WHAT IS THE GOVERNMENT DOING ABOUT IT?

Whenever there is a problem about aging and elderly care, the first question is, “What is the government going to do about it?”

Whenever I am at a health and aging conference the favourite question is, “What is the government going to do about?”

My favourite question is, “Is aging only a government issue?”

The government knew that there will be over 5.5 million population over the age of 60 by 2030 and we do not have enough facilities, infra-structure, manpower and in this case mostly women power to deal with this aging wave. The government has only limited homes under both federal and states management.

The homes and centres by NGOs, associations and religious organisations and companies are also limited. The nucleus family is getting smaller. Most children of the elderly who are married and their spouses need to work to cover the cost of living and can hardly find anytime to look after their own parents.

Taking care of an elderly is no easy task, they are more than 10 times the weight of babies and far bigger than babies and harder to carry. The elderly feces are smellier than baby’s and some may have funny body odour. If they have other wounds, well that adds on to it too.

So, taking care of our own elderly parents is not easy. So, if you and I find it hard and the government also have too little resources what choices do you have? I have 3 unpleasant choices for you.

The first is one of the spouse to quit his or her job and then try to adjust to a lower income lifestyle. The second is to send the parents to care homes or centres which cost a lot and very often with suspected standard and finally, get a maid which is cheaper or get a professional home care giver, which is more expensive.

You can see that all 3 choices involve money or lowering of standard of living without having a guarantee that the parents are well taken care off or cause inconvenience to you. This is a lose-lose-lose situation. It is like between a rock and a hard place.

I know how it feels, my dad at time of writing is 87 years of age. He was cycling and playing mahjong until age 85. Then one day age caught up with him and he cannot ride his bicycle, he cannot paly is mahjong. My dad told me, “Son, I cannot play mahjong because I am too slow.” And now he is suffering from pain on right knee, so now he cannot walk and his leg muscles deteriorate like a melting snow in the spring. So he needs physiotherapy that cost a bomb if we do it everyday. So I need to discuss with my siblings on the cost. I need to work out with my wife and business partner when I can go to my hometown in Ipoh, to see my dad and help and where I can give my mom a moment of relieve from caring for my dad.

All these decisions I had to make is not based on logic, I like to think that it is based on logic but really it is based on love. If it is based on logic, I would send my dad to elderly care centres, its cheaper and my mom can take a break. I don’t have to make inconvenient choices to travel back to see my dad every week.  If it is based on logic, I will probably say, “Well he is going to die anyway, let’s give him less care and let him die faster.”

Logic, is simply just not enough for me to make any decision, it has to be love. I still remember the days when my dad will do all it takes to get what I needed. I remember I came back from school and told him dad, I need a whole coconut tree leave, and by 3 pm it was lying at the back of our home. There are many more stories like this and my dad is my hero.

Why can’t the government monitoring the standard of the homes and centres?

This is a real problem here, most homes and centres are not up to standards of most consumers but are they below the standards set by the government. The fact of the matter is most homes and centres and I use ‘most’ because it is a known fact that there are homes and centres operating without license or permit and some are still applying for it. There are many homes and centres, that I have visited and in my opinion, are well below the standard I have set in chapter two. As I am writing this book I am still researching this together with my mentor from the welfare department.

The question then is, why don’t the government act against such homes. The answer given at a conference a few years ago in 2016 was, “If we act against such homes and centres, where will the residents go to?” Again, it is like between the devil and the deep blue sea. How are we to implement a law that will affect hundreds if not thousands of lives? The authority has laws, acts and information, but to take action is also an act against humanity and compassion. No answer here. Total silence.

The fact is we cannot solve today’s problem using today’s solution.

No problem can be solved from the same level of consciousness that created it. – Albert Einstein

That is the reason this book is written, it is to encourage people, young and old, entrepreneur and corporations to help look at today’s problem at a new level of consciousness.

This book on riding and impacting the aging waves is not just a self-help book, it is an idea, a movement to get everyone to be part of a new consciousness to solve our own problems with a renewed mind, desire and commitment.

In the next few chapters I hope take you through the understanding of the function and key performance procedures and maybe, just maybe, you can see something that I missed.

ALLOWING MY PARENTS LIVE AND DIE AT THEIR OWN TERMS AND THEIR OWN PLACE

ALLOWING MY PARENTS TO LIVE AND DIE AT THEIR OWN TERMS AND THEIR OWN PLACE

This is the hardest decision i have ever made when I started working and moving out of my hometown Ipoh. I knew as my parents aged they will have to decide where they will be and I have to decide too. My decision to allow my parents to live on their own was forged during my years in the elderly care industry.  

Talking to the elderly helped me to realisethat  most elderly persons if not all wanted to die in their own home, which very often are either sold to fund their stay at centres or because their children insisted that they stay with them. Usually after long coaxing, sometimes scolding by the children and diseases that reduced their mobility, they relented and moved out.

Many still hope to go home to spend their last days. This lead me to decide that my parents should grow old at their own terms and place. 

Now it is not an easy decision, it is  decision that lead to many sleepless years and worries of that fateful phone call from Ipoh. Why? Because both my parents were very mobile. My dad cycled about 1 km to play his mahjong and sometimes 2 km to the government clinic in Pasir Pinji.  While my mom cycled across a major road to the market every morning to have a coffee and chat with friends till late noon. My mom even cycled 500 metres to her bank to withdraw RM150 every week. Don't ask me why she didn't withdraw more, that's my mom. 

In fact, my dad was once knocked off his bicycle by a car and he flew into the air and according to him he floated down as if some divine hands were holding him, well he only suffered minor scratches.

My dad cycled till he was 85 years old until one day his right knee gave way and he lost the strength to stand and walk. He lasted two more years and in that two years my mom cared for him and we later got him a physiotherapist to helped him twice a week to work his muscles. on September 16 2018 morning , passed away at the age of 87 years old.

After my dad's passing my mom then went to London with my sister for 3 months. She came back to celebrate Chinese New Year at my house in Klang and returned to Ipoh on the second day as she has hospital appointments. A week later she passed away in her sleep.

I must say that my parents were very blessed to have departed in their sleep in their own home. They gave us siblings very little to worry and now we have nothing more to worry. We can now only miss them very much.

Now not many children will have this experience and their ageing parents gave them all sorts of worries. Most of us do not know how we will aged and what our journey be liked. Is it going to be a peaceful journey or is it going to be filled with turbulents. I can only pray that children with ageing parents do not have to worry about their ageing parents and that their parents may aged at their own home. 

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.