HOME SERVICES FOR YOUR CONVENIENCE

Back in the early 1980s a close friend of mine bought over an old Milo van and converted it into a hot-dog and burger mobile business venture. It was probably the first meals-on-wheels in the country. I'm not sure whether it was the novelty that attracted customers wherever it went, or the friendly service, but he did a roaring business especially on Saturday nights.

If Lake Gardens was your favourite couples' haunt in those days, you would probably have seen Prem's mobile van parked there to cater to hungry young lovers out on a date night. (pic: a typical Meals-on-Wheels).

Mobile vans are great for providing home services too. There is money to be made for those enterprising and creative enough to venture into this niche business. I was waiting for transport in the Mont Kiara area when I chanced upon the Hello Handyman mobile van. I thought it was such a great idea to have repair services brought right to your doorstep. We have used their services and find them quite satisfactory.

Above: Lawrence Yoong and Ryan Foong - the enterprising young men behind Hello Handyman, the home maintenance and repair business.

That's also how I met Casey of MV Ideas Enterprise. Give him a call if you want to get your car washed, waxed and vacuumed without having to leave your house or lift a finger! How absolutely convenient, especially on a lazy Sunday when you would rather relax at home with the family.



Above: Casey and his car wash business. A look at what's inside his mobile van.



It was Casey who drew my attention to MyIdeas set up by the Ministry of Science, Technology and Innovation to encourage Malaysians to come up with creative ideas "to improve the society and overall Malaysian life". It's a great way to get feedback on your ideas. The ministry will convert the best ideas into reality, as in Casey's car wash mobile business.

With my mom (and me) housebound, I can think of a host of home services that could be quite successful with the right marketing and management, beginning with home nursing care. Here are more to think about:

Pet grooming

Dry cleaning (pick up & delivery)

Aquarium cleaning

PC troubleshooting

Grocery delivery

Shoe repair

Clothes alteration

There's no limit to the kind of home services one can provide for the stay-at-home, in particular the elderly who have to rely on others for such services.

Five steps to getting your creative ideas realized. (Source: MyIdeas website)

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DEMENTIA - ARE WE AT RISK?

I'm glad I decided to go ahead with my plan to attend the just-concluded Asia Pacific Conference on Ageing organized by the Gerontological Society of Singapore in conjunction with its 25th anniversary celebrations.

Given my mother's condition, I was particularly interested in the presentations on dementia and caregiving of the elderly with dementia. I picked up some really useful information that helped me understand my mother's dementia and my role as her primary caregiver. It was comforting to know about the existence of support groups and options available for homecare and nursing services.

There is currently no pharmaceutical cure for dementia. The risk of dementia increases with age. That puts most of us aged 65 and above at risk. The statistics below are certainly alarming:





By 2030, 20% of Singapore's population will be aged 65 and above.

Fortunately, there are steps we can take to reduce the risk. Seek treatment if you have high blood pressure, high cholesterol and diabetes. You are at risk if you have had a stroke or suffer from depression.

Here are the 10 warning signs of Dementia to look out for. We may experience similar situations from time to time. The difference with dementia is that these behaviours will progressively get worse and affect the patient’s ability to live and function safely and independently.

1.Memory loss that affects day-to-day function
2.Difficulty doing familiar tasks
3.Confusion about time and place
4.Problems communicating
5.Difficulty planning or solving problems
6.Poor or decreased judgment
7.Misplacing things
8.Changes in mood or behaviour
9.Changes in personality
10.Withdrawal from work or social activities
(Source: Health Promotion Board, Singapore)

Conference attendees were each given a copy of the award-winning short film "Ah Kong" written and directed by Royston Tan. It's a story of a young man's attempts to help his grandfather remember his past as he struggles with dementia. However, it is not the past that the old man forgets, but the present.

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IT TAKES THE WHOLE FAMILY

My mother was discharged on Monday evening 21 March. The final bill for 15 days of hospitalization, angioplasty and bipolar hemiarthoplasty came to RM45,532.90. There's still weeks if not months of follow-up medical examinations and physiotherapy, not to mention a supply of expensive pills for the rest of her life. By no means is the final bill truly the last one. (Pic: mom taking her first steps on the stairs in the physiotherapy room)

Looking after an elderly parent who's just had hip surgery can be very demanding. Many times more so when she has dementia. Whatever advice or precaution you give doesn't sink in. A lot of time and patience is needed to explain and repeat instructions given by the doctors. As soon as you have done explaining one simple instruction, it's forgotten within the next minute.

It is this dementia that complicates an otherwise smooth transition to full recovery for my mother. It is also this that wears down the caregiver, yours truly, who has to keep an eye on her almost every minute of the day. Fortunately, everyone at home helps out. My 5-year old grand-daughter watches over mom while I am in the kitchen preparing a glass of milk for her. "Make sure great grandma doesn't try to get up from her bed," I tell her. She nods her head, feeling important and proud to be a member of the homecare team.

The nights are the most stressful for me. I have to be alert for every sound or move that my mom makes. There's the constant fear that she might try and get up on her own. So I fight sleep to be on guard. My mom doesn't fully comprehend the dire consequences of a second fall, even though the doctor has repeatedly reminded her. In fact she stubbornly insists that she's never had an operation in her life, even when we show her the x-rays and medical reports.

That's the challenge of caring for my mom. And it looks like the family's in for the long haul.

If it takes a village to raise a child, it takes the whole family to care for an elderly parent, especially one with medical problems. At least, that's the way it should be. Not only should family members contribute towards the medical expenses, but also share in the caregiving. More helping hands means less stress for the primary caregiver.

Siblings can take turns to spend time with their aged parent. It shouldn't always have to be the daughter who is not married, or who has no children, or who is widowed, to be the primary caregiver, as is the general practice. This is making presumptions that she is the best person to take care of their aged mother or father. Everyone has to make sacrifices, not just one sibling. It should not be that life goes on uninterrupted for all, except the caregiver sibling who has to make drastic adjustments to her lifestyle.

I am pointing this out because I know of many cases where the unmarried daughter is often the sibling who bears the heavy responsibility of caring for an ailing parent all on her own. It's time the other siblings woke up to the fact that it's a shared responsibility. Those who can't provide the physical caregiving, can contribute financially towards the care of their elderly parents. So, ladies, you are no less filial if you appeal to your other siblings for some assistance, financial or otherwise. Their empathy alone is not enough. (Pic: I picked this up at the National Library Singapore last month. A good read for daughters who are caregivers of their elderly parents.)

I am fortunate that my siblings are supportive. My younger sister from Batu Pahat is relieving me for the next few days so that I can attend the Asia Pacific Conference on Ageing in Singapore. I have cancelled all my scheduled activities and appointments for the coming months, except for the APCA. Hopefully I might pick up something useful that will help me to better understand my mom's dementia and provide her with the care that she needs.

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NO SCHOLARSHIPS FOR RETIREES

Here's another personal encounter with age discrimination.

Early this month I heard that UniSIM was offering a Master of Gerontology course commencing this July. It was the first university in Singapore to do so. I was excited as for the past two years I had been looking for just such a course of study. A post-graduate degree in gerontology would definitely add credibility to my writings on Seniorsaloud, and open doors to new career opportunities.

As a strong advocate of life-long learning, I was eager to register for the course. Classes would be held on alternate weekends at the Clementi campus in Singapore. The modules covered areas that were familiar to me. The entire course could be completed in one and a half years. Students could start with the 9-month compulsory course leading to the Graduate Diploma in Gerontology. They could then decide whether to continue with another nine months of elective courses leading to a Master of Gerontology. The flexibility of the course structure suited me perfectly.

My Seniorsaloud card which I always refer to as my PASSION card.

The only hesitation I had was over the fees - S$15,408 for the Graduate Diploma, and S$30,816 for the Master degree. There was a 20% concession for applicants aged 60 and above. That would certainly help retirees thinking of registering for the course.

Then my mother had a fall.

I watched incredulously as the hospital bills kept escalating, and the savings kept dwindling. That started me on an online search for scholarships.

To my utter disappointment. I found that every foundation that offered post-graduate scholarships had a maximum age limit for applicants - not more than 30 or 35 years.

Age is a deterrent to older applicants for scholarships.

Fine, I can accept that companies consider scholarships as investments, and that it makes more sense to invest in younger people, simply because they can get more lifelong mileage out of a 30-year-old than a 60-year-old. But older students are more committed, and bring with them a wealth of life experiences that would contribute richly to the class dynamics and to the learning process. This is particularly so with gerontology - the study of the ageing process and the problems of the aged.


Sometimes, when you're older, you really have to go the extra mile to compete with the younger folks.

There shouldn't be a cap on upper age limit for scholarships just as there is no age limit placed on university admission. I am sure the members of scholarship selection committees are themselves in the 50+ age group. Surely they could be more supportive of older adults returning to school again. And haven't they heard that 60 is the new 40? Why must it always be about ROI?

I have at least a good 10 years of working life in me. At present, one in 11 Singaporeans is aged 65 and above. By 2030, it will be one in five. With the population ageing rapidly in Singapore and across the region, there is an urgent need for qualified gerontologists. I know I make a darn good one.

Click here to find out more about careers that involve a knowledge of gerontology. (Source: Mississippi State University)

The closing date for application is coming up on 31 March. I am applying the Law of Attraction and hoping that the universe picks up my request and respond. Who knows I might find a letter in my (e)mail box with an offer of scholarship or sponsorship for the Master of Gerontology course!

In the meantime, I shall resort to buying a lottery ticket of two...

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ENCOUNTERING AGE DISCRIMINATION AT THE BANK

My mother hasn't been discharged yet, but every few days, the hospital would contact me and request for a RM8000 top-up. So far, the cost of her 12-day hospitalization, angioplasty and hip surgery has exceeded RM31,000. She has at least another 4-5 days to go before she can go home. I dread to receive the final bill.

Yesterday I was at the bank on what I knew was a 'mission impossible' - to ask for a raise on my credit card limit so I could pay for each hospital top-up. No harm trying, I thought. Just as I had feared, the bank imposed conditions that I couldn't meet because of my age. It was all too familiar, as I was given the same conditions when I tried to apply for a second credit card last year.


What were the conditions? They wanted me to submit my latest income statement. Hello, I'm 63 and retired. I haven't been in full-time employment for years. They also asked for a copy of my FD accounts. The amounts I have in my FDs are embarrassing, and for my eyes only.

Doesn't it count that I have never been in credit card debt, or any debt, for that matter? I have a sparkling clean record, and an AAAA rating on my integrity. But I guess the banks are not impressed by such pristine track records. They can't impose a fee on me for late payment or charge me interest on bank loans or overdrafts. In short, I'm not considered a good customer.


The bill I received on 16 March - this is only a sub-total of page 1. Take a closer look at the most costly items. (Click on image to enlarge.)

All this means I have to get a banker's cheque made out in favour of the hospital. The hospital does not accept personal cheques. And if the costs keep escalating, as they definitely will, I'll have to visit the bank 2-3 more times to get the cheques done. What a hassle!

And that's not the only case of age discrimination I encountered of late. More in the next blog post.

Related Post:
Credit Card Discrimination Against Retirees

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POST-SURGERY CHEER

My mom's hip operation was a success. She was wheeled into the operation theatre at 1.30pm yesterday, and by 5pm she was out and transferred to ICU. As I am writing this, she has just been moved back to the general ward - a sign that she is doing well post-surgery. The doctors say she should be discharged after a few more days of healing and physiotherapy.

To all Seniorsaloud readers who have been following the postings about my mom's hospitalization, and who have left comments, phoned or emailed me, I thank you for your concern. Your moral support kept my spirit up during the long hours sitting by my mom's bedside in the freezing hospital ward.

The road to recovery will be a long and slow one for my mom. If looking after my 85-year old mom was stressful before, it will be doubly challenging from now on. I welcome any sharing of personal experiences either on post-surgery healing, caregiving or home nursing care. Information especially from those who have been through a similar situation will help me tremendously in making better decisions.

My thanks also to friends and relatives who visited and cheered mom up. I shall keep you updated via email.

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TAKING PRECAUTIONS AGAINST FALLS

In an hour or so, Mom will be wheeled into the operation theatre for her hip surgery. Right now she's fast asleep after a light breakfast early this morning. Dr Gan has come by for a final check on her, and has given the thumbs up to go ahead with the surgery scheduled for 12pm.

Last night Dr Wahida, the anaesthesiologist, informed me of the risks involved due to mom's age and her recent heart attack. But we are all optimistic as we have heard such encouraging reports from friends and relatives who have been through a similar surgery.

She will be in ICU for a day or two before she's transferred back to the general ward. After that she will remain a few more days for observation and physiotherapy. I'm sure she can't wait to be discharged, to feel the sunshine and breath the air outdoors. I can empathize with her eagerness to be up and out of hospital. Only those who have had surgery and been hospitalized for an extended period of stay can fully understand what it is like to lie in bed day after day, not able to move much, and in discomfort if not pain.

All the more reason why we should take care of ourselves, and also take all the necessary precautions to prevent falls in our elderly parents. Statistics reveal that most falls occur in the age group 65 and above.

Here's a good article you can read: Prevention of Falls in the Elderly.

And here's a Youtube video on the same topic.



Prevention is better than cure. How often have we paid lip service to this when it comes to taking care of ourselves and our loved ones. Let's pray that we don't have to pay too high a price for lip service.

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MARKING TIME IN HOSPITAL...

Today is Day 7 of my mother's hospitalization. She had an angioplasty done on her last Tuesday. She's doing fine, eating well and enjoys being pampered by her visitors and the nurses. Still, she is impatient to go home. She has been lying in bed 24/7, unable to move much as her right leg is in traction. The doctors are waiting till her heart is strong enough for the hip surgery. Although she is generally cheerful especially when she has visitors, I know she feels depressed sometimes. That's when she talks about joining my younger sister who has passed on. We haven't told her about the hip surgery scheduled for next Tuesday, or she will worry no end about it.

Blocked arteries are not the only setback that my mother has. Dr Tiang suspects she also has early signs of dementia. She can't differentiate between night and day. She sleeps more during the day than at night. Her room-mates have complained that she keeps them up during the night. She's either snoring loudly or pleading with the nurses to allow  her to go home. Having a family member stay the night with her compounds the problem, as she keeps up a running conversation with whoever is by her bedside. Mom just loves to chat.

To solve the problem, every night at about 11pm, the nurses move mom to the treatment room next to the reception counter. She has the room all to herself, and the nurses are close enough to hear her when she calls for assistance. In the morning before the doctors make their rounds, the nurses move her back to her 2-bed room across the hallway. I have told the nurses I am not too happy with this arrangement.

Mom says the smile is to let family and friends know that she's fine except for her immobility.

It didn't surprise me at all to hear that mother is in the early stages of dementia. In the past two years, I've noticed she's become increasingly confused about dates, faces, and places. She can't remember where she leaves her things, and accuses people of stealing them. She is easily suspicious.

To understand my mother's ailments better, I have been reading books on caring for elderly parents, in particular, parents with Alzheimer's Disease. Looking back, I wonder if in my sub-conscious mind I was perhaps preparing myself for a time when my mother would be needing specialized care-giving beyond what I am able to provide on my own.

If you are looking for an insight into the ageing process, and how to cope with elderly parents with special needs, I would recommend the above books. I am not sure if "You and Your Aging Parent" is available now. I bought my copy years ago. "The Alzheimer's Caregiving Puzzle" is on loan from the National Library Singapore. I'm still reading it.

I shall be sharing what I've gleaned from my readings in future posts on this blog.

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WHEN COMPLICATIONS SET IN...

My mom's hip surgery scheduled for yesterday afternoon had to be postponed when tests showed that she had suffered a heart attack earlier. She has no recollection of it at all. It could have been the cause of her fall. I'll have to find out more from her cardiologist, Dr Tiang Soon Wee. (Left: Xray of mom's hip fracture.)

So instead of the bipolar hemiarthoplasty of the hip, mom had an angioplasty done on her this morning. Several of her blood vessels were 60%-70% blocked. As her age was a factor, the doctor inserted a balloon in one of the more critical arteries to enable smoother blood flow. The whole procedure took just over an hour, and she was fully conscious throughout.

Dr Tiang pointing to one of Mom's blocked arteries.

She spent the night in ICU. This morning Dr Tiang informed me that she was doing fine and would be back in the general ward as soon as a bed was available. Once she is strong enough, orthopaedic surgeon, Dr Gan Eng Cheng, will proceed with the hip surgery, most likely in a few days.

A Google image of what bipolar hemiarthoplasty involves - a ball and socket prosthesis will be inserted to bridge the fracture.

Meanwhile the medical costs are mounting. When we registered her on admission Sunday evening, we had to pay a deposit of RM8000 before Xrays were taken. Just this evening, that's Wednesday, the hospital requested that I top up the initial deposit with another RM8000. And mom hasn't even had her hip surgery done yet!

Plenty of choice, but only if you can afford the rates. We opted for a 2-bed room for mom.

Already we are checking out options for home nursing care. Mom's mobility will be severely reduced during the healing process. She needs daily monitoring and care. It's good to know that home care service is readily available, and the charges seem quite reasonable. We will have a better idea of what sort of professional nursing service to engage after her surgery.


Pity the hospital doesn't offer help to source for a full-time live-in maid to help me look after my mom.

It was only by sheer luck that we discovered the hospital gives discounts to patients who are aged 55 and above. Most senior citizens do not have insurance coverage. My mom too. The receptionist at one of the clinics mentioned the discount to us as we were leaving the clinic. We immediately applied for a card for mom. There is a fee of RM5, and the card is valid for a year. Patients get a 20% discount on room charges, and 5% on medicine, and other incidental charges.



I doubt many people know about this discount card. There are no pamphlets or notices informing patients and their families about this. 

Mom is doing fine, and is her usual cheery self. Her appetite is excellent - there's no leftovers after her meals for hungry me! The doctors say she's in relatively good health for her age. It's probably due to decades of doing exercises and daily walks. Last night she was even attempting to do arm exercises lying in bed.

Occasionally she complains about pain when she tries to move her right leg, and is impatient to go home. She doesn't know the full extent of her injury. We think it best not to let her worry too much. 

She perks up whenever she has visitors, and has taken a fancy to Dr Tiang, calling him 'such a handsome young man', and flirting with him whenever he drops by at her bedside.

That's mom alright!  

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MOM FELL AND BROKE HER RIGHT HIP...

Source: Straits Times 5 March 2011

 Mr Khaw Boon Wan, Singapore's Minister of Health, announced on Friday that geriatric medicine will be a 'core competency' for all doctors and nurses. A far-sighted move, given the fact that by 2030, one-fifth of the population will be aged 65 and above. The government is making sure that all health-care professionals will be equipped with the knowledge and skills to help the elderly manage their diseases well.

Priority will be given to the treatment and care for five major problems that afflict the elderly: hip fractures, stroke, heart failure, chronic obstructive pulmonary disease and diabetes. The aim is to help patients make a smooth transition from hospital to home. More support will also be given to caregivers who suffer from burnout and emotional stress, and to voluntary welfare organizations such as NTUC Eldercare, to help them expand their home-care services.

When I read the above news yesterday, little did I realize that in less than 24 hours I would be in dire need of some geriatric knowledge.

The doctor on night duty explained to us with the aid of visuals the type of hip fracture that mother has.

My 85-year old mother had a fall Sunday (yesterday) afternoon. I came home to find her lying flat on the floor just outside the bathroom door. She was conscious but somewhat confused about why she was lying there. Afraid that I might aggravate her pain by moving her, I called for an ambulance. It arrived within five minutes.

My brother and sister-in-law helped me get her admitted to a specialist hospital in PJ. The X-rays showed she had sustained a right hip fracture. Surgery seemed inevitable. The doctor would give us a clearer prognosis a few hours from now (Monday morning) after examining her. We would know what the options are - if any.

At her age, it would take a while for my mom to recover sufficiently to be on her feet again. As I look at the days ahead, one thing is for sure - I will have to learn how to tend to my mother's special needs during the healing process. I've read enough and seen enough to know that caring for an elderly patient during and after hip replacement surgery can take a toll on the caregiver.

I pray I will be up to the task...

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DON'T LET YOUR DREAMS DIE WITH YOU

Source: Straits Times 2 March 2011

   "...We can each live our dreams, with or without help. If there is help, we get there faster. But if there isn't, we should keep trying anyway."

This was what Mr Sam Tan (Tanjong Pagar GRC) said in Parliament on Tuesday when he took the floor to debate on Singapore's fiscal policy. He was responding to complaints about the recent Budget. Despite the goodies promised in the Budget, there were people who complained that the government wasn't doing enough to help young Singaporeans buy property, get married and raise a family.

His speech titled "We don't need a fat Budget to live our dreams" drew inspiration from the video (see below) of a group of Taiwanese buddies, average age 81, who went on a 13-day motorcycle trip around the island to pursue their dreams.

I first posted the video a week ago under "Live life, love life, for who knows when our time is up". Here is the video again, this time with English sub-titles.



There is no such thing as the perfect Budget that pleases everyone. The world doesn't owe us a living. And in the case of Malaysia, neither should we depend on the government for hand-outs and subsidies, for these can easily become crutches - remove them and we stumble and fall. Nothing like learning to stand on our own feet.



So, do we want to see the rest of our lives as full of aches and pain, or full of hope and promise of better health and improved finances? The choice is ours, and ours alone to make. Ultimately, it's about how we choose to view what we have on our plate - goodies or measly crumbs.

If it's the latter, think of how we can transform those crumbs into pies. Personally, I think senior citizens in Singapore are getting a generous slice of the apple pie in this year's Budget.

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NEVER TOO OLD TO STUDY THE OLD

Just found out that UniSIM will be the first university in Singapore to offer a Master of Gerontology in July this year. This is truly exciting news for those of us who have a passion for this area of study.

Here's the full report from ChannelNewsAsia.

SINGAPORE: From July this year, SIM University will offer a Master of Gerontology, the first of its kind in Singapore.

UniSIM said the multi-disciplinary programme will allow individuals to seek specialised training and upgrade their skills and qualifications.


It said the programme will also prepare graduates for leadership roles in the eldercare industry.

At the programme's launch, Minister in the Prime Minister's Office, Mr Lim Boon Heng, said the programme is a timely one.


He said it comes as Singapore faces a rapidly ageing population, with a projected one in five residents being over 65 years old in 2030.

The programme is already widely offered in countries like Australia, the United States and in the United Kingdom.

UniSIM said while the programme is targeted at those with a background in areas like psychology, social work and nursing, it is also suitable for those wanting to make a mid-career switch into the eldercare sector.


UniSIM said scholarships will also be offered for the programme.


The Master programme, which takes between one and a half and three years to complete, is also offered as a Graduate Diploma.

For more details, visit SIM University website.

Closing date is 31 March 2011. Applicants aged 60 and above are eligible for a 20% discount. Even so, many would find the tuition fees beyond what they can afford.

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