knows this. He has been caring for his wife, who suffered two strokes in the last four years. “Because she is wheelchair-bound, I have to take care of her all the time. Even going out to buy something from the market is tough,” he said.

Initially, Mr Tan had thought about putting his wife in a nursing home. The monthly fee was a concern for the childless couple, and Mr Tan also could not bear to part with his wife. “I made a vow that I would take care of her for the rest of my life. I couldn’t bear to part with her,” he said. He decided to take care of her at home on his own.

But it was difficult and stressful for Mr Tan, who suffers from aches and pains himself. Fortunately, Mrs Tan was referred to the Peacehaven Bedok Day Centre, run by The Salvation Army, for day care. With his wife in day care, Mr Tan gets a few hours of respite, where he can make some purchases at the market, and sit down at the coffee shop to have a cup of coffee.

Lightening a caregiver’s burden

 Besides Mrs Tan, as a caregiver, Mr Tan himself also requires care. The pilot Temasek Foundation Cares - CarerSupport@Centres programme is a partnership between Temasek Foundation Cares, the Agency for Integrated Care and five Eldercare Centres (under the Alzheimer's Disease Association, AWWA, SASCO Hong Kah North Day Care Centre for the Elderly, and The Salvation Army Peacehaven Bedok Day Centre). It supports caregivers so that they can better manage caregiving stress and continue to care for their loved ones at home. With the programme, caregivers will be offered resources and services such as care coordination.

Ms Stella Phua, a case manager and social worker at the Peacehaven Bedok Day Centre, explained why caring for caregivers is so important, “Care is more effective when caregivers are supported. Caregivers know who they can turn to when they have a problem, and would be more willing to listen to our advice for their loved ones.”

Providing respite care also plays a large part in relieving the burden of caregivers as some of the more physically demanding aspects of caregiving like bathing the patient can be handled by the Centres. Caregivers are given training and advice to help them better care for their family members at home. For example, Mr Tan was taught how to safely transfer his wife between the wheelchair and the bed, and how to manoeuvre the wheelchair on a ramp. Ms Phua also provides counselling and emotional support, or simply a listening ear, when he needed someone to talk to.

Plan for caregiving

Ms Phua believes that those considering caregiving for a loved one should have a care plan in mind. They should start by knowing the wishes of their loved ones and how much they can commit as a caregiver, taking into consideration their ability to handle the medical needs and resources available to support their loved ones at home and in the community. For example, what kind of caregiver training is needed? Who should be trained - the main caregiver or the domestic worker supporting the caregiving? What kind of services are suitable for the patient - day care, home care or a nursing home? Caregivers should also consider joining a support network in the community so they do not feel isolated.

Would having such care support be useful? Mr Wong believes so. “If we had known there were day care services for the elderly near our home and support for caregivers like us that we could have tapped on, it may have helped ease some of our worries and burden,” he said.

Watch Mr Tan Rui Fa’s story here: