UNCLE: I DON'T WANT TO GO HOME.

Festivals in Malaysia are aplenty. Chinese New Year, Hari Raya, Deepavali, Christmas and the list goes on. These are also moments we like to go home to be with our family.

At the care centre we encouraged family members to bring their parents home, to see old friends perhaps even for the last time. Not being morbid here, just candid. For the elderly every meet  could be the last time one is seeing their relatives, children, friends, brothers and sisters. 

But many old folks just don't like to go home, they like to stay in the centre. I asked them why don't they want to go home. They gave me various reasons, like:

"I don't want to trouble my children to take care of me."

or

"I don't want to follow them to visit relatives, so troublesome."

or

"Too many people in the house."

The last one got me thinking and over time I analysed the reasons for, " Too many people in the house."

Here are some of the reasons why old people like to remain in our assisted living centre for CNY: In fact they don't want to meet any people or relatives because:

1. THEY MEET PEOPLE WHO ASK QUESTION THAT MAKE THEM FEEL STUPID

People who claim to be the relatives always asked the elderly folks "You remember me?" or "You recognise me or not?"

Of course he/she cannot remember you, you have gone from fat to ugly. I mean seriously they only see you once a year or less.

It is really painful for them and even embarassing  when they honestly cannot remember their relatives or loved ones. Please do not subject them to such torture.

2. THEY MEET PEOPLE WITH DEMENTIA

One question that makes the person who ask looks demented is, "Uncle/Aunty do you know who am I?"

Hello if you do not know who you are check your own IC la, don't ask an elderly confused uncle.
'Remember' is a swear word for an elderly. It falls under the category of expletives because the elderly do feel offended somewhat as they struggled to search their distorted internal drive.

3. THEY HAVE TO ANSWER A QUIZ QUESTION ABOUT THE RELATIONSHIP.

There are relatives who tells the elderly folks, "Hi uncle i am your second brother's wife's cousin who is married to aunty Ming next door who is now living in UK. And you use to buy me the five cents coconut sweets." And then you expect the old folk to remember your name and who you are.

4. THEY HAVE TO DEAL WITH THIS 20 TIMES A DAY FOR 3 DAYS OF CNY.

People think such quiz and questions are helpful for the old folks brain, no , it only confuse matter further. In fact the elderly feels embarrassed for forgetting something which, they think is so important.

Therefore, when you meet your elderly uncles and aunts and  if you see any elderly  in your family just give a big smile, a big hug, speak happily and tell your name and if he/she remembers great, if not move on.

Don't frustrate an old folk. 

PITIFUL FAMILY MEMBERS

Being in the elderly care industry for 20 years helps me to realise that the hardest people to work with are the family members, their spouses, children , relatives and so on.

There are many dynamics to their behaviours and the hassle some of them gave the care organisations and the staff.

As carers, we get blamed for injuries, bedsores, bruises, sickness and general decline of the elderlies health. We get accused quite often for being incompetent, being called stupid. Accused of stealing. Get scolding for occasional missing medication or wrong timing. Being scolded for giving the food which the family members decreed out of bound for their loved ones.

And you know what, it is ok with me and the carers because we knew one thing that the family members don't, even though they think they knew.

We know why the family members get anxious and why they behave the way they did.

There are many reasons:

1. They wanted us to do what they wanted to do. This is a case of expectations. Many family members have a mental image of what kind of care and how their loved ones are to be cared.

2. They want things to happen now. Which of course very often it does not happen that way, so they get frustrated.

3. Most are taught and educated with how problems should be solved, cause and effect. This problem this solution. But reality with elderly and care is not a straight line. This leads to frustration.

4. Their ego dented with the knowledge that with all their wealth, intelligence and knowledge they need to let a much lower qualified, lower salary individuals to care for their mother. Afterall in this society , wealth, big cars and house equals ability and success. And with all those success they cannot care for their parents.

These family members and children are the most pitiful and in need of compassion.

For the readers of this post please do not judge them but pray for them. They do live their parents or spouse.

For caregivers, please continue to love and uphold the family members, they need the care and love too.

The only way to reduce their anxieties is to be the best caregivers we can be . One who understand the elderlies, one who also understand the dynamics of family members.

May the peace of the good Lord be with us all.

UNDERSTAND THE BUSINESS OF HOME CARE, INDEPENDENT LIVING CENTRES, ASSISTED LIVING CENTRES, DEMENTIA CARE AND DAYCARE.

Somtime in January 2020 someone I knew came quietly with the intention to study and explore the possibility of opening an assisted living centre. I knew her purpose and i knew she came from a very renown private hospital. They have home care. And as usual because they have so many staff, money, resources and what not they are exploring.

But I can tell you that going into elderly care is a total different animal, one must understand ageing, they must understand what business it is and why it is not a business for the faint hearted. It is harder than a hospital in some ways.

Point blank is that home care structure and business is different from that of daycare. and day care is very different from assisted living centre and independent living centre is different from assisted living centre.

There are people who wants to build a 3 stage retirement village from independent to , dependent to high dependent. This tells me that they don't understand ageing in Malaysia. They learned from overseas experience which if Australia is a bacon and eggs culture, if japan it is a sushi and sake culture but in Malaysia we are capati, wan ton mee, nasi lemak culture. We are different.

There is not short cut to cut and paste any model into your business. I don't like to call age care a business because then the elderlies are just consumers and we are selling a product. And people go into all these high fly marketing and branding which in operational reality means nuts.

I like to start debunking the difference of each of the above care needs.

Home Care - almost 100% of people do not like to age in a centre, and home is the preferred choice. I strongly suggest that people stay at home, because they deteriorate slower. Because their home has the smell, feel, touch and familiarity that reminds us of who we are and where we are.

But home care can be expensive and sometimes the family members saw that the home care does very little, only 20% to 30% of their time are actually caring for the elderly. Ad you have a stranger in your house.

Assisted Living Centre - This can be high care or just assistance for those with mental, medical and physical needs. it is generally more economical than home care, but it has its limitation. The place is not familiar and they elderly lose control and ownership and the sense of belonging.

Independent Living - is well really not necessary a retirement village which i am against, for now. it could be anywhere, you don't need to pay a bomb. It could be just your own current house.

Daycare is a different business all together, the client are usually mobile who just need company for the day, very much like a children's day care, full of activities for 8 hours or so.

Dementia care- this is a totally different from all the above, you need to have trained and competent staff to manage the elderly and the right systems and SOPs to deal with situations like ramming their head against the wall, climbing the fence and what not.

The differences in all the above care models are:

1. Staff with right abilities

2. Target clients differs.

3. SOPs differs

4. Operational models differs.

5. Cost of investment and equipments differs.

Back to the opening story of a friend from a big corporation looking at investing into elderly care my advise for her was, "Your organisation needs a major mind shift" The reason being that big organisation are always out there to make the big bucks, their lingo is always let us corner the market. But elderly care is not something where we approach the usual corporate all guns blazing method. Elderly care is about the conditions of the hearts and not just the mind.

If this article has helped you in anyway, please share it.

PATIENCE, PATIENCE, PATIENCE

I never thought that God will use my son and my mother to teach me patience.( I talk about my mother in the next posting)

Patience is not a commodity nor aptitude that I possess in any quantity. I was impatient, rash and reactive. The kind of attributes not required in elderly care. I believe God in his humor put me in a situation that I had to learn patience.

When my son was born in 1997, I learned one thing from his birth and growth, that is to be patient for he will grow.  Let me tell his story and my journey.

My son was born prematurely, and nothing prepared me to deal with his kind of birth and his growth from baby to adulthood. No books, no manuals, no nothing. Only experienced anecdotes from relatives, parents and anybody who had a baby before. Even friends who were not married came to give us advise saying, “I heard from this friend of mine who had a similar situation, and this is what they did.”

I got it from my gynecologist, well, my wife’s gynecologist that my son will be born on 15 May 1997, estimated of course. I got it all worked out by working backwards from May 15 until my wife developed PIH, pregnancy induced hypertension. I was thinking how can this be, her blood pressure was always low, but it did happen and her BP shot all the way up to 200 over 140, if it that’s the speed of my Proton Wira 1.3  I will be happy, but it is not. Dr Sheila, the gynecologist wrote a letter to University Hospital for immediate operation. I was s worried because this situation was not in my perfect plan of how my son should exit from my wife, it should be on the date stated of 15 May 1997. In fact, I was so worried that I do not know what to worry because I have no clue what to worry. Still he came and on 28 March 1997, my son was born.

 When he was a few months old, the babysitter could just leave him in front of the tv and he will not crawl. He just doesn’t crawl. He does not do anything a so call normal baby does, at least those I knew from friends. When he was two years old my wife and I noticed that he could sit in front of a tv forever. Once we gave him his favourite toy. He sat and played with it but when the toy fell from his hands and went out of his reach by a couple of inches, he just will not go and fetch it, that is unusual. In my heart I thought finish lah( A Malaysian expression). Something must be wrong with him, but I chose to stay calm and prayed for the best. Anyway, that is the most I can do besides any medical testing and he seems to be normal.

By preschool all the teachers’ complaint that he was too quiet and does not speak in school. When we asked him who was his best friend, he does not know any except the same boy who grew up with him with the baby sitter. By standard four his results were not something to shout about and I told my wife, we better get ready money to send him vocational school. My late father in law who loved this grandson of his very much, was a teacher also gave up teaching him. Then in standard five his results picked up and he even got 4 As for UPSR. Now he would not stop talking.

I know now that I just need to be patient and be there to watch. For my son will grow and I am sure yours will too. No magic formula just be patient. Now he is young man University, but that’s not the end, in 2019, just a year before he completes his degree, he called and told me,” Dad, I want to stop studying.” I do not need to tell you how I felt, but I was prepared for that day in 2019, because I knew my son well. I also knew that not all are meant to be top notch academics. I console myself saying even Lim Goh Tong the founder of Genting does not have a degree and Bill Gates did not graduate. I told him it is okay; you have to decide for yourself.

Most important for me is that my son returns home safe and sound, which I am thankful to God.

So how does this relate to caring for aged? Well, my son is now being trained as an administrator and caregiver in the centre which I started for Harvest Christian Assembly in Klang, called D’Home. The person whom I mentored to manage the place and the nurse whom I have recruited to help is now mentoring and teaching my son.

What did I learn from this? I learned that all things that we do today has value in the future. What ever entrusted to us to do and if we do well will comes back to us in a positive way. 

So, whatever that is not right today with your family, friends and things around, it is only part of larger picture and endgame shall be revealed in good time. Stay Patient.

MY SON TODAY

KEVIN, MY WONDERFUL CARING FRIEND

On 25 March 2020 I had a long chat with an ex colleague from Reliance. A wonderful caring guy who was ever so helpful. Let just call him Kevin.

It started with a whatsapp message, “You free to chat?” I said yeah. Actually, with the lock down I was pretty relax and chill. He told me that he has this idea to start food truck and hire special people with Down Syndrome and train them to work and be self-supporting.  

I told him, that is a great idea, not the food truck or self-supporting part, but very important was that he saw a problem and then decided to step out to help. And that makes my heart glad. He wanted my thoughts on how to start. He told me how he can help by setting up the truck and getting his cycling ‘kakis’ to be part of it.

I told him that I don’t know much about down syndrome. The first thing is to recognize that care for different community takes on a different mind and skills set. In the care community there are several core groups which the welfare department had identified. They are women with issues, special needs, orang kurang upaya/disabled and elderly care. And in each category, they have sub categories.

For example, in special needs we can sub categorize them to autistic, down syndrome and spastic just to name a few. And in disabled you will have the physical disability like wheelchair bound and visually challenged. In women we have the abused women, single mother and unwanted pregnancy. In elderly care we have the medical care, dementia care and assisted living only. Now there are even more but very often centres cross served multiple sectors of care due to dire needs and lack of resources to serve all sectors individually.

I shared with Kevin that, very often caring is not just about passion, it is a calling and some are called to be very specific like me, in elderly care. Before we can help anyone in any sector, we want to serve in we must do the following 3 things.

First, we must understand the down syndrome and its varying spectrum. We must learn the behavior the conditions and understand it as if you are one of them.

Next, is that we must ask the most important question, “Do they the down syndrome needs help?” Most of us will answer yes they do need help. But ask this one more question, “Do you think the person with down syndrome knows he/she needs help or even wants help?”

 Finally start to understand them, go through them as a human being, ask simple questions like, “What makes them happy?”, “What makes them laugh?”, “What does he/she likes to eat?”, “What does he/she likes to do?” Learn to understand their expressions, each one will have different expressions expressing he same thing.

In any care community, there is a person under that skin, that look, that condition. There is that person that we need to know and understand. Perhaps then we will see ‘help’ very differently. We may not look at the special people as someone who need help. Perhaps through them we can see that we are the one who needed help more than them. Perhaps through these people we can truly see who we are. Through our reactions to the sufferings of others, truly then will we see ourselves. Perhaps these special people are the mirror to our soul, the empty void that our achievements can never bring. The deep dark hole that crave filling and fulfilling and even fulfilment.

Remember, before we can help others let see what help we need too.

To all you lovely people of bangsa Malaysia, who love and care for these people, may your life be the light and beacon of both their life and yours too.

And to my good friend Kevin may you be the light for others.

ONE LEGGED MR KONG TO WALK AGAIN

Went to visit the centre which, I have completed my mission. Brought my daughter there as she is still working there covering admin and hr. Had a few chats with my ex colleagues and then this Mr. Kong came down the lift by himself.

What so special about this 62 year old Mr Kong is that he is diabetic with both his kidneys gone and he needs dialysis 3 times a week. He came into our centre around end of November 2019 after he had his right leg amputated at Hospital Universiti Kebangsaan Malaysia. The amputation was just below his right knee.

When he first arrived, he was just like a lump of jelly. He kept falling off the bed, toilets and what not. This was due to the fact that he had not got used to the idea that he does not have a right leg anymore. Each time when he tried to walk, he will fall because he can’t put his right foot forward. Couple by the fact that he was in the hospital for a couple of weeks and plus his operations, he was left with very little muscle’s mass to support himself.

Because of his regular moving in and out for dialysis plus dinners with family, he fell a few times and hurt his right leg’s wound and resulted in further amputation until above his right knee.

The funny part about Mr. Kong is he always carry this hope that he will walk and even drive again. And in January, after his second amputation I told him that yes he can walk again and perhaps even drive but he must listen and work with us. He said yes and we laid out a plan for him.

I told him from my experience and based on his personality, mental health and out look he will probably recover by April and be fitted with a prosthetic leg by May. However, to be fitted with a prosthetic leg, one must have arms and leg muscles to support the prosthetic and not the other way around initially. So, I say you must do what the nurses and caregivers tell you to do. So, we started with building his arm muscles by getting him to push himself in his wheelchair, his family members hired a physiotherapist for him and couple with staff daily exercises he recovered his muscles very well. Today on 27 March 2020 my colleague gave me an update that Mr. Kong can now transfer himself from wheelchair to bed and vice versa. He can take himself to toilet and shower himself. In fact, he could stand by himself.

What an amazing transformation. Mr. Kong told me he is ready for his prosthetic. I told him I think so too. So once the Covid 19 lockdown is over, he can get a prosthetic leg fitted in May as expected.

I have seen many miraculous recoveries over the years, and I believe that all healings and recoveries are divine, be it through the wave of God’s hand or very often through the loving hands of the medical professionals, family members and caregivers. The most important is that we do not lose hope.

Here I thank the medical professionals, Tim the Physiotherapist and my team of caregivers colleague for doing such a wonderful job.

May this story brings encouragement to anyone who reads it.

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.