Caregiving of the elderly or bedridden takes various forms:
physical care
home chores
financial support
emotional support
Caregiving of the elderly or bedridden can take
various forms such as:
The actual physical care
Less direct work such as cleaning
the house and running errands
Giving financial support,
regular visits and phone calls
If all this is done by one carer over a prolonged
period, there will be great physical and emotional strain.
Shared tasks among family members are not easy to arrange
especially if there are pre-existing relationship problems.
Caregiving is made more difficult when the elderly person
has depression, fatigue, frustration and anger. It is important
for the family to understand the illness, and its impact on
the elderly, the family and the carer.
Illness impact
While the elderly is in hospital, the family should keep in
close contact with the staff to understand the illness and
how it affects the elderly person. They are encouraged to
participate in the rehabilitation programme.
It is traumatic when the onset
of illness is sudden; especially when it affects his mobility
and the ability to take care of personal hygiene.
The person is often shocked to
find himself having to be fed and having his personal hygiene
and toilet needs attended to by others.
He can be confused, even angry
and very often depressed when recovery is slow or not noticeable.
There will be anxiety about eventual
recovery and he will not be able to respond enthusiastically
to rehabilitation.
A lot of support will be needed
in coming to terms with his illness and reduced functional
ability.
Sometimes, the person cannot appreciate the goals of rehabilitation.
Usually he is very anxious to start walking again. It will
therefore be useful for the relative to understand and help
to encourage him.
Understanding
the person
The family is usually very
protective towards the elderly person sometimes even to
the extent of restricting the elderly person’s freedom.
It is a question of how much to
let go and allow the elderly to have self determination
versus how much care and control the carers should exercise
on them.
Instructions to the elderly not
to walk around in the house when no one is at home because
of your fear of falls can have a debilitating effect on
him.
In many instances, the elderly
person becomes fearful and refuses to walk when he actually
can. Yet the risk of a fall is real if the elderly is allowed
to walk on his own.
The decisions made can be painful and are often fraught with
feelings of guilt, fear, anxiety and frustration. Until you
have come to terms with these emotional conflicts, it will
be difficult for you to manage the elderly at home.
Effect
of the illness
On the family
The sudden onset of illness is a crisis to the family and
can often cause disruption to family life and daily routine.
Prior to the hospitalization,
the elderly might have been performing one or multiple roles
as housekeeper, childminder, income earner, helpmate and
companion to his spouse.
With the illness and the resultant
disability, he can no longer perform these functions. Far
worse, he becomes an additional burden to the family.
Before you have adjusted to the
changes and vacuum that the elderly leaves, you are required
to assume care of the elderly.
If all family members are working,
there will be no one at home to care for the elderly.
It may not be feasible for
a family member to give up a job to look after the elderly
as it can mean substantial lowering of standard of living
or experiencing acute financial pressure.
If you are caring for your parent,
Remember your parent is always
your parent – providing care for a mother or father
does not mean you have reversed roles, and the adult child
has become the parents’ parent.
Neither has your parent become
your child and should not be treated like one.
The responsibility of care
may change, however. For example as your parent ages, you
may need to care for him in contrast to his caring for you
as you grew up.
It is helpful to understand these changes, and the effects
they have on you and your family.
On One’s Life And Feelings
These changes can sometimes make you feel helpless, angry,
guilty, or depressed about the loss of what is familiar. Painful
questions arise:
Should the person live with you?
Should you resign or employ a
maid?
Should you take full responsibility?
How will it affect your own life?
You can control your response to these changes.
Know yourself, your values, strengths,
limitations and goals.
The next step is to learn coping
skills.
These include evaluating yourself
and your situation, setting goals, getting support, listing
opportunities, and taking action. Have a positive attitude.
Understanding your elderly relative
and his needs, learning specific skills and developing positive
attitude.
On The Family’s Resources
Even if the person is unable to talk, he will still benefit
from the company of family members.
Being there with the elderly person,
providing physical care or bringing food and continuing
to give pocket money are ways of showing care and concern.
He is bound to experience moments
of depression and despair. At such times, encouragement
and patience are most required.
Members of the family can perform
different roles and functions.
This will relieve the carer as
well as meet the physical, social, emotional and even spiritual
needs of the elderly person.
Family members who are cooperative
and supportive of one another ensure continuous and good
care of the elderly person.
Appreciating
your own needs
Caring for an elderly person can place considerable restriction
on the carer’s social life. The carer may worry about
leaving the elderly alone and may choose to remain at home
with him. This usually ends in isolation and loneliness. Carers
must know their limits and stop before they reach burnout.
You cannot take good care of him unless you take care of yourself
first.
Carers must seek help and support
from other family members, as well as from professionals.
Family members can relieve the
carer so that she can take regular breaks.
It is very important that the
carer is aware of all available sources of help and knows
how to make use of them.
Care
arrangements
The family needs to understand what the person can do and
what assistance he will need on discharge. Care arrangements
need to be made.
Foreign maids
It is not uncommon for families to employ foreign maids.
Employing a maid is cheaper than paying for a nursing home.
It also has the added advantage, of having the elderly person
remain in the comfort of the home and having someone to
do household chores.
Day care
The elderly person can attend a day care centre. He can
benefit from the mental, physical and social stimulation
that the activities at the centre provide and the carer
can have a break when the elderly is away at the centre.
Community hospital
The elderly person can benefit from a stay in a community
hospital for rehabilitation or convalescence. It also gives
time for the family to work out the care plan when the elderly
is finally discharged.
Nursing homes
Admission to a Home is another option. On entering a Home
however, the individual begins to lose his or her identity
and becomes an inmate in an institution. Often, accommodation
is in shared rooms or in a large dormitory style ward. There
is also the feeling of being abandoned. This is made worse
if the carers feel guilty and avoid visiting the elderly
at the Home.
Intermittent respite care is an alternative
care arrangement that provides an elderly person with either
day care or a short-stay in a Home or community hospital.
It can help the carers by giving them a break for a short
while.
It will be useful for the family to discuss care arrangements
among themselves. They can also discuss these issues with
the doctors, nurses, therapists or medical social workers
in the hospital.
Relatives' Support Group
Join a relatives’ support group or get to know
other carers. The group gives each of the carers an opportunity
to share their feelings and experiences with others in the
same position and having similar problems. Through this group
you may find the answers to the problems you encounter. Sometimes
the group can invite professionals who can inform and advise
on the various aspects of the illness and the services available
to you.
Community Resources
We have a list of services according to zones which you may
find useful. We hope you and your family can have a rewarding
experience of caring for your elderly relative and that the
elderly can have a dignified life.
Inpatient Services
These are the hospitals providing medical, nursing, rehabilitation
and respite care and for patients who are chronically ill.
Copyright 2006. Changi General Hospital. All Rights Reserved
2 Simei Street 3, Republic of Singapore 529889
Tel: (65) 6788 8833 Fax: (65) 6788 0933 Reg No 198904226R
