Saturday, June 27, 2009

Walk the journey 漫漫人生路 (1 of 2)

Singapore's population is ageing rapidly. The first batch of post-war baby boomers will reach 65 years of age by 2012. Today, one out of every 12 Singaporeans is aged 65 or above. By 2030, this ratio will become one out of five.

A colleague shared with me his experience in dealing with elderly with dementia. How would you cope with a situation when ageing parent who used to offer you a shoulder to cry on, has changed to be misbehaved and does not even recognise who you are?

The decision to move a person into a nursing home is often difficult. It involves a challenge of moral values and beliefs. Filial piety is one,switching between love and sacrifice is another. For the person with dementia, he may not wish to go into a nursing home and may become outraged. What ever the decision be, it would appear to be cruel to the person with dementia and the immediate family.

However, because of the intensity of care that may be required, it is often difficult for even a loving family to provide 24/7's care that a patient may need. If friends or family wish to provide these services it is very important for them to be aware not only of the patient’s needs, but also of their own needs. It is not uncommon for a spouse or children to feel that they have an impossible choice between being utterly overwhelmed by trying to provide all the care, or feeling they are betraying their relative if they so decided send the relative with dementia to a nursing home. This often leads to the care provider becoming exhausted and family relationship turn sour.

There are reasons why a person with dementia should move to a nursing home. Usually this happens later in the illness. Generally it because his or her care needs or behaviours exceed the abilities of their family to care for them at home. This may include the need for skilled nursing care such as treatment of infected ulcers or behaviour that requires physical intervention such as violent conduct and falling.

Back to the colleague of mine. His granny eventually died in the nursing home with peace. There were emotional adjustment in between but on reflection, he felt that the decision was a right balance for everyone.

In reality, age sneaks up on us unexpectedly, and there is no escaping the fact that we are all growing one year older every 365 days. Hence, the art of living is to know how to grow old gracefully. Perhaps we may also have to state our preference upfront before we reach the stage of becoming unrecognisable. These effort would help to release some of the burden for our love ones, and enable them to move on with life without suffering too much from the extra agony.

But before reaching such decisive stage, let’s appreciate that life is a full cycle. The start point is also the end point. We can't extend life and we can't delay death. For that limited time between life and death, we can be kinder to each other and leave some warm memories among us.


Lam Chun See said...

Sorry. I know English is not your 1st language. So hope you don't mind if I point out one quite serious mistake. Later feel free to delete this comment.

It is not correct to refer to a person suffering from dementia as a "demented person". To say somebody is "demented" means he is crazy or mentally ill. Usually we used this word in negative way.

So instead of saying "demented person", I suggest you say (I know it's much longer), "person suffering from dementia".

Kok Leong said...

Chun See,

Thank you for pointing out the "demented person". Recently I read some medical articles and found that "demented patient" is a medical term frequently used to describe a person with dementia. Some examples could be found in "The ethics of surgery in the elderly demented patient with bowel obstruction" and "Ethical issues in the management of the demented patient" through the following links:

I checked dictionaries and found that "demented" carries two meanings: crazy and suffering from dementia. Longman suggests that the meaning of suffering from dementia is of old fashion.

Perhaps "person with dementia" would be a better way of saying in order to present the true meaning.

Once again thank you for pointing it out.


Lam Chun See said...

Thanks. I also learnt something. But I was referring to more common day to day usage.