New Companion

We have an addition to the household. A new person, brought in to help look after Mom. It cannot be helped, Mom needs a lot more assistance nowadays, and I could not keep taking time off work and being awake half the night.

So we did what anyone else in Singapore would do in the circumstances, we applied for a FDW – a foreign domestic worker. At last count, there are over 200,000 FDWs in Singapore (population 5.5 million). FDWs are here to do housework, look after young children, and care for the elderly. It’s a viable, affordable, multi-purpose solution to our burgeoning caregiving problem as more and more people get older and sicker and need assistance.

Unfortunately, I think it is but a temporary solution, and maybe in 5 to 10 years, we will have to think of something else. This is when the countries where the FDWs come from progress economically and they no longer have to come to Singapore to work. But that’s a problem for another day. Meanwhile, I am so thankful.

Mom is at peace and laughs. There’s someone to help her with her showers, and accompanies her day and night. She gets hot food and clean clothes and takes her medications on time. And I take this respite and carry on and catch up on stuff that was put on hold.

Mom is not getting much exercise nor additional mental stimulation. We’re all just happy that she came through her major medical issues and is still alive. She watches TV and walks to the toilet and sits at the dinner table. During weekends, I take her out for a meal and care for her on the FDW’s day off. So that’s our routine now.

Thank you

A very thoughtful post by Gill about the relationship between caregivers and care recipients inspired this post. Please read it, she writes beautifully about her reaction (as a person with dementia) towards caregivers when they blog about their trials.

It got me thinking about my relationship as a caregiver, albeit part-time, with Mom, who has dementia. To tell the truth, I strive to do the minimum. Which is fine when things are stable and sailing along. Unfortunately, when things deteriorate as they have for the last few months, I wonder if I’ve done too little and feel bad as a consequence. Rest assured, I think I’ve sorted through what was within my control and what wasn’t, and learned a few lessons to be applied in future. So, I don’t feel so guilty.

I don’t know how my mother feels about needing care. We don’t talk about these things. But I do know she says “Thank you” at every opportunity.
Thank you (for my medicine).
Thank you (for taking me out).
Thank you (for helping me dress).
She simply accepts the help and thanks us for it. And I accept her thanks, “You’re welcome.” I used to protest “No need to thank me!” but I’ve stopped.

When I think about it, Mom’s independent streak makes her want to do everything by herself. Yet, although she never says it nor complains, she is aware that she is no longer able to do some things. She is able to graciously accept assistance and relinquish control. My “minimal help” suits her, because I only step in after she has tried and failed.

Dementia Village

When my children were young, they used to play at running a cafe and set up everything – the toy teaset and cutlery, handwritten menus and bills. I was often corralled in to be a patron, and made to order and eat up and pay up. When I wasn’t available or wouldn’t play, they just made do themselves. It gave me a pang to listen to them play at life – and what would you like to eat? Any drinks with that? Here’s your food. Bon appetit! 

There is an award-winning home for persons with dementia somewhere in Europe. It has beautiful apartments and gardens, where the residents can walk about and wander without “escaping”. Laid out like a little town, in this dementia residence, clients can visit the supermarket, restaurant and hair salon. Well-trained healthcare staff dress up as shopkeepers and unobtrusively observe and aid the persons with dementia (PWD). Any unsuitable purchases or payments are tactfully rectified without embarrassing them, and often without their knowledge.

I couldn’t understand it. I am sure I wouldn’t want to live in an segregated dementia village, where I am kept safe but essentially locked in, and given the delusion of freedom and free will. It smacks of condescension and play-acting. I don’t think I would want that, although I’m sure it is the best solution for some PWD. I should reserve judgement though, who knows what I’d want if and when my mind goes.

Instead of putting PWD into a village, perhaps we should bring the “village” into the community. How do we do this? This video from UK (May 2014) suggests how persons with mild dementia may get by “with a little help from friends”. A story here from Japan tells of how an entire community chips in to look out for an elderly woman with moderate to severe dementia who wanders for miles daily.

In short, whichever solution we choose, PWD ought to be able to live out their lives with dignity and comfort in a safe environment. The same can be said for their caregivers.