THE CAREGIVER'S OATH

Over the course of me developing training programmes for carers and operators i was always intrigued with the Doctors Hypocritical oath and the nurses' Nightingale oath. So i starting searching for a care givers oath and i found it. except for the first oath, all the rest i took it from a carer's website but i have modified it a little to suit the elderly care industry.

THE  CAREGIVER’S OATH

1) I will care for each elderly person as my parent and their children become my brothers and sisters and we are one big extended family.

2) I understand that I can’t care for anyone else if I don’t also care for myself. I will keep an image in my mind of putting the oxygen mask on myself first.

3) I will remember that the only person I can change is myself. I cannot change the person under my care who is ill, nor their family members.

4) I will find opportunities to laugh, daily. These might come in movies, jokes, television, or with friends who can see the humor in my situation and remind me to do the same.

5) I will get away from my caregiving duties on a regular basis, even if it is just to walk around the block. But I will also find ways to have lunch with a friend, go to a movie, window shop, breathe in fresh air, watch the sunset, or have an ice cream.

6) I will visit a support group, either online (at caregiver.org) or in person in my community, so that I know that I am not alone. If a support group isn’t right for me, I will find a friend to talk to, call my family consultant, or attend a workshop.

7) I will learn as much as I can about the person under my care’s illness so I can better care for him or her with understanding. I will learn techniques that will make caregiving easier for both of us.
8) I will say “yes” when people offer to help from colleagues, other residents and family members. When there are not offers, I will ask for help, even though it might be hard to do so.

9) I will use community resources—such as college , NGOs, government and elderly support groups and volunteer —to help make my caregiving duties easier.

10) I will find something I really like to do and make sure I find time to do it on a regular basis. Just because I am a caregiver doesn’t mean I have to give up everything that is meaningful to me. I will read, knit, garden, scrapbook, cook or any hobbies for a designated period of time every week.
11) I will remember that I am loved and appreciated, even when the person I am caring for can’t tell me that.

12) I will honor the nurturing, responsibility, caring, and support that I provide to those under my care as a gift I give.

MISSION ACCOMPLISHED

On 1 April 2019 I was appointed home director of The Mansion, Jalan Gasing. The conversation with the CEO was clear and that is  to achieve 35 residents by end June 2019 or else I go, fair. At the time of appointment, The Mansion has 28 residents, so 7 was not a tall order.

By 1 July, I achieved full house with 44 residents at an average of RM5.5k per residents. The full house status was maintained till today March 2020. 

Most important of all I promised the Management that within 6 months I will build a team that can run without me. That's what I do I duplicate myself.

That too is accomplished.

Then when The Mansion Sri Aman started In October, I went over to be part of the set up team. I brought along two staff whom I have hired  groomed to supervise. 

Within the first month, October, we had 4 residents which immediately made us operationally sustainable.

We were operationally sustainable from October till we hit full house of 23 residents in February 2020, slightly less than 5 months. And oh at a fee of RM6, 500 per residents

Likewise as I pen this end of contract message I am sure both the team that I had groomed can manage The Mansion effectively and efficiently.

Of course, the pandemic is a different ball game all together.

Effectively on 17 March I am to let the management take back both centres. This is normal to ensure smooth transition.

So while the pandemonium is going around I was rewarded  my full final fee, 14 days transitional days off and no worries of this Covid Lockdown issues.

My success at the Mansion is definitely not about me alone but about the team and people I worked with. Yes I am good at building teams that last, but it  depends on the materials and people I got. All my success I give glory to God who took me through this and many other journeys over the years.

To the team I built and come to love as friends and family, may you grow and prosper in all you do.

To the management, thank you for the opportunity to make something good, great.

Till we meet again.

Muntoh

Former Home Director of The Mansion

STOP JUDGING, STOP CONDEMNING

I read with amusement and sadness many comments from the netizens condemning those who travelled back to their kampung inspite of the current restricted movement exercise. There are people posting pasar pagi selling things and people still go there inspite of council officer giving warning.

Let's break it down here. many who migrate back home the last few days did it not because it is a holiday, well perhaps a little break for them. The reality is most workers from others states who worked in KL live in small poky flats or only one small room and some even share it with friends. With this lock down and no work, no entertainment, and many things that they cannot do means they will be lock in a small poky room smelling their own fart.

Most of the rented areas that they can afford are dirty, traffic congested and smelly.

They cannot even go to the park in Kuala Lumpur, so sad. I would have thought that open air and sunlight is a good prevention idea.

For those who had condemned and made fun of these groups going home, think twice most of them are not as lucky and blessed like of of us living here. We are commenting in the comfort of our home and air con. Going home means more space for them. Yes there is a risk of transmission, but staying back also face a risk of depression.

My nephew is staying in a rented room of only 6ft x 6ft, if he wasn't busy at work that's what he live in.

Before we call them stupid, ignorant and bodoh, please lah Malaysians show some compassion.

What about those opening for business, opening their nasi lemak stalls and what not. do not many of them do not have a credit card, or sufficient reserves to last two weeks. They need food, I hope that is not too much to ask. So they need to make a choice between penniless and coronavirus. They are stuck with Hobson's choice. Don't do business, die, do business may die. You tell me what would you choose for them.

Looking at myself, at least I have wifi, a comfortable 1500sf terrace house with two airconed rooms. there are many who are not living so comfortably.

Therefore, before we comment and condemn, go a layer deeper.

Shallow thinking is seeping through fear of coronavirus or that virus. Yes the virus can be deadly, so is hunger and no money for medical bill.

Maybe this group is ignorant, but aren't we all at many times and instances.

The fear is not the virus but DEATH, that's what this is about because it can affect comfortable people like you and I, rich and affluent. The rich can actually die too, all is fair in the death and taxes as the saying goes.

What if we die, but hey as an insurance friend of mine once said , there are two ways we die, failure of organs or accident.

So can we between life now and death then spare a moment to say a kind word like, yes have a safe journey home. Pray for their safety. Wish time joy and beautiful moments with their old parents and old friends. See you in 14 days. May the peace of God/Allah/Buddha and what not be with you.

My Malaysia now do not need condemnation and judgements, we need love, kind words, caring thoughts and positive action.

Peace.

THE PRICE OF BEING A CAREGIVER

Want to know what is the highest price I had to pay being in the elderly care industry?

People talked about how hard the caregiver’s jobs are. That it takes a special kind of person to do it. But have you ever wondered what is the greatest price a caregiver has to pay? Oh yes, there is a price to pay for whoever chooses this industry.

There are two categories of caregivers. The first is the family members and yes, they do have to pay a price for caring for their loved ones. The second is the industry professionals, like me and the hired caregivers and nurses.

Let’s tackle the first group family and relative caregivers. There are many levels of price that they pay. Among them are giving up their jobs, careers, time and even life to care for their loved ones. Sometime ago a family 8 siblings, seven daughters and one son, came to see me about their dementia mother. They liked the place I was managing, and they wanted to check their mother in. And I said,” Wait we need to assess her over a few days to see if she is manageable type of dementia.”  As it turns out their mom was walking all the time, trying to escape and can be a bit violent. To cap it all she constantly looking for knife and scissors. 

My observation was that she has more conditions besides dementia, and I told the sisters that no home can manage her unless she has been properly evaluated by psychiatrist. I also told her that her mom’s behavior seems to indicate that she needs more that the two types of dementia medication given now. Then the daughter opened up and told me all the information she was trying to hide. According to her one sister quit her job and got depressed taking care of her mother after a few years. Then passed on to another daughter who is not married, and she got so stressed up that she just drove her mother to a cheap nursing home and left her there. All the other siblings had tried but just cannot take it.

For caregivers who are family members they may even pay the price of their own sanity. I found another solution for them but it is not a road they are prepared to travel. I told them very likely only with full medication management, in short heavily sedate her, that they can manage her. Still it is not a foolproof solution. Nobody fully understand for the mind is both a playground and a minefield.

What about industry professionals, what is the price they have to pay? Let me share with you the highest price I had to pay. I can’t be there when my father was sick, dying and died.  All because I was helping to manage and operate a new centre for a Harvest Christian Assembly church. We were short handed and we had to deal with many high care cases and worse of all I was given a ‘special church friend’ who was dying from cancer who needed super high care to manage.

Now, again as usual, (yes a double oxymoronic expression here) the family members lied about his condition saying he is okay, he can walk and eat. I was told that the tracheostomy is very easy to manage. But when I went to Klang General Hospital, the specialist told me an entirely different story. I was told he can hardly walk for his back pain was excruciating, he needed constant suction of phlegm, to be precised every hour for 24 hours. The care needed was so demanding that our staffing was simply insufficient. Not to mention that his cancer stank. The smell even drew in flies in drove. When my dad died on 16 September 2018, I cannot even go back. When my dad was sick for 3 weeks prior to his death, I could not be there. I depended on my trusted friends.

Now, I understand why my mom who was a nurse often gets condemned for not attending closed relatives’ funerals. My mom always said to my father, “cannot simply just change, there are people who are depending on me.”

But what about me?

IF ONLY I CAN SAY THESE AND GET AWAY WITH IT.

Have you ever thought of giving naughty and sometimes sarcastic replies to questions asked?

I have. There are many things I would like to say to family members if I could get away with it. 

Most elderly are checked into a care centre simply because the family members cannot manage them or care for them physically. They could be tired and feeling helpless, yet, family members never failed to surprise me with unreasonable questions.

I know they are desperate and sometimes exasperated because they can do nothing much to care for their parents, I understand this, but I feel that sometimes the most important person in a care centre, which is the carers were being unfairly treated. 

I do not belief that customer is always right when they start scolding and use abusive and condescending tone towards the carers. Personally, I have been askeddesperate  questions that I have decided to give a tongue in cheek answers to in this posting, which you will never hear me telling the family members.

Desperate question or DQ: Why my aunt/mother/father who can walk in the previous home, but now she hardly walks?

Tongue in cheek answers or TICA: Oh that’s because your aunt is getting older weaker. They have good days and bad days as they aged.

DQ : But that cannot be, your place is advertised to be so much better, it looks nicer than the other place.

TICA:  Probably the other place is an Olympic training centre for the seniors preparing the elderly for marathon or the 25km walk event. We are just a professional daily assisted living centre.

DQ : She couldn't walk maybe because you all don't help them to walk?

TICA : Er, where were you when we helped your mom to walk? What kind of children you are? You should quit your job and sit in our centre to see us when we exercise her.

DQ : Why my mom looks older now compare from last visit last year (children living in uk) ?

TICA : We call this ageing, you will get there too if you stop asking question like this.

DQ : Why is it that my father is eating less?

TICA : Food he likes doctor won’t let them eat, food they don’t like you kept giving to make sure he stay healthy to live a longer miserable live.

DQ : Why is it that the staff sits around doing nothing?

TICA : It is call lunch break.

DQ : You must force my mom to walk, she always complaint about leg being painful. She always pretends.

TICA : You called your mom a liar, may she is lying about her age too. Please take her to nursery school.

DQ : I saw your staff using wheelchair the other day, why don’t they listen to our simple instructions?

TICA : Because your mom complaint her leg is painful and we do not know that she can pretend and lie. Obviously ou are the only one who can take care of your mom, would uou like me to tell our manager to prepare the refund cheque?

DEATH - PEACEFUL AND BEAUTIFUL?

Here is a story of death and how it can be peaceful and beautiful thing.

Visited my late Father in Law's grave this morning. He passed away on 24th Dec 2011.
Sitting on the side of his grave stone it helps me to reflect that definitely all things will come to an end.
Our earthly revelry, sorrow, sufferings, anger and hate all will end.
Lying before me are people who were once well known, rich, successful and arrogant together with the humble, poor, destitute and down trodden.
All will end.
What's left are memories.t

Over the years I have seen many deaths; closed the eyes of a few; carried the remains of a few. Many people struggled to come to terms with their mortality. This story is not one of recovery but about the last journey of a lady named Grace who showed me how death can be peaceful and beautiful.

I met Grace somewhere in August 2019, she was in her 60s and suffering from stage four cancer of the lung. I assessed her in PPUM at the cancer ward. She was located next to the nurses’ station, which meant that she was critical and may go anytime.  Yet, when I spoke with her in PPUM I did not see death in her eyes but peace and full of cheer and life. I thought her visitors and relatives were the one dying, they looked so grimed.

Our conversation was fun and candid and she went straight to the question, “ Do you accept one who is about to die and could die anytime?” I thought that was pretty direct. and I replied, “Yes we do, because I have seen staged four recovered before, you may live longer than you think.”
She checked in a week later in one of the room with all the essential trappings. Oxygen concentrator, oxygen tank, morphine and the works.  She received many visitors daily and we even had a birthday party for her in the centre.
She had good days when she could sit up and chat with visitors and me. There were days when she almost departed. But in all the days she spent preparing for her eventual reunion with God. She prepared what to say and to give to each one of her friends and relatives. She even prepared something for each and every caregivers, nurses and myself. All these given to us by her niece after her death about 2 months later at her request, in her own home.

She was peaceful and happy till the end and this helped me to reflect the reason why her death was so peaceful and beautiful.

The reason was that her life was not her own to live but for others. She spent days in our place preparing all her luggages for departure.  It was death waiting at her door that gave her the life that she lived towards the end. When we got news of her death, me and our staff cried and when we receive each an angpau with our names on it, we were flabbergasted and lost for words. We asked, “How can someone who is going to die spent time  preparing angpaus for each for each of us with our name on it!?

It was because she did not live for herself and through her death we saw whom she lived for.

Share this with your friends to encourage them.

HEALED IN 21 DAYS, NOT 180 DAYS

This is one among my favourite stories It is about a 75 year man who is a bit of a rascal and fun-loving character. His name is Bernard.

Do share if this story inspires and edify you.

Late last year he came to my centre with a serious spine injury and operation wounds. While in hospital he fell in the bathroom after the operation and was lying in the bathroom for 2 hours until his wife/girlfriend went inside the toilet and found him there. The bathroom incident happened when his wife/girlfriend, depends with whom you ask, went to get some stuff from the private hospital stores. Bernard went into the toilet to pee and he fell, aggravating his post operation wounds.

He tried to reach the bathroom’s call bell, but some smart Alex tied up the long wire that allows it to dangle all the way to inches off the floor on the handrail. Making it out of reach for him as he could not stand he lied on the floor. The wife/girlfriend came back a few minutes later not realizing that he had fell, thinking that he had been wheeled for more test. After almost an hour watching the tv she went to the toilet and found him there. Oh, they actually had to break the toilet door to get in.

On reaching our centre somewhere on the first week of October 2019, he could hardly walk, sit or talk much and suffering from excruciating pain.

Physio and acupuncture was arranged for him daily and within days he could talk, sit and stand. That’s when the fun start and his wife/girlfriend pusing kepala(shook her head). He started calling all his friends, all loud rascally, fun-loving professionals who visited him. Follow by bunch after bunch of gorgeous women although in their 60s and still hot coming to visit him in droves.  Bernard told me loudly these are my girlfriends. I told him you want to die talking like this. Bernard happily replied, I have gone through worse.

Within the second week he went to his home one day with his wife/girlfriend and came back to our centre in a big black Porsche Cayenne, and he went out every day. And on the 21^st day of October I wanted to kick him out, albeit jokingly, and he said, “Never mind paid one month might as well enjoy peace and quiet here.”

Here I must point out the the key things that helped in his recovery.

The first is that Bernard is generally a happy man and was an active man. He has lots of friends and he was not afraid to be vulnerable in front of them. He did not ask for pity, In fact, the rascal (in a nice way) took advantage of his droves of girlfriends with his conditions. Of course, the other is the support from his wife/girlfriend was tremendous. The wife/girlfriend was so supportive in spite of her recent trauma of losing her 40 year old daughter to cancer. The wife/girlfriend teared when she shared this and asked why her daughter being young did not fight on. But that did not stop her being a cheerful soul.

Being in the care industry allows me to meet many people whose life inspired me and helped me to look beyond myself. It helped me to realise that there is nothing wrong with being sick or need help. Being vulnerable is not a weakness but a strength that I can draw on.

Oh Bernard left me with a beautiful video saying thank you to everyone and I do believe in miracles.