FONG MUNTOH ON AGEING IN MALAYSIA: THE 4 PILLARS IN AGED CARE MANAGEMENT

FONG MUNTOH ON AGEING IN MALAYSIA: THE 4 PILLARS IN AGED CARE MANAGEMENT: 15 years ago I saw how Living trust worked to support an expatriate from Netherlands living in our Elderly care centre in the former hom...

THE 4 PILLARS IN AGED CARE MANAGEMENT

15 years ago I saw how Living trust worked to support an expatriate from Netherlands living in our Elderly care centre in the former homes that I managed.

Our centre only have to send our invoices to Netherlands and the resident's fee will be paid online. When additional medical costs were incurred we just sent the total bill to Netherlands and it will be reimbursed.

I thought that was great, and that was why I propagate the idea of 4 pillars of ageing which my friend used to start a company to provide swupport for total aged care management.

How does a total aged care management system works?

It goes like this, the 4 pillars are Care Centre Operations, Administration of Care Management, Trustee and Funds Management.

These four pillars are to help the elderly answer a few important questions.

Q 1. I have no other relatives, there is only me and and my wife, who will take care of anyone of us if one of us die first?

Q 2. Whom can i trust among my relatives and friends to help managed my funds when I am mentally incapacitated?

Q 3. What will happen to my funds and money after i am gone?

All these are real issues which I have given consultancy to. I believe organisations of reputes and with good ethos should consider setting these four pillars to help their community. We do not have to worry about the rich, they have their plans and people and corporate bodies to managed their lives and funds. It is the middle income with not enough clout to access such set ups.

The first pillar, which is the care centres will provide the care required by elderly.

The second pillar is the administrator of care centres, which function as a quality control and assessor of care centres and advise the elderly or the trustee board.

The third pillar, which is the trustee’s job is to ensure the funds are well managed and to ensure that the funds can last the lifetime of the elderly.

The fund management shall be provided by financial institutions, which can be a bank or any other financial institutions job is to ensure the funds grow at an acceptable rate.

I will talk more on this later.

AUTUMN IS GOLDEN

AUTUMN IS GOLDEN AND BEAUTIFUL

I named my agedcare academy Autumn and many asked why autumn, it sounds like winter is coming and nothing to look forward to. I told them it is because to live is to acknowledge the truth and that death is not a bad thing but something to embrace for what is life if there is no death. I borrow a beautiful passage on autumn from a friend's posting , I do not know where it is from but it is beautiful.

Signing MOA with Open University Malaysia's Professor Dr Richard Ng

There comes a time in our lives when the innocence of spring is a memory and the exuberance of summer a song whose echoes faintly remain in the air, when, as we look out on life, the problem is not how to grow but how to live truly, not how to strive and labour but how to enjoy the precious moments we have, not how to squander our energy but how to conserve it in preparation for the coming winter. A sense of having arrived somewhere, of having settled and found out what we want. A sense of having achieved something also, precious little compared with its past exuberance, but still something, like an autumn forest shorn of its summer glory but retaining such of it as will endure.

I like spring, but it is too young. I like summer, but it is too proud. So I like best of all autumn, because its leaves are a little yellow, its tone mellower, its colours richer, and it is tinged a little with sorrow and a premonition of death. Its golden richness speaks not of the innocence of spring, nor of the power of summer, but of the mellowness and kindly wisdom of approaching age. It knows the limitations and its richness of experience emerges a symphony of colours, richer than all, its green speaking of life and strength, its orange speaking of golden content and its purple of resignation and death. And the moon shines over it, and its brow seems white with reflections, but when the setting sun touches it with an evening glow, it can still laugh cheerily.

HOME ENQUIRERS SELDOM TELL THE FULL STORY

One of the most common statements by enquirers to the care centres where I was and is now is;

"Oh my mom/dad can fully take care of themselves, they can feed themselves, shower themselves and feed themselves and they do not need much help."  

Yeah right.... In fact this statements raised my antenna every time they say it.

I mean if an elderly person who is independent , why then do their children want to explore the possibilities of sending them to a elderly home. Why must the children subject their elderly parents with the feeling of rejection, neglect and unwantedness? Make no sense to me and make no sense to a cow either.

I have many such enquiries and discovered during interview and assessment that their parents are suffering from alzheimer and dementia in general and need medication. Very often the missing information is that my parents do not sleep at night and walk from room to room, perfect for security guard job. They did not tell you that their parents are violent at home and beat their loved ones. One such experience crossed my path recently. I had a 91 years old lady with serious dementia and when she goes off the rail she will disturb everyone, she will scold everyone in typical flowery chinese language bringing up other peoples parents, family, organs and ancestors, in short swearing all the the way. She can even beat up people with the strength and power of Ip Man with he r walking stick. Two of our strongest ladies can't hold her back.

Another common enquiry with insufficient information is this;

" Oh my mom/dad is on wheel chair and JUST  need some basic day to day care like shower and daily care. Very easy to take care."

This could mean many things. The parents could be big in size or tall or hard to carry or handle. They could be suffering from arthritis and body is painful from top to bottom or they have bedsores that need serious managing and care. Sometimes they did not tell me that their parents are about to die. There are children or their spouses who do not want their parents or father in law and mother in law to die in their house. 

Generally many people are desperate to get rid of their parents from their home, and I do not mean it in a bad way. Many children or carers are just desperate for help in this area of care. They are tired, they are arguing with their brothers and sisters and whom their beloved parents loved more. They are fighting to see who should pay what. They are fighting with their spouses.

Not too long ago, a couple and their niece were desperate to get better care for their brother of the man and father of the niece. They told me oh his condition is very easy to manage and to care for. His condition actually needs a good nursing care and trained nurses are the best to manage his condition. I just had to reject their application to our home. 

There is no end to desperate children in desperate situation till they are will to say what is necessary to get a care centre to accept them.

I hope I can live long enough to build an eco system to help more children with elderly parents to care for their parents in their home.

HOME CARE VERSUS HOME CARE

I am playing with words here. I am referring to the choice of choosing sending your ageing parents to a home or centre to be cared for or employing care givers to go to your home to care for your ageing parents.

I received a call one day, just like any normal day I get many calls asking for help and suggestions on how to take care of their parents. It was from an Indian male professional, race is added in not as a racist comments but to emphasize the ageing parent issues are not a problem for a particular race or nationality. Just so happened this happened to be an Indian man. I get calls like this from all races.

This man told me that he has problem with getting reliable maid to care for his father. They all ran away after two to three months.

I said, "Wait, let me guess. "Your maid worked 24/7 without rest right?"

He replied, "Yes"

I said, "Brother with working conditions  like that even I want to run away."

It is very common to get family members turning to  cheap maids to care for their ageing parents. They treat them like a maid and expect them behave like a care giver. The rationale in the mind of many family members who hired care givers was,"After my mom or dad slept, they have time to do other things." Very often, family members try to fill up the leisure hours of the caregiver.


Important note: Caregiver is not a maid, their job is to care, they are entitled to their rest. If they don't rest they cannot do their job.

So let care givers be care givers, if you think paying a maid RM1,200 to care for your parents and to do house work is what you wanted them to do, good luck to you .


So when do one decides on care at a elderly home or care in their own home? In Malaysia it is usually when it is medically impossible and physically draining and financially limitations do Malaysians send their parents to an elderly home.

If one can afford RM4,500 monthly then they can choose having caregivers caring for their parents at their own home.

Sending ones parents to a elderly home is a traumatic experience with a few psychological and emotional consequences. The elderly will feel abandonment and rejection, while the children will fell useless for not able to care for their parents themselves.

Whichever options appear, one can only take it one step at a time.

I NEED POSITIVE AFFIRMATION FROM PEOPLE I HELPED

Without sounding like a glory hunter, I must confess that I too need some positive affirmation from people whom I have helped. Sometimes in my journey to help others, I always wonder if my suggestions had helped them in anyway.

Recently a lady name Miss Tan called me. She got my number from a cousin who was a former colleague of my cousin. Her situation was that her father was very ill and many of his organs were failing and needed a home with proper medical care. She had searched high and low but found none as she also wanted a single room as her father also had weak immune system and will get flu quite easily.

She contacted me and I found another wonderful friend who managed a successful nurse company with over 600  nurses. My friend sacrificed a double room to make it single for Miss Tan and gaver her a very big discount.

Later Miss Tan called me and asked me , " How did you get the special deal for me? I contacted this company (my friend) and they cannot accommodate me?"  I replied, "My friend and I went go back a long way."  Miss Tan was happy and I will share screenshots of our conversation.

This was the first communication between Miss Tan's cousin and myself.

This message from Miss Tan and Wai Teck is her cousin, and he was my cousin's ex colleague. Never mind the tongue twister.

My reply to Miss Tan

After visiting Miss Tan's dad, My friend who owned the centre took me for a free lunch.

About a month later mid July 2018

This was our final communication.

It was a happy sad ending for Miss Tan, Happy that her dad no longer suffered. Sad that he was gone. To all those who had passed my way, may God bless you and your family and thank you for your encouragements through social media or otherwise. Your encouragements gave me strength to carry on.

EPILOGUE - MANAGING YOUR ELDERLY PARENTS

Further to my posting early in the morning of 25 July 2018 i received the foolowing updates from my friend's son.

Here are the updates:

[09:30, 7/26/2018] Ray: Wah...you featured our story in your blog! FYI, my dad couldn't do the procedure after consulting 3 specialists. The soft bone between his vertebrae are already quite worn out and the procedure (called Neucloplasty) is basically removing part of the soft bone. The only available procedure is to inject steroids into his back (like epidural) which is not necessarily successful but may offer temporary relief. In any case, we checked him into the nursing home almost 3 weeks ago. We got him a single room as they didn't recommend sharing because of my dad's psoriasis which may scare the other patient. A few positives can be experienced by my dad after only one week: 1. His back pain practically stopped! This is possibly due to the proper handling of him at the home. He was indeed very pleased with this development as this is a great improvement to his quality of life. 2. As his pain reduced significantly and proper moisturizing of this skin, his psoriasis improved significantly as well. Another positive outcome for him.

[09:36, 7/26/2018] Ray: I will be back to Ipoh this weekend to visit him and I hope to see that his skin condition to return to normal. One issue which needs more attention is his bedsore. They are changing his diapers 6 times daily as opposed to 3 times daily when he was at home. We are paying extra for the nurses to tend to his bedsore. I believe my dad is quite comfortable in the home (if not quite happy) as he has most of his leisure items with him such as his smartphone, iPad and computer (which I got a new one for him). I would like to thank you for your invaluable advice and we are now managing this 1 week at a time. Hopefully we can then move to 1 month at a time in due course. Shall keep you updated! Cheers!👍🙏

[09:43, 7/26/2018] Muntohfong: Good to hear bro.  Your story that I shared touched  many people and will help many.

[09:45, 7/26/2018] Ray: You may update your blog with the recent development. Hopefully, others will find it useful. Once again, thanks a million! Take care!

[09:46, 7/26/2018] Muntohfong: Yes Raymond your dad's life is still helping others in his last journey.

MANAGING ELDERLY PARENTS- TAKING 1 DAY, 1 WEEK AND 1 MONTH AT A TIME

An 81 year old friend spoke to me and shared his problem. Cannot walk, hearing weak, bedsores at both butt cheeks and spine sitting on his nerve. He is getting 4 to 5 episode of painful attack, maid is going home and he needs an operation to solve his spine problem. He needs MRI but the pain so bad when he lie down, he has to move , so MRI is out.

He asked me to speak to his son. I did, and his son told me he has made all the arrangement to have the operation in Fatimah hospital in Ipoh...but the next part is the issue...no one to care for the father...he told me that he found a pakistani with work permit who can take care of him and I said no way any pakistani can enter and have a work permit to be a care giver on their own. Still one person cannot take care of your dad.

So the eldest son in Australia suggest nursing home or care centres, the youngest child, the daughter don't think it is a good idea. And this son in Malaysia found it hard to convince the father to go to a nursing home

So here is my reasoning why my elderly friend needs to go to nursing home.

1.  His conditions needs constant care. At home with one carer is not enough.

2.  The wife will be of no help in moments of pain.

"But the father don't want to go to nursing home and stay", my friend's son replied. So I said this.

Take 1 day, 1 week and 1 month at a time, this is not the corporate world where we can set goals for the next 5 years. Even corporate goals set and implemented by young brilliant minds very often failed. Managing an ageing parent needs a paradigm shift, no two elderly persons aged the same way so we need to work with each one differently.

Then i told him the secret that gave the son the peace of mind to manage this.....I said..."Let him go into the home after operation. Don't think if it is only for a month or two. Remember the home may be operated by caring people but it is also a business, they will do their best to please and make your father comfortable to stay on." 

And in a moment of eureka the son laughed out loud saying, "Haha, that is a comforting thought."

You know what, “ I know this because I managed two centres before.”

IT IS NEVER OUR OWN FAULT, IT IS ALWAYS SOMEONE ELSE'S FAULT

When standards and quality of care is poor in any industries, people will point straight to education, training and the type of people we got for doing the job.

So let’s start with education, is our education level poor, I do not think so, we have many forms of education from government school, private school, international school and even home school. They focused on education and preparing people for further education and to be part of the work force. The system encourages people to be a professional like lawyer, doctor, engineer, IT expert and accountant. Our education never talks about ageing or becoming a care giver or going into the care business. it teaches the 10 core subjects at primary and secondary school and then send you of to colleges and universities

Most parents never hope their children to be a care giver, it is a low-grade job, a dead end job. Truth is I was like that too until I was managing care centres and saw the need for better quality people.

Years ago, when I was studying in England, I had a chance to chat with a bus driver and asked me what I am doing in England and why I can speak good English unlike the Chinese restaurant workers. And then I asked him about his job and he told me love this job and that he graduated from universities with an arts degree but somehow felt that working in offices just do not fits him. I asked him a typical Malaysian or even Asian question, “What did your parents say about you being a bus driver with a bachelor degree?” He replied without a flinch, “Hey a job is a job, it is not about the degree, it is about doing a good honest job, well?”

He had me there for a while and left me this powerfully engraved impression in my mind and heart till today.

WHAT IS THE GOVERNMENT DOING ABOUT OUR AGEING PROBLEMS?

When I started to talk to people about elderly centres, everyone will talk about how good are the centres in Australia and England. And then they will say we should have something like this in Malaysia. When I told them there are a couple of centres like this and it costs RMxxxxxx, they will say,” Oh the government should do something about this problem?” I told them they should move to Australia or England if they think their elderly centres are so good.

According to Knight Frank Wealth Report which measures the net assets of individuals across the world and it states that there are 41,750 millionaires in Malaysia in 2015. these made up only 0.14% of total Malaysian population. These are the rich or super rich, for this group of people retirement and where they live as they age is not an issue. When I discussed this statistics with my friends, they felt it is impossible that Malaysia only has slightly over 40,000 millionaires. The property prices in most cities in Malaysia are over a million, therefore, there should be more millionaires. Two things to note is that first, the statistics is based on year 2015. I am sure we have more millionaires now. Secondly, Frank Knights based their reports on net worth, which means, total asset minus liabilities. So, owning a million ringgit house does not make one a millionaire, neither does owning a Ferrari makes one a Formula One driver.

In a 2014 report by Malay Mail Online, it was stated that the top 20% of the household has a median income of RM9,796, the middle 40 per cent at RM4,372 and the bottom 40 per cent at RM1,852.

The reports do not augur well for our future as we age. At the speed of light, one can see that we are sitting on the time bomb. When I got this figure, immediately I can see card board box city located under all the bridges and slums. I can almost see the growing queue at the food kitchen in all corners of the city. I just hope I am not one of them.

The fact of the matter is money is an issue, Malaysia is not a welfare country, most of the Malaysians will not have enough savings for their old age. Their savings in the Employee Provident Fund is hardly a song to sing about. Therefore, most centres charges a much lower fee, get cheaper labours and usually foreigners, cut corners in their food and service delivery. They will cramp four beds into a room meant for three or less, just so that the centre can stay afloat and the operators make some money.

AGEING IN MALAYSIA BY FONG MUNTOH: A PLACE I CAN CALL A HOME AWAY FROM HOME

AGEING IN MALAYSIA BY FONG MUNTOH: A PLACE I CAN CALL A HOME AWAY FROM HOME: A place I can call my home away from home was a tagline I used in my presentation to potential clients. I got this tagline from my years o...

A PLACE I CAN CALL A HOME AWAY FROM HOME

A place I can call my home away from home was a tagline I used in my presentation to potential clients. I got this tagline from my years of working with the hotel management division of Reliance Pacific Berhad. I was the marketing and operations manager for the 16 Seri Malaysia Hotels in the whole of Peninsular Malaysia. We used to describe our budget hotels as an affordable place, a home away from home. Our décor was very cultural Malay home style with lots of floral drapes, batik pictures and we used tiled floors instead of the usual carpet, just to be like an average home in Malaysia.

In the like manner we want our homes or centres to be like a home, our home. Where we have good friendly people who became our friends, good clean places, good homely cooked food and have a good time

But the truth is, most of the current homes are just not good enough. There are not many good centres around that I can called a home away from home. Most make me want to run away from the homes or centres. During my rounds visiting and reviewing many centres, I can see a big divide from one end of the standard spectrum to the other extreme end. If I apply the tagline to the homes or centres I visited, I will not call most of them a home away from home.

But please do not look down on them, most have existed since a long time ago to meet certain segment of the society and had in many ways contributed to the society. The have played their parts to meet both physical needs and financial abilities of many children who have no choice but to send their beloved parents to a centre.

DO YOU STILL WANT TO BE IN THE ELDERLY CARE INDUSTRY

I said that elderly care business is a business of LOVE. But over the years I can see some part of my humanity and love being eaten away. To see residents who became my friends passing away one by one is heart wrenching. They were laughing with me one day and gone the next day. Sometimes I had to tell myself this is life and life must go on. I had to tell myself that this is just a job and not get too personal. I must learn to separate work life from personal life. Till one day I had to slap myself and said, “Look I cannot live in a dichotomy, there is no such thing as work and personal life, there is only one life. My work and personal life is one.”

I decided that this work life balance idea is nonsense. I am many people in one, to my various family members I am the husband, father, son and brother. I am still all these when I am at work and at work I am the subordinate, the head of department, the leader of the distributors and manager of the two nursing homes. And at the home, I am the friend of my residents, maybe even a son. At the end I learn to embrace myself as person, a human being with all these functions, titles and relationships. These helped me to handle my encounter with deaths and departures of my residents and friends more comfortably. I even learn to embrace and be comfortable with death.

My 87 year old father and I have many frank talks, we are very closed. I grew up following him everywhere he went and doing practically everything he did. One day we talked about death and my father told me that he wants to be cremated and his remains be thrown to the sea. He said, “In this way I can travel the world all at once.” I told him, “Ok, consider it done.”

So, do you still want to do this business of elderly homes or centres? Of course, you should. One could just do it as a business with hired professional nurses and care givers to run the homes. I am not judging. I am just suggesting that you should this business and do it with a heart. The future of ageing needs the contributions of all sectors to manage the ageing waves. Managing a care centre well needs business acumen too. Love alone does not cover the bills but it start with love.

ARE YOU SURE YOU WANT TO DO THIS?

ARE YOU SURE YOU WANT TO DO THIS?

What’s wrong with death sir? What are we so mortally afraid of? Why can’t we treat death with a certain amount of humanity and dignity, and decency, and God forbid, maybe even humor. Death is not the enemy gentlemen. If we’re going to fight a disease, let’s fight one of the most terrible diseases of all. Indifferences.”

-           Robin Williams as Patch Adams

I loved this movie and I loved the quote at the end and it remains long after I watched the movie.

In March 2010 BFM, the business radio station interviewed me. Two of the memorable questions were, “Is Nursing Home a profitable business?” and I replied “Yes, it is, if it were not I will not be involved.”

The second question was, “What are the criteria to go into this business?” I replied, “If anyone going into this business just for the money, then I can show them many other ways to make money. Elderly care or nursing home business is a business of LOVE.” The interviewer pondered for a moment and replied “yes”.

Unlike childcare or kindergarten where we get to see young, energetic and noisy kids coming to the centre and watching them grow. And then we hear stories of them growing up, getting good grades and their graduations. It is all about achievements. Elderly care centres are just not like that. Most came in old, fragile, weak legs, weak heart and most will not leave the home alive. Most of them do not even want to be there. Culturally most Malaysians like to die in their own homes. The elderly knew they will not leave the centres or home alive. They will end up in hospitals or pass away in their sleeps. There will be stories of them struggling with pain from bed sores, cancer and arthritis.

There was this lady who suffered from Alzheimer, arthritis, diabetes, hypertension, heart and allergy to some of the medications. She was taking over ten types of medications. The many types of medications caused her body to be as stiff as a log. One day a care giver tried to take her to the shower. The care giver had to lift her up from the bed slowly. And then she had to slowly loosen her muscles before she can put her on the wheel chair. Without warning the lady just slipped and fell to the floor like a log and cut her forehead. She was sent to the hospital in Penang and I had to go to investigate the incidents before we get sued.

The sad story of this lady was that it took her a long time to die, I know I sounded crude, or perhaps you may prefer she lived a bit way too long. She lived in our home in Penang for almost eight years, she could hardly move, bedridden, pain all over and towards her end life she suffered from very bad bed sores, which our best nurses and doctors could do nothing to prevent. The only comfort from this entire story is that I knew my nurses and care givers had given their best although very often the best is simply not good enough.

AGEING IN MALAYSIA BY FONG MUNTOH: ELDERLY CARE IS NOT MY FIRST CHOICE PROFESSION

AGEING IN MALAYSIA BY FONG MUNTOH: ELDERLY CARE IS NOT MY FIRST CHOICE PROFESSION: Managing care centres, nursing homes or old folks was never my first choice of profession, not even when I was managing two of them during...

ELDERLY CARE IS NOT MY FIRST CHOICE PROFESSION

Managing care centres, nursing homes or old folks was never my first choice of profession, not even when I was managing two of them during my time at IHM Sdn Bhd. It was just a job. True that I had many wonderful stories talking to the residents, but it never dawns on me to be ‘my vocation’ or ‘my calling’. Not until 2012 when I left IHM’s employment.

(Visiting the Home where I got started.)

Suddenly all those people I met over the years kept popping up. One of them was Carol Yip, The CEO of Agedcare Sdn Bhd, she called and invited me to be part of PEMANDU expert panel. PEMANDU is Malaysia transformation think-tank and they conducted many conference and discussion which they call LAB, short for laboratory where many issues are put on the table with teams of experts to experiment and tinker with the problems and then formulate plausible and possible solutions. 

                             (A testimonial letter from the now disbanded Pemandu)

The lab I went to was on Senior Living and Aging. My personal experience with Pemandu was that there are some good decisions that came out of the lab. It is not perfect, but it is a good start.

From there on I kept moving in the circles of aging issues, friends kept calling me to give solutions for their aging parents and its related problems. And in 2016 I was invited to be a consultant for Managed Care Sdn Bhd, a subsidiary of Agedcare. My job was simple, to visit nursing homes, review them and if they meet our stringent requirements I will sign them up as a panel for Managed Care, who in return will recommend to their clients.

I was generally disappointed with many homes and centres that I had visited, smelly, dirty and overcrowded. It is nothing like the two IHM homes, I would sincerely consider it one of the best in Petaling Jaya in terms of services, quality and price. Still, how I wish every elderly has an apartment like that in Bournemouth.

In 2016, I met an old doctor friend from the Ministry of Health and he encouraged me to get myself certified in elderly care and I did.

Some people set their goals, and some had it thrown at them. In my case it was the latter. As an encouragement for all those people who do not know what they are going to do with their life or where they are going, do not frown nor fret, keep your senses up to see, hear or even smell what God has planned for you. Most important God has placed many wonderful mentors along my way. Four of them made a difference to my journey and somehow showed me my path whom I shall mentioned later.

AGEING IN MALAYSIA BY FONG MUNTOH: MY RICH COUSIN WHO STILL LOVE AND CARE HIS OWN SEN...

AGEING IN MALAYSIA BY FONG MUNTOH: MY RICH COUSIN WHO STILL LOVE AND CARE HIS OWN SEN...: My cousin's wife who read my Facebook posting entitled  "NO MAID CAN DIE!" saw me and told me "aiyo if i have no maid i...

MY RICH COUSIN WHO STILL LOVE AND CARE HIS OWN SENILE MOTHER

My cousin's wife who read my Facebook posting entitled  "NO MAID CAN DIE!" saw me and told me "aiyo if i have no maid i will die" and she was right if she has no maid she will definitely die. 

Their bedroom is bigger than my terrace house, two hyperactive kids and my cousin's late mother was suffering from alzheimer and started spitting all over the house. This is not a boast but a true rags to riches story which I want to share with you. This cousin of mine was from Ipoh grew up in the coconut oil factory with his mother. His father worked there before he suffered a stroke and died later. The mother worked very hard and she nearly died from a curious case of thyroid but survived because my father introduced her to another doctor for a second opinion, the doctor gave her some medication on the cheap to help her out and she survived to live a full life till 89 years old.

My cousin started working a a medical rep earlier on after form 6 as they cannot afford to continue his study in  university. Around the mid 90s he started going into business , got cheated by his own class mate(so much about old friend), suffered a short spell of depression. But he came back and got a few good clients supporting him. Within a few years he moved into a semi detached house and then later into a big bungalow fifteen times the size of my terrace house area, land area is even bigger. 

He is the only guy who is willing bring his mother around everywhere without feeling embarrass about the mother spitting everywhere and making funny and irritating sounds(I used to manage two nursing homes and my homes were filled with residents whose children are doing fantastically well but refused to take care of their mother giving all kind of excuses. 

This cousin of mine and his wife both have no problem bringing the mother anywhere and everywhere including breakfast in those old fashion packed coffee shop, while the mother kept spitting everywhere. 

How many of rich people willing to just take care of their old senile mother without a single excuse or feeling embarrassed? I wonder......... which is why I really respect this cousin and his wife, both grew up in simple life , got rich but still stay simple. 

3 LASTING IMPRESSIONS OF AGEING IN BOURNEMOUTH

My first encounter with aging was in United Kingdom while pursuing my MBA. At 25 years of age, ageing was as near to me as the sun to earth then.

I still remember one summer in Bournemouth, a beach side town in the south of England with its long fine white sandy beach stretching all the way from Christchurch to the ferry terminals to Sandbanks, another long luscious white sandy beach. The year was 1989, I was driving my second hand beige Vauxhall on the way back to my rented place. While waiting at the traffic, an old lady in her electric buggy drove passed me at a steady unhurried pace. She turned and glanced at me and gave me a smile as she passed me and then she continued her journey. In UK the electric buggy with a senior citizen do not have to stop at the traffic, they were considered a pedestrian on wheels. Every other vehicle must stop and give way.

                           (A view of the long sandy beach in Bournemouth)

I thought to myself, wow, this is so great. “You will not find this in Malaysia. If I do see this in Malaysia, the old lady would not last long on the road, obituary will be the next time I see her.” I thought to myself.

But the image of the old lady overtaking me unhurriedly and her glance left a lasting impression. What a way to age.

My second encounter in Bournemouth was when I helped an elderly lady, who was a stranger, to take her shopping’s at Sainsbury back to her elderly home. She invited me in for a tea as gesture of thanks for helping her. Her home was a purpose built one-bedroom apartment with a view to the garden. The decoration was very British. Her apartment was designed for elderly with every aspect from safety to access. She could have easily ridden a buggy right to her apartment door, if she had a buggy.  This encounter got me thinking, what would it be like growing old in my own country.

My third encounter was when all my Malaysian classmates and friends had tragic experiences when they got news of their sick parents. One of them, Alex, could not get home on time to see his father one last time. Another girl, Wan, could not get a ticket to get home for her dad’s funeral. Her family were Taoist and staunch believer and followed what the Taoist priest say or do. Wan barely made it on the sending off day.

Both Alex and Wan stories and many others left me with my first taste of emotions of aging and death. The question of filial piety was carved into to my heart and remained like a ‘thorn to my side’ till these days. In fact, the thought of my aging parents and my failure to perform the duty of the firstborn son was the reason I returned to Malaysia after six years studying, working and living in the UK.