Sometimes, home nursing creeps up on you. You gradually take on more tasks for your elderly parents. You start by phoning them daily and visiting every night, then you use up all your holidays looking after them. Then you start applying for unpaid leave. Eventually, you realise even that’s not enough when it comes to taking care of elderly parents.
Other times, you are catapulted into home nursing after a medical crisis. Your elderly parent has a stroke or heart attack, or they need somewhere to recover from an operation or cancer treatment. In my case, it was for both reasons. I’d been spending more and more time trying to care for my parents while juggling a full-time job. Then, my mother fell and broke her hip. Suddenly I had to look after two terrified 90-year-olds, both with multiple medical conditions.
My dad had bladder, kidney, heart, mobility and hearing problems, and only 15 per cent sight. My mother was already almost blind before her fall, and now she was mostly in bed or a wheelchair. Worst of all, her mind was affected. Three operations, multiple anesthetics and pain pills had turned my funny, clever mother into a confused and forgetful child. She needed 24/7-care. So I moved into their home to provide it. Here’s what I learned:
Don’t try to care for elderly relatives alone — get help
Take it from someone who has been there. Don’t try to do everything alone. I know you’re loving and filial. But you’re also just a human. You will break if you try to do it all alone. New grants and home help packages are arriving in 2023. Do check them out and apply.
I remember the exact time I realised I needed help. I’d started sleeping on the floor next to mum’s bed because she needed my help six or seven times a night. Sometimes she needed my help to go to the toilet commode. Other times she needed a heat pack for her pain, or more blankets, or fewer pillows, or she had nightmares and needed soothing… it was endless.
Anyway, that night, I woke with a start around 4 am. I’d heard a noise. Through my fog of exhaustion, I realised my mum was not in bed! I heard her in the living room! Although she could hardly walk — or see — she had somehow managed to get out of bed and slide along the walls to the living room. I was so shocked. She could have fallen! Or killed herself! I was so scared; I shouted at her.
And that just made things worse. She started crying. It was clear she had no idea what time it was — or even who I was. In a little girl’s voice, she told me she’d gone looking for her dolly. “Please don’t scream at me,” she sobbed. It broke my heart. I found my mum’s knitted teddy bear, put her back in bed, and stroked her hair until she fell asleep.
Then I sat on the floor and quietly cried my eyes out. I was exhausted, lonely and terrified of failing my parents. I’d lost 15 kilos in four months, and my hair was coming out in handfuls. I needed help.
Investigate home-nursing services
It’s common for elderly relatives to have several health problems. You may have to watch for warning symptoms like sudden fevers after cancer treatments. You’ll probably have to keep track of a gazillion pills and medicines. Also, you may have to handle practical medical tasks like changing commode liners, inserting and removing urine catheters, or giving injections.
Home nursing services can do many of these tasks for you to make long-term care safer and less stressful. One such service provider in Singapore is Ninkatec. This company offers 24 hours personalised healthcare solutions and palliative care for elderly patients. They use a combination of personal assessments, and hi-tech tools, like the Ninkasnug mat. The mat lies under a patient in bed, and intelligent sensors pick up micro-movements from the patient’s breathing rhythms and heartbeats. The record helps doctors with treatment, and it reassures you that everything is okay.
Tap on home nurses for life skills, not just medical help
As well as medical skills, part-time home care nurses can give you practical tips. One of dad’s home nurses showed me her “go bag”. She stocked a backpack with extra underwear, anti-mosquito spray, drinks, extra trousers, jumpers, wet wipes and plastic bags, to carry soiled clothes. She uses this bag when she takes elderly clients on outings, or on appointments to the hospital.
So I bought a backpack and stocked it with items she suggested. It was really helpful. A backpack is best, because it helps to be hands-free when you’re pushing a wheelchair.
Take a break for yourself every day, even for 30 minutes
Something about providing long-term care will drive you especially CRAZY. Maybe your parent will ask the same question 20 times or refuse to wear a hearing aid, so you have to shout all day. Or they’ll move as slowly as frozen ice when you have so many other things to do.
Unless you are a living saint, it will get frustrating. But it helps to stay calm and move at their pace. For one, it’s not safe trying to hustle a fragile, elderly person on or off a shower chair. You’ll slip on the wet floor, or they will.
I’ve learned you can only be an effective and loving carer if you are in control of your emotions. That’s why you need a break every day. You need to de-compress. It’s great if you have access to a helper or maid. Still, there’s no substitute for medical training, especially if your elderly parents have complex medical needs. Every day, when our part-time home nurse arrived for her hour’s visit, I could go out for a walk or bike ride. I’d get one hour to myself and know my parents were still safe — worth every cent.
Suggest specific tasks your family can do to share the load
Not everyone in your family will volunteer to help with long-term home care. Some people live too far away. Others have too much on their plates with children or in-laws. Others are not sure what to do.
So it helps to suggest specific tasks they can take on. For instance, if they live too far away to visit, can they contribute financially? So you can get more home-nursing help? Other essential tasks they can help with include buying home-care tools like shower chairs and walkers, dealing with legal or medical paperwork, doing regular household tasks, and taking mum and dad to medical appointments.
Make a list of all the tasks you do, and share them with your family. It’s true some of your relatives may still be too selfish to help. What can I say? That’s on them. But I found many are willing — if you give them clear direction.
Learn “manual movement skills” to protect your back
Don’t ignore your own health when you are providing long-term care.
For instance, you can easily hurt your back or shoulders when you’re carrying an adult. Protect your back by investing in a few simple tools — like a slippery plastic slide sheet. As this video shows, slide sheets make it much easier to move someone in bed.
It’s easier for an elderly person to slide into the car if you put a slide sheet on the seat. Also, try a car cane — a portable handle that fits any car door. If they have weak legs, it makes it much easier for them to exit the car and stand up. You can buy all these aids online
Our home nurse also showed me safer ways to carry and move heavy objects without straining my back. You can see some medical “manual movement methods” in the videos in these links.
Check the house for hazards, so you can prevent elders falling
Anything that helps your elderly relatives move around with more confidence is a good idea. My mum broke her hip when she tripped on a rug. She had refused to throw it out, despite my nagging. Now I will feel guilty forever. I should have just thrown it out like I wanted to.
So do what you can now to make their home safer. Remove rugs that can trip them up, and install motion sensor lights in cupboards and along dim passageways. Add handrails along corridors and in bathrooms. Resurface slippery tile and marble floors with non-slip tiles, or use a paint-on surface treatment.
You can apply for funding to modify an HDB apartment for elderly, here. And this website gives ideas and safety tips that are directly relevant to Singapore homes.
Investigate funding to pay for eldercare at home in Singapore
In Singapore, when it comes to taking care of elderly parents, there are a number of grants and schemes for home carers, including the Home Caregivers Grant of up to $200 a month (it may be raised to $400 a month in 2023). There’s also the Seniors Mobility and Enabling Fund which helps you pay for tools like wheelchairs, to help them move about. Most of these funds are means-tested.
When it comes to applying for funding and grants, you need to keep track of all the paperwork. I got a physical concertina file to keep all letters, contacts, IC numbers, passwords and papers together in one place. When you get through to anyone on the phone, you want to be able to follow up — on the spot!
If you prefer to keep e-forms online, go ahead. Whatever helps you find all your records quickly. Once you start looking after your elders (and their finances and grants and appointments and medical records) you will have a million passcodes and things to remember.
I also took a screenshot of all papers and ID info on my smartphone and filed them in “albums” of screenshots, by topic. This made it easier to work on the go. I often sent emails with attachments while I sat in a doctor’s waiting room, waiting for my mother or father to be seen.
Join online forums for caregivers
I found this website very useful because carers share tips that work in real life. For instance, I learned to use big textured rubber play mats for kids under the bedside toilet commode. The mats are cheap, non-slip and clean-up is easier after any “accidents”.
The website content includes other caregivers sharing tips and people venting their frustrations. It’s comforting to know you are not a monster if long-term care of your elderly folks sometimes makes you feel angry or overwhelmed.
As someone on the forum wrote, “Caring is not being a perfect saint. Caring is doing your best, even on bad days. And then getting up and doing it all over again the next day. And the next.” Even just knowing other people know what you are going through can be enough to keep you going for another day.
Updated April 2022.