IS CARING WITHOUT COMPASSION POSSIBLE?

"Balancing Compassion and Business in Aged Care Centers: A Reflection on Caregiver Dynamics"

In the realm of aged care, it's not uncommon to encounter caregivers who, while providing essential services, may lack a deep sense of compassion. These individuals, whom I refer to as 'Incidental Carers and Professionals,' are not inherently bad people, and their motivations often stem from pragmatic reasons rather than malice. Understanding the reasons behind this phenomenon can shed light on potential solutions for fostering a more compassionate care environment.

Reasons for Care Without Compassion:

1. Need to Put Food on the Table:
   Many caregivers fall into the caregiving profession out of economic necessity. Foreign maids, constrained by their job descriptions, and individuals bound by socio-economic constraints often find themselves in caregiving roles. These circumstances limit their choices and job options.

2. Limited Job Options:
   Some individuals, especially those not academically inclined or seeking higher education opportunities, may enter the aged care industry due to limited job options or parental influence.

Solving the Compassion Issue:

Building Systemic Compassion Structure:

1. Build Systems with Compassion as a Foundation:
   Integrate compassion into the core of caregiving systems. Establish schedules ensuring care activities are performed, and implement Well-Being programs for residents. Recognize that compassion and systematic care are interconnected; both must be prioritized for an effective caregiving environment.

2. 
   

3. Build Your Business on the Foundation of Love:
   Business owners of care centers must infuse compassion into their core beliefs. While profits are essential, prioritizing the greater good and genuinely believing in the positive impact on the community is paramount. Aged care is an embodiment of economics, love, and compassion.

4. 
   

5. Build Your System on a Higher Moral Ground:
   Make decisions and establish processes on a higher moral ground. Ask the question, "Do I have no regrets?" and ensure that your actions align with sound philosophies and solid moral values. Strive to do your best, even in challenging circumstances.

In Conclusion:

While caring without compassion may be possible, it is often stressful for caregivers and may not be a sustainable approach. Those who endure likely face personal challenges, making it crucial to acknowledge their circumstances. Balancing compassion and business in aged care requires building systemic structures infused with compassion, establishing businesses on the foundation of love, and adhering to higher moral values. By doing so, we create a holistic and sustainable approach to caregiving, ensuring both the well-being of caregivers and the quality of care provided to the elderly.

MY DAD’S WISDOM & FAMILY FEUD OVER ELDERLY PARENTS

My late dad had a heartfelt wish for all four of us siblings: to live in harmony and love. I'm grateful to say that we've managed to fulfill this wish, although keeping such a promise to a parent isn't always an easy feat.

The first week of March wasn't particularly cheerful for me, as I found myself fielding three calls about siblings entangled in disputes over their parents. Whether it was two sisters clashing over parental matters or a larger family, comprising over four siblings and five grandchildren, feuding over a parent and grandparent, the reasons behind the conflicts echoed the drama found in family series.

Reflecting on my dad's wisdom in preventing family feuds, or at least minimizing their impact, here are some key insights:

1. **Taking Responsibility:**

   One of the children should take full responsibility, irrespective of their position in the family. Just as the human body requires distinct parts to function, there's a reason we were given one mouth and one head. Perhaps, two heads aren't necessarily better than one.

2. **Choosing the Right Time:**

   It's crucial to back down, even when you're in the right, and wait for the opportune moment to address the situation as mature adults.

3. **Apologizing for Harmony:**

   Apologize, even if you're in the right. Being right doesn't always trump the importance of maintaining a cordial relationship, as a good relationship can often make wrong things right.

4. **Humble Seeking of Help:**

   The one who assumes responsibility must be humble enough to seek help when necessary. Just as the saying goes, "It takes a village."

5. **Inclusive Support:**

   Allow other siblings to be part of the care support team if they wish to contribute. In unity, strength is found.

6. **Respecting Choices:**

   Don't push those who choose not to be part of the care support team. Everyone may have their reasons, and it's essential to continue maintaining a cordial relationship with them.

7. **Avoiding Bragging:**

   Refrain from bragging to others about taking full responsibility. Humility goes a long way in fostering positive relationships.

I hope sharing these pieces of my dad's advice proves helpful in navigating the complexities of family dynamics.

TWO 99 YEARS OLD PARENTS & 3 SISTERS- WHAT IS THE FIGHT ABOUT?

My friend Jo reached out to me from Singapore, visibly distressed. To provide context, Jo is the youngest among three sisters—Verona being the eldest and Holly the second. Their elderly parents, both 99 years old and grappling with dementia, reside in a care center in Tambun Ipoh. Initially, Jo's father had a joint account with Holly and Jo. However, Verona, during a visit from Canada, presented a form meant for certification in Canada, asserting that her parents were in palliative care. This claim was not true, as the parents were in general good health, albeit dealing with dementia. Verona aimed to use this certification to claim allowances for caring for her parents, whose monthly care expenses in Tambun amounted to RM7,600. When the two retired nurses managing the Tambun center declined to sign the form, Veron threatened to sue the home and decided to relocate her parents to a nursing home near their residence in Kg Simee, citing dissatisfaction with the Tambun facility. Despite Verona's assertion that the new place was more economical, concerns were raised about its quality of care. Here are some crucial points to consider: 1. Jo is the official guardian, as per the signed terms and conditions, giving her exclusive authority or the power to approve anyone discharging the parents.

2. A palliative diagnosis must come from a qualified doctor, making the act of certifying generally healthy parents as palliative a criminal offense.

3. Given the parents' dementia, it is recommended for them to remain in the familiar Tambun nursing home. Veron's concerns about staffing and management may not be valid unless there is concrete evidence of misconduct or care deterioration.

4. Threatening legal action against the center requires substantial grounds for a lawyer or court to intervene. While there are varying opinions on this situation, the hope is that the sisters can engage in a humble and constructive conversation, motivated not just by love for each other but, more importantly, by love for their parents—central figures in this complex family narrative.

EPILOGUE

• Last night 2 MAR 2022 the sister implicated in this story called me to tell her side of her story. In dealing with feuding family issues and stories, there are more than one side. in fact there are as many sides as the number of people involved. The parents, the children, the carers, the centres, other relatives and friends who each knew both sisters and the family will have their sides too.

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  Muntoh Monti

  I just hope all the sisters can humble themselves and talk it out not out of love for one another but out of love for their parents, the common players in this story.

UNITY, CHOPSTICK AND CULTURAL ASSIMILATION

 

"We are Borg, you will be assimilated, resistant is futile" 
The famous quote from Start Trek

Tun Dr Mahathir's recent statement on Chinese culture and assimilation stirred controversy among the Chinese community, but I remained unfazed. Recognizing Dr. Mahathir as a skilled politician, I understood his strategy to garner majority support, yet I found a deeper message in his words—highlighting "unity" and "assimilation."

Assuming that Dr. Mahathir implied the necessity of assimilation for unity, I delved into the concept. Anthropologically, assimilation refers to the absorption of diverse ethnic groups into a dominant culture. This led me to ponder whether minority cultures could truly become Malay, as our constitution defines Malays based on religious, linguistic, and cultural criteria.

However, historical and global examples contradicted the notion of assimilation as a panacea for unity. China, despite a common language, remains culturally diverse. Similarly, the United States and religious denominations experience internal divisions. Even in Malaysia, political parties aligned with the majority culture witness fragmentation.

Constitutional assimilation does not ensure genuine unity. Minorities retain aspects of their culture, enriching the majority culture. Hence, I argue that true unity lies in diversity, emphasizing the well-being of the "rakyats." Unity is an action—a commitment to care for all, irrespective of race or religion. It transcends assimilation, encouraging unconditional love and understanding.

In conclusion, my perspective rejects assimilation as a path to unity. Instead, I advocate for unity in diversity, recognizing and celebrating the unique contributions of each culture. Unity, as a dynamic concept, requires continuous effort and a genuine embrace of our differences for a harmonious society.

LAND AND THE ISSUE OF LICENSES FOR AGED CARE CENTRES

 

Random pix of property in Malaysia

In the foreseeable future, demographic shifts in Malaysia predict that more than 10% of the population will be over 60 years of age by the year 2030. This aging population will likely necessitate an increased demand for aged care services, prompting concerns about the current state of aged care centers in the country. Presently, over 95% of the approximately 1700 aged care centers are situated in residential housing estates, encompassing various types of dwellings such as terrace houses, semi-detached houses, or bungalows. However, the snag lies in the fact that the land upon which these centers are located is categorized as "residential land," resulting in a staggering 80% of these facilities operating without proper licenses.

The predominant model employed by aged care operators involves leasing residential properties for commercial or charitable purposes, leading to a situation where local councils often require these properties to undergo 'temporary conversion' to operate as aged care centers or other care facilities. Consequently, the licensing dilemma primarily rests with the state and district councils, which regulate land use across various regions. Rather than assigning blame to specific entities for the prevalence of unlicensed centers, it is essential to recognize that the roots of today's licensing challenges extend beyond immediate circumstances. Quoting Albert Einstein, "No problem can be solved from the same level of consciousness that created it." The current issues surrounding licensing in the aged care sector have their origins in historical priorities and choices that prioritized economic development, infrastructure, housing, industry, education, and health over specific land allocations for aged care. To comprehend the present licensing issues faced by operators, it is crucial to examine the interface between the aged care industry and the National Land Code of 1965. The requirement for 'temporary conversion' renewal every one or two years, subject to changing guidelines, forms a key aspect of the licensing process. The heart of the matter lies in the absence of a designated land category for aged care in Malaysia, with land use traditionally divided into agriculture, building, and industry, leaving a critical gap in the planning of housing developments.

Addressing this long-standing issue requires a new consciousness in land use planning. While this shift in awareness may not immediately resolve the existing licensing challenges, it paves the way for a more profound and courageous approach. An amendment to the land act, enforced retrospectively to all current residential developments, becomes essential. This amendment should not only silence detractors and opposition but also grant freedom of conversion for the operational tenure of these centers without the need for frequent renewals. Moreover, an amnesty provision for existing unlicensed centers during the legislative transition would provide a pragmatic solution to the pressing issues faced by the aged care sector in Malaysia.

MY MOM, AH TOONG 3 + 1 WISDOM

My mom used to smoked when younger, and this picture from the movie kung fu hustle seems to fit the bill.

In the tapestry of life, parents often weave lessons into the fabric of our being, and my mother, affectionately known as Ah Toong, was no exception. While my earlier blog delved into the wisdom I gleaned from my father, this narrative aims to unravel the unique lessons embedded in the story of Ah Toong.

Unlike my father, who imparted knowledge through spoken words, Ah Toong's teachings were subtly interwoven into the tapestry of her actions and behaviors. Educated and well-versed, she embarked on her career as a State Enrolled Nurse, demonstrating resilience and resourcefulness that would later become emblematic of her character.

The first distinctive trait I observed in Ah Toong was her unwavering frugality. Despite a modest income and a pension of RM1,045, she managed to accumulate savings nearing RM100,000. Her secret? A savvy approach to market shopping. Ah Toong, a familiar face in the wet market of Taman SPPK, Pasir Puteh, knew that the best deals often emerged after 9 am. By negotiating skillfully and opting for second-grade fresh produce, she maximized the quality of her meals while minimizing expenses.

Her approach to the market was a microcosm of her life philosophy: negotiate, adapt, and don't settle for less. In the dance of supply and demand, Ah Toong recognized the sweet spot after 10 am when sellers were more inclined to accommodate buyers. It was a lesson not just in grocery shopping but a metaphor for navigating life - knowing when to press on, negotiate, and secure what you need.

Nature, according to Ah Toong, held the key to many of life's challenges. Her belief in the healing properties of natural ingredients, particularly those derived from pigs, manifested in her culinary remedies. When faced with ailments or challenges, she concocted dishes like pig's stomach with pepper soup for gastric issues or stewed pork trotters with mushrooms and black fungus for tired legs. However, she coupled these remedies with a stern reminder that no supplement could substitute for diligent effort and hard work.

The third distinctive trait was Ah Toong's belief in divine intervention during exams. In a unique negotiation with a temple deity, she promised offerings of a free-range chicken, American apples, and Sunkist oranges if I achieved stellar results. The ritual involved ingesting blessed ashes dissolved in water. While the results were not entirely as anticipated, this experience instilled a valuable lesson - caution in committing to rewards before the task is completed.

Ah Toong's adaptability was evident during Chinese New Year of 1978. Faced with conflicting advice on the orientation of the praying altar for welcoming the god of prosperity, she decided not to put all her faith in one belief. Instead, she divided the offerings, facing altars in both north-east and north-west directions. This scenario unfolded as a metaphorical lesson in diversification and avoiding overcommitment to a single approach.

Lastly, Ah Toong's refusal to accept defeat even in the minutiae of life revealed a resilient spirit. The episode during Chinese New Year, where she set up altars facing multiple directions, showcased her determination not to succumb to losses easily.

In conclusion, Ah Toong, my mother, was a living book, each page filled with lessons waiting to be learned and absorbed. Her life, a narrative of frugality, reliance on nature, negotiation with the divine, adaptability, and an unwavering spirit, continues to resonate in my journey, offering wisdom that transcends time. Every parent, a living book, imparts lessons that become the chapters of our own stories. What were the lessons from your mom and dad?

MAN: YOU DIE FIRST

I found this amusing, when men are busy the have no time to die but.....

Started managing two nursing homes in 2000 . I noticed after a few years most if not all the men will be no more, gone, dead.

After 20 years I am very sure my statistic is quite accurate, that most men will die within 3 years of moving into a nursing home.

The funny thing is that we started each home with about 40% men and 60% women but by the third year all the original men were gone. Men generally last no more than three years in a home (that is my personal experience. 

When I shared this information during a talk for senior citizens on planning for retirement and how to select a nursing home, many pf the participants offered their views. One lady said it was due to their ego, because they became helpless at the centre and felt abandon.

Another lady said, "We women are build stronger and better." Most men present at the talk kept quiet because they are not happy with the statistics that don't favour them. 

A gentlemen in his sixties came to me after the sharing and gave a me a very nice phrase which sounded more like a poem on why man die faster in nursing home. He said:

“See girl cannot touch,

can touch cannot do, 

got party cannot go, 

can go cannot dance, 

got money cannot spend, 

got good food cannot eat, 

got wine cannot drink. 

Like that better die”

The saying has a ring of truth in it…women usually last so much longer the longest client we had (some are still alive today) are over 12 years with the 20 year old homes.

And here is my take on why men die faster. I have read a lot on this subject and there are many-many information out there, but I want to narrow it to why elderly man die faster in a nursing home.

I want to touch on what I believe is the true reason why  men die faster and women live longer.

It is the BEING of a man and a woman.

Let's start with the being of a man. Men's being by our culture and societal context are known and defined by what they do, the titles they carry and the positions they held.

At the basic level most men are known by the job they do,  like Ali the mechanic, Ah Kau the farmer and Muthu the labourer. In Malaysia it is important to acknowledge the three races and in our textbook they are always Ali, Ah Kau and Muthu. Everyone of the men are known by their jobs they do they are not known as the father of Nora or Mei Leng or Kamala. Nor are they known as the husband of Azizah or Rose or  Gita.

Those with 'conferred' title like Tun, Tan Sri, Datuk Seri and Datuk will always be known by the title. In fact the title is used so often we sometimes forget what their names are. But the moment this people enter a nursing home, titles and power do not mean a thing. 

The last group are those  with positions like CEO, COO, CFO, Managing Directors and Directors of this and that board. These group will be the hardest hit because of the nature of the work life where they often command the hundreds and the thousands, managing a financial portfolio of millions and billions. For this group, the music will stop one day and when it does, they will find it hard to identify who they are. They will get depressed because when they are in the nursing home, they have no one  to listen to them. They have to people who are lower qualified than them, younger than them and they have not choice but to obey albeit grudgingly. That's when I see depression hits in for a number of them.

I have had in my life, GM's of Multinational Bank, Directors of many boards and people of high achievements living in my centre and they still die and usually not in a very dignified way.

Women's being,  on the other hand are defined differently. By culture, nature and design, women are made differently. Even at the pinnacles of their careers as CEO or carrying a title of Datuk, they at the core are still known as the mother of Nora or Mei Leng or Kamala. At the core the are still known as the wife of Ali or Ah Kau or Muthu. They even sometimes are known as the daughter of Makcik Nik or Aunty Rosy or Aunty Letchumi.

Women are also defined by the seasons of things they do, when like to bake, they are called the baker or the florist or sewing expert.

Women can put one thing down and move on to other roles sometimes 3 to 4 roles change in one day.

The difference I noticed was that men need something to look forward to, a challenge, a goal, women can jump from one need to another without being too attached. Perhaps God has given women one natural achievement that no man can never claimed, that is the ability to give life to another being.

Most women hearing this will laugh and be happy because they live longer and most men will dread that day when their being of a man is no longer what they can do.

My take on this?

Look at it this way. God gave women the ability to achieve the greatest achievement of giving live. But God is kinder to men for He does not want men to suffer the indignant journey of  ageing and bless us with early death.

Peace.