Jun 6, 2017

Elderly Care And My Second Myanmar Helper

Elderly- friendly home: Safety bars outside and inside the toilet and shower, anti-slip treatment of bathroom flooring, and new beddings with safety handle

We can finally heave a sigh of relief as my first helper is being sent home and we were no longer held liable for any trouble that she might get into (read about my first helper here). Thankfully, we were informed that our second helper will be here within a month.


As mentioned before, we hired a helper to take care of my elderly father-in-law (FIL). If you are interested in our first-hand experience of elderly-parental care - initially, without a helper - this is the article you'll want to read. And why did we hire a maid eventually? What did we actually do everyday as caretakers? What happens in our everyday life as caretakers for an elderly parent, particularly in the context of Singapore? What can you expect to happen? I hope that this article can give you some pointers when you are to take care of your elderly parents one day


First, let me tell you about our situation which led us to hire a helper. What made us commit to this long-term and expensive expenditure? Can't the son/daughter or their stay-home wife/husband take care of their parents? A helper can cost you about $1000 a month (monthly pay, pocket money, clothes, daily necessities, dental, medical, insurance, outings, lodging, etc.). This is about the same as the monthly expenditure of owning a car. Here's why...


Throughout the years, my FIL has been whizzed in and out of the hospital about once every year. He would either fall in the bathroom, get a mini stroke, or would suddenly be too weak to move. He had a major stroke more than 10 years ago and is slightly disabled in his left arm and leg and walks about with a walking aid. He stays with his younger son (my hubby's younger brother) in their home in Woodlands, but he only prefers to speak to my hubby and no one else.


Due to this communication hurdle, my husband has to travel from the west of Singapore to the north whenever my FIL has a medical appointment, is being rushed to the hospital, or for any other matters pertaining to my FIL. This went on for the past 15 years. 


But in recent years, FIL's health further deteriorated. Although he has high blood pressure, diabetes, and skin inflammations/bleeding all over his body, he doesn't watch his diet and doesn't take his medications and injections properly. He'll either skip them or finish a whole day's worth of medications in the morning, for convenience sake. And as usual, he eats whatever oily and unhealthy food he wants and whenever he wants, even when the doctors say his health condition is getting worse and he is putting on a lot of weight. 


Eventually, within the span of a year, he went into hospital twice, each time lasting for about 3-4 months because he has gotten so sick and weak. After series of physiotherapies, and weeks of proper diet and medications that he received in the hospital, he started to regain his mobility and health and is eventually send back home. But he'll set out to begin yet another vicious cycle where he'll ignore all advice, continue his unhealthy eating and medication habits, only to get another stroke and be sent to the hospital for months again. 


All this while, my hubby has to rush between his work, the hospital, bringing my FIL to periodic medical appointments at other clinics (eye, skin, urology appts, and etc.) and between the homes in the north and west of Singapore. Day after day, I witness my hubby getting increasingly thin and frail.


I couldn't bear to see my hubby wasting away any further and suggested to bring FIL over to our house and let me take care of him instead, on top of taking care of my then 4-year-old son. So, we foresee that hubby only need to rush between work, home and FIL's routine medical appointments. With me watching FIL's diet and administering his medications properly, he'll have lesser chance of ending up in the hospital again. 


In the meantime, my FIL could also spend quality time with my young boy - the only grandchild that my FIL speaks to and play with. 


Furthermore, my FIL's medical account and all other savings are totally depleted and my hubby has to pay cash in the thousands for each of my FIL's hospital stays. We simply cannot afford to keep paying for this. We're getting very broke. 


And so, we set out to prep our house to be elderly-friendly before bringing FIL over to stay with us. We installed safety bars inside and outside the bathroom (he is given his personal bathroom and bedroom), had the bathroom floor sprayed with anti-slip chemicals, and bought a new comfy bed, drawers, and his personal TV. Finally, we moved his personal belongings from his Woodlands home to our house.


PS: Safety bars around the house, anti-slip floor treatment in the bathrooms and even ramps for wheelchair accessibility can be installed at subsidised rates under EASE programme. You can apply from there. There are also discounts if you want to buy wheelchairs, walking aids, bathroom chairs, etc. Please enquire from your assigned social worker.


By the time FIL arrives at our house, we have already got a well-planned daily routine for him. In the morning, my hubby would bathe him (if FIL wants to) before going to work, and I'll prepare food and medications. In the afternoon, I'll push FIL in his wheelchair and we'll send my son to his 4-hour day school before coming back home for lunch. While FIL takes a nap in the afternoon, I would do the housework, laundry, buy groceries, or run some errands. Then, in the late afternoon, I'll bring FIL to fetch my son and we'll go to the nearby playground and my FIL will enjoy the breeze and outdoors and watch in delight as my son plays with the other kids. Then in the evening, hubby would buy dinner and come back and bathe FIL and administer the needed medications, while I take care of my son. After dinner, all of us would gather in the living room to watch TV and FIL would enjoy watching his grandson playing toys on the floor. This routine went on peacefully for weeks. Until....


One day, FIL wet himself while heading towards the bathroom. He was losing bladder control but did not know it himself. So there was a trail of urine between his bedroom and the bathroom. I quickly did the cleaning up, because apparently, he simply walked over his urine even though I told him to wait. Did he not know (did his cognitive function decreased)? Or he can't hear me? I really don't know. Because, as usual, he was a man of few words. Often, he'll go on for days without uttering a word. When my hubby asked him about it, he too did not answer. Finally, after another few times of such 'accidents', and upon our further probing, he said that he 'kind of' know about it (his losing of bladder control). 


So, every time after I mop off the urine and try to help him change his pants, he adamantly refuse to let me help him in any way and demanded that I leave his room, though in a courteous way. I figured that he's most probably awkward about letting his daughter-in-law (me) help him change. But, what seemed easy (putting on pants) would take him about an hour to accomplish, since he was partially disabled in his left limbs. Sometimes, he didn't want to change at all and goes about the day with the soiled pants on. When we suggested letting him wear diapers, he flatly refused.


One morning, he suddenly vomited while I took him downstairs to shop for his stuff. When we got home, he refused to let me clean him and change his clothes. Never mind! No need, no need (to change), he said to me smilingly.  And so, he wore the soiled clothes until my hubby came back in the evening to bathe him.


And on a few occasions, FIL had diarrhea and soiled his pants but he simply refuse to tell us and went about the day wearing the soiled pants (we'll find out while washing his pants or when we detect a foul smell throughout the house).


This is when the idea of hiring a domestic helper comes in.


We reviewed our financial situation and thought that the next best thing that we could do is to hire a helper to take care of FIL. For one, he may not feel awkward for a helper to change or clean him up, just like how he'll let the nurses in the hospitals clean/change him. And my husband simply couldn't take emergency leave all the time just to rush back to clean him. Most importantly, we just can't let him be in soiled clothes throughout the day, all the time. Also, sending him to a private nursing home would cost at least $2000 - $3000 without subsidy. Mind you, you can only send your parent to the subsidized public nursing home only after fulfilling certain stringent conditions (ask your allocated social worker about this). If you are rich enough, you can send your parent to the more expensive private homes, provided there are vacancies. 


So, the most affordable solution for us is to hire a helper. After the departure of our first terrible Myanmar helper, our second Myanmar helper came 3 weeks later. Let's call her Nin.


Nin is also a new helper with no experience (the information they write in the helpers' resumes, I figured, isn't very truthful/accurate). But thankfully, she's good. She's hardworking, friendly, polite, willing to learn, can speak simple English, does a clean job, can cook well, can play along well with my son and takes care of his safety. Even my FIL likes her a lot, which makes hubby and me very relieved.


Unfortunately, a month later, we have to pay about $600 in total to have one of her wisdom tooth removed (her insurance doesn't cover dental expenses). In fact, we'd actually noticed that her cheeks seemed to be swollen and upon probing, she admitted that she's in pain. Apparently, Nin was already having a toothache during the body check-up in Singapore but she didn't dare to say anything for the fear of losing her job and being send back home. She needed the job to help make ends meet for her family in Myanmar. Since she's been good so far, we paid for all the dental expenses and prayed that she will not quit on us before her 2-year contract ends. 


The initial weeks went pretty well. My hubby supervised Nin in bathing and administering medication to my FIL, and I orientated Nin about our house rules, cleanliness and safety at home (lock window grilles at ALL times), familiarize her to the surrounding areas of our home, initiated her to some of the Singapore culture, adjusted her cooking style (less oily, salty), and I also function mainly as a translator between Nin and my FIL, and etc.


Then something else began to happen. My FIL began to be complacent.


Once, while pushing my son (who is sitting on FIL's wheelchair, on FIL's insistence) towards a small road with an oncoming fast car, my FIL simply refused to stop for the car, insisting that the car should stop for him instead. In my moment of panic, I gathered all my might to pull back the wheelchair with my dearest son in it! (Reminder: my FIL has a big built and is really quite strong). At the next moment, we witness the fast car speeding across us, with no intention to slow down at all. If I weren't there that day, or hadn't stop my FIL in time, my son would have died.


Then, on many instances, while my son was playing his toys on the floor, FIL would suddenly push his wheelchair towards my son, crushing his toys along the way before scaring and cornering my tiny son to a corner, just for the fun of it. What if my son's tiny fingers were on the floor? Wouldn't they be crushed? Once, he even used his huge body weight to crash on my little boy trying to 'play' with him. My hubby was shocked too and deduced that FIL overestimated himself and didn't know that he might hurt his grandson while trying to 'play' with him. We tried explaining to him but our advice was simply brushed aside. Nevermind, it's ok, he'll say laughingly.


In addition to safety, there's another problem: cleanliness. 


One day, out of the blue, my FIL began to resist washing his hands after visiting the bathroom and went on to have his meals and feed my son his share of food with his bare hands. Usually, after his meals, he'll have some food splattered onto his shirt and pants, since he can only use one hand to feed himself. And when we tried to clean him up, he refused flatly, saying that we're such clean freaks and it's not good to be too clean. And so he went on his day switching on/off the light switches, turning door knobs, touching the TV remote controllers and everything else with his unwashed hands. Eventually, on two occasions, our whole family, which includes our helper, my son, hubby, and me, was subsequently down with stomach flu. All of us vomited, and/or had diarrhea and fever for days. The medical bills for the whole family were really getting unbearable.


Sometimes, my ignorant son even picked up FIL's dead skin on the floor to eat! (My FIL has a skin condition where he had bleeding ulcers all over his body and can shed a lot of dead skin, some, in pieces/crusts. Every morning, after he wakes up, we'll have to sweep off his dead skin on his bed or wash the bed sheets altogether.) Moreover, FIL began to revert to his unhealthy eating habits consisting of all sorts of unhealthy snacks, and loads of oily and fatty pork/pig trotters meals which obviously worsens his skin condition - which means more ulcers, more bleeding, and more shedding of dead skin around the house.


By that time, living in our house has become too much to bear. The filthiness throughout the house, the illnesses, the daily stresses and everything else...


That was when hubby and I decided, mainly for the safety and health of our young son, to send FIL back to his own rightful home in Woodlands, where he can be himself and not be restricted in any way by us. Of course, this time, he'll have a personal helper to serve his daily needs - bathing, meal preparations, medications and daily strolls in the park. Besides, there are only adults in the Woodlands home where my hubby's younger brother who is living there with his wife is hardly at home. They work on weekdays and usually visit Johor over the weekend, leaving the house empty most of the time.


Things were fine after the maid and FIL settled down in Woodlands and Nin even mentioned that FIL seems to be in good mood, occasionally whistling and singing to himself and enjoying all his favourite food. Until about six months later, FIL became weaker and couldn't walk anymore. He was eventually admitted to the hospital and has become bedridden.


That's when the doctors advised us to send him to a nursing home as one helper cannot handle him alone. You need at least 2 persons at a time to, say, lift FIL up, in order to clean him. Of course, we cannot afford to have 2 helpers. And this time, with certain conditions fulfilled, we will get a sizeable government subsidy to reduce the cost of the nursing home bills. So, in about a month, FIL was send to a nursing home. We were lucky to get a bed/placement. Just like subsidised childcare in Singapore, there are not many vacancies in our subsidised nursing homes. Sometimes, you have to wait for 3 months.


With my FIL settled at the nursing home, we ceased the services of Nin - our hard working helper, who has been doing a rather good job (with some glitches here and there, but hey, nobody's perfect) - and sent her back to her agency to find another employee since she wants to continue working here in Singapore. PS: If she wants to go back home, we'll have to buy her a one way ticket and send her off at the airport.


Later, we heard Nin found a new employee. I wish her well.



Subsequently, on top of our own family (which includes the whole family of my hubby's brother and sister), we heard that other relatives and old friends of FIL has been visiting him at the nursing home periodically too, making him rather happy. Although he's still the man with few words. And every Sunday, my hubby would visit him and bring him out for a good meal.



Thus, this ends the episode of taking care of one of our elderly parent.