Caring for the Caregiver
Mdm Ang, 63, singlehandedly looked after her older sister, 67, who suffered from Parkinson’s Disease. Although the sisters had a close relationship, it did not help to reduce the amount of caregiver stress that weighed upon Mdm Ang.
The older Mdm Ang had delusions and often ramble incoherently such as claiming that she saw ghosts. In the night, she would pull off her soiled diapers and dirtied the house. On several occasions, she ran out by herself and had to be escorted home by the police. On top of all that, she was uncooperative and quarreled a lot with her sister who tried to take care of her.
When O’Joy first came in touch with the Ang sisters, it was older Mdm Ang who was referred for counselling for low mood and behavioural issues. After the initial assessment, our social worker appraised that her behavioural issues were due to the illness and counselling would not be an appropriate intervention for such manifestations. Therefore, O’Joy decided to help the sisters by providing support for the caregiver – younger Mdm Ang.
Mdm Ang herself has poor health and suffered from several medical conditions including the typical “three highs”. Yet as a result of caring for her sister, she neglected taking care of herself, causing her own health to deteriorate. Due to her limping leg, it is physically taxing for her to keep chasing after her overactive sister. Her coping mechanism would be to use scolding and shouting to make her sister listen to her. However, the daily squabbles were mentally distressing for both of them. There were several times when Mdm Ang said she wanted to end it all by killing herself together with her sister.
O’Joy social worker Poh Yee built a relationship with Mdm Ang slowly even though it was not easy. Her eccentric temper and frequent emotional outbursts kept people away from her. Hence she became social isolated. She also had poor family support, resulting in no respite from her caregiving role.
Sometimes, Mdm Ang was so exhausted herself that she did not even have energy to answer a phone call from Poh Yee. When she was stressed, she would either call Poh Yee and chatter non-stop, or she would slam down the phone abruptly. As Poh Yee recalled, each session of talking to Mdm Ang was very exhausting.
Other than attending to Mdm Ang’s emotional needs, Poh Yee also assessed her needs in other areas and helped her with the following: monitored her health and wellbeing, applied for financial assistance, helped her to understand more about the behaviour and management of people with Parkinson’s disease by accompanying her to Parkinson’s’ Society and bought her a book on Parkinson’s disease. Poh Yee also attended case conferences with Mdm Ang regarding care plans for her sister and advocated for her.
One day, Mdm Ang’s sister had a fall and was eventually sent to a nursing home. This happened during the circuit breaker where visitors were restricted. The situation made Mdm Ang very anxious and helpless. Poh Yee provided phone support to help her manage feelings of guilt and helped to book her visits to the nursing home.
When her sister passed away after a few months, Mdm Ang was on the verge of an emotional breakdown. She lost her temper a lot and cried every day. She was very sad but could not express her grief. Instead, she would call Poh Yee to vent her anger about the hospitals and her relatives. Poh Yee provided support very closely, even on weekends. As Mdm Ang had ideated suicide, Poh Yee also visited her often to ensure her safety.
As Mdm Ang is now alone, it was necessary to ensure that her living conditions were safe and conducive. After some searching, Poh Yee managed to connect with two of Mdm Ang’s nephews who are supportive. Together they explored her living situation. Mdm Ang felt that her late sister still haunted the apartment. Therefore, Poh Yee helped her to clear her sister’s belongings and got rid of the old furniture that cluttered the apartment. A monk was engaged to perform the rites, and Poh Yee also accompanied Mdm Ang during the funeral and sea burial.
Eventually, Mdm Ang decided not to move out and to continue living on her own. As she likes to talk, Poh Yee matched her with a volunteer para-counsellor who visited her regularly to chat with her. Gradually, her mood improved. Mdm Ang began going out on her own and started talking with her neighbours. Finally, she told Poh Yee that she has let go of the past grievances. She now visits her other sister often and the relationship with her relatives became better.
As Mdm Ang is still a vulnerable senior, she continues to be monitored under O’Joy’s Services for Older Persons.
Our social worker offers this advice to any caregiver:
Stress can destroy a person, and we need to seek help when necessary. In this story, although Mdm Ang was a capable woman, the problem was bigger than she could handle by herself. Remember that you can reach out for support when needed.
Support means to be there for the person. This is an example of how O’Joy worked with our clients. We take an holistic approach, assess the client via the bio-psycho-social domains, and conduct our interventions according to the needs of the client. Our assessment and intervention are dynamic, depending on the prevailing needs of the client at the time. We take a collaborative approach – be it with community partners or our in-house volunteer para-counsellor to better serve the needs of the client.
* The names, photos, and some details in this story have been changed to protect the privacy and confidentiality of the client.
O'Joy serves vulnerable elderly like Mdm Ang to help them cope with caregiver stress. Such support can often be a long-drawn process. By supporting our Services for Older Persons, you can help such elderly live out the rest of their lives with new meaning and purpose.