Category: Caregiving

Aged care, clinical (medical & nursing),

Posted in Ageing & Culture, Caregiving, International Campaigns, International Policies

Where do Asian immigrants go when we have dementia?

Posted on by Joanna Sun

My husband and I have been talking about kids for a long time now, and I’m certainly not getting any younger. As the days tick by and my facebook is filled with walls of baby photos in my activity feed, I wonder about having my own. On top of that I wonder what the future will hold for my children? I am Singaporean, my husband is Australian, our racial and cultural differences are vast. We look like chalk and cheese and our cultures are chalk and cheese. I am born and raised in Singapore and proud of it.

Looking back at my youth when I was growing up, the house was filled with an orchestra of languages. Instead of the wind, brass, drums and percussions, we had English songs from Abba, Michael Jackson, Kenny Rogers, playing on the radio. I remembered my mum even attended a Debbie Gibson concert. That was really cool! I remembered the souvenir she brought back, it was a fan in the shape of a blue hand, sounds odd now but when I was a kid, that was possibly super cool.

There would be English in the background, my great grandmother speaking in the Teochew dialect, my mum in Mandarin and my dad would speak in either English or Teochew. Sometimes I hear him speaking Malay to the man who comes to collect the payments for our daily newspaper. Singapore was an amazing melting pot of cultures and languages, and I embraced every crumb of the colourful heritage that I can call my own. There was never a dull moment growing up in Singapore, my childhood was certainly a happy one.

Image from abusymom.wordpress.com

My child will have an Asian migrant parent depending on where we will reside when we retire, and I often wonder what will happen to my children when I have dementia. Will they be able to speak my language if I regress to Mandarin or Teochew? Will I lose the ability to communicate because there will be no one who can understand me? I remember caring for a lady who spoke Russian and I would carry a notebook with me with some basic words like “dobroye utro” or good morning, “Da” for yes and “Net” for no, and about 20 other phrases for different times of the day and meals.  I wondered if her children could speak the language?

Sometimes I watch the western videos on nursing homes or visit residential aged care homes and I think, I’m never going to be comfortable in a place like this. It’s beautiful, no doubt about it, but there’s nothing familiar in the four walls. Even the people look foreign, no one speaks my language, the food is all wrong and if I were to live in a residential aged care facility, it would be like living in a foreign television show. I would think I was on the Truman show or something. I have only seen one Asian nursing home in Australia, the home is lovely, with Asian staff and sumptuous simple Chinese meals, with menus beautifully printed in Mandarin, but the environment itself looks like community hospital on the inside with nursing reception counters and a very modern western feel.

There are 10.6 million Asian immigrants in the United States of America in 2009, in the United Kingdom almost 10% of immigrants are from South Asia and in Australia a million immigrants were from Asia according to the statistics in 2011.

I wonder if I am the only person with these worries and thoughts? I wonder what happens to Asian immigrants who work long and hard to bring their children to the west, only to live out the end of their lives in confusing and disorientating environments? What can we do for them, and how can we make their lives better? Will there be more places that can cater for Asian migrants? Where can we go to feel at home when we have dementia?

I have no answers and only questions, hopefully, time will tell.

References:

Australian Bureau of Statistics 2004, ‘Where do the Overseas-born population live?’ in Australian Social Trends, cat. no. 4102.0, viewed: 18 May 2012, <http://www.abs.gov.au/AUSSTATS/abs@.nsf/mf/4102.0>.

Department of Immigration and Citizenship, Booklet 6, General Skilled Migration, viewed: 24 April 2012, <www.immi.gov.au>.

Australian Bureau of Statistics 2010, Migration, Australia, 2009-10, cat. no. 3412.0, viewed: 18 May 2012, <http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3412.0Main+Features12009-10>.

Salt, J. “International Migration and the United Kingdom, 2010.” Report of the United Kingdom SOPEMI correspondent to the OECD, Migration Research Unit, University College London, 2011.

U.S. Department of Homeland Security, Office of Immigration Statistics. 2010 Yearbook of Immigration Statistics.

I’ve attached a video that I found very moving about the trials and tribulations experienced by migrant parents to help people understand the difficulties of resettling and raising children in a foreign land. I also found a funny video about the same group of kids and parents imitating each other and that’s actually really funny.

Children Of Asian Immigrants Reveal Sacrifices Their Parents Made

Asian Moms And Their Kids Imitate Each Other

Posted in Caregiving

Enrolled!!!

Posted on by Joanna Sun


I’m really excited today! I know this sounds really silly but I am enrolled in the University of Wollongong and I’m officially a student. I posted the “don’t anyhow meow” cat picture, that’s my husband’s way of telling me how not to make unnecessary announcements. I can’t help it though, I’m too excited! A big thank you to everyone who have supported me over the years, you know who you are!  Now on to the next chapter of life! I can wait to start!

Posted in Caregiving, International Campaigns, International Policies

Our Kampung Spirit, Technology and Dementia.

Posted on by Joanna Sun

So what can our kampung spirit and technology do to help people aged in place in the community? A report last year by the ABC pointed out that there were 5 million people with dementia in Japan and thousands are going missing every day. In another report, it was cited that 10,783 people with dementia have gone missing in Japan in 2014 alone. Even in Singapore, there are more frequent reports about older adults who have gone missing. Some people have turned to social media for help, posting images on facebook and requesting friends to spread the word and be on the lookout. According to Alzheimer’s Association in America, approximately 60 percent of older adults with dementia wander. It is no surprise when you google the words “dementia” and “news” to find at least one report of a person diagnosed with dementia who has been missing and more has to be done about the issue.

Revealed: Sad plight of the thousands of elderly left alone in homes ‘without letters, visits or calls’ in their final years Read more: Click here to read article by the daily mail

We all want to age in place in the community, with our loved ones around us. We want to remain in the home where we have cultivated our memories, where our stories are embedded in the walls and every little item and furniture has a story that speaks to our soul. Unfortunately, when we have dementia, we may wander out of our homes and have difficulties finding our way back.

This brings me to point out the ‘Safe Wander‘ device designed by Kenneth Shinozuka. He invented a sensor that can be attached to the base of a sock which can send alerts to the smartphone. For Kenneth, the push to design such a device was the result of his grandfather who has dementia. For all caregivers out there, this will possibly make you skip a beat, but his grandfather wandering alone at night and had walked onto the highway. Thankfully, he was found by the kind boys in blue and the police officers brought his grandfather home safe and sound. Stories like these are not new and many caregivers would have experienced this at one time or another. For 16-year-old Kenneth, he decided that he had to do something about it.

With growing success in technology support from neighbours and the police force, pockets of residential estates with a high density of older adults may benefit from an age or dementia friendly community programme. With the community attaining awareness or dementia, everyone will be able to work together to not only enable more people to age in place in the community but it allows community ties to be strengthened and friendships to form. This builds community spirit, and with that a sense of pride and care for the people around them and the community. Or as some Asians may know, the “kampung spirit”.

Let’s be honest, I’m not the only one here that feels that the kampung spirit is dwindling in our communities. Gone were the days that I would know everyone that lived on the right and left of my home. Us kids knew what dialect and language everyone spoke and we even knew the routine of the lady we affectionately call 婆婆 (grandma in mandarin). We knew all the shopkeepers in the market and would holler “大老板早”。Whenever, we pass the herbal smelling Chinese medicine shop, the owners were an older couple from China in their 60s, possibly 80s now. We don’t know our neighbours anymore, we are busy all the time and with millions of people around us but we are truly alone. A volunteer with a senior group once mentioned that he lived in an apartment block for thirty years and a neighbour he had never known had passed away downstairs, all alone. He wished he could have done something about it. At a staff session, a colleague pointed out that a lot of older adults in residential aged care, despite having all the care staff and nurses around them, they felt isolated. Such is the irony of our lives.

Before the intellectual debate, to which many have fallen prey to what D.T Suzuki describes as the force of intellect without moral construction. The need for intellectuals to hastily call attention to, deconstruct, criticise and tear down concepts and ideas like a negative force of deconstruction without the provision of positive contributions.

We should reflect on what we can do for the community to allow people to age in place in the community.

To not feel ashamed of growing old or having dementia, to not feel like everyone have been let down. To not feel like living in an isolated institutionalised facility, thinking that living away from family is the only option, as a punishment for not being “normal”. To think that it is alright to be restrained, bed bound and living to 103 as a result of nasal gastric feeds. To not feel like a burden on society, the community, our friends and the people we hold close to our hearts. We need to look deep within ourselves and work on reducing our need for deconstruction, to stop critiquing ideas, people and ultimately ourselves when we observe the cracks on the wall. Let’s work together as a community to fix this crack of stigmatism against the elderly and dementia and be builders as our forefathers had been before us. Let’s do something about the stigmatism behind dementia before the wall that is our society crumbles before us.

Posted in Caregiving

The start at the end of the world

Posted on by Joanna Sun

I’m starting my research project in a couple of months on defining and assessing the characteristics of the built environment that contribute to the well-being of people with dementia living in aged care facilities in Singapore. Enrolment is at the end of next month and I’m excited. I’ve got my air tickets booked and even arranged for an air BnB near the University of Wollongong. I’ve never been there before, so pretty nervous and I get to meet my supervisors too! My primary supervisor is Prof Richard Fleming, who is an international expert in dementia environmental design; I have admired his work, and it’s a real honor to be able to work with him on my project. Some days I feel like I’m in the movie, “the castle” and people should be telling me “you’re dreaming!”

I grew up in Singapore, in Pek Kio (Hokkien for White Bridge). Historically it was also known as little England, as a result of the all the roads in the area being named after parts of England, such as Cambridge, Gloucester, and Kent.

Pek Kio Market and the Area Around Ex-Owen Primary School, Singapore (Photos Taken on 7 January 2015) Posted on January 8, 2015 by Roy Chan

As a child I never even dream that I would be a Ph.D. candidate. That was an impossible dream for me. The sheer cost of going to university at such a level felt like such an impossible feat. I remember being told to get married and have children instead of studying and there was not much point of doing much study being a woman. I was horrified. I soldiered on and never looked back.

Dementia is a subject that is very close to my heart, and it is an area that I had become highly passionate in, in the last decade. My great grandmother had dementia in a time in Singapore when no one had even heard about the word dementia. Her home had been renovated and she become trapped, living in her home that was not. She exhibited behavioural and psychological symptoms as a result of the unfamiliar environment.

As a personal care assistant and later an enrolled nurse, I witnessed the beneficial and detrimental effects of the environment firsthand. The design of the facility can impact the quality of life and care for the residents, the “care burden” for staff and the level of emotional distress for the caregivers. There is so much involved in the process, all the ambiguous loss and grief involved in moving from a home that one has resided for 30 years into a small compartmental space. I recall one lady telling me that it is “like moving into a much bigger coffin, and now we just have to start counting down the days”. Those says I was carrying out a small research project on how residents had positively adapted in their residential aged care facilities.

Going home to Singapore, our traditional homes are smaller, and our vernacular architect is different to those of the west, but the sentiments are the same. The sight of the residents broke my heart, and I wanted to do more. The concept of care appeared to be a “do whatever it takes” to prolong life and homes were boasting about residents who were living to 103. However, to see people restrained with hands tied to the bed rails and nasal gastric tubes snaking out like a lifeline. While they lay in bed with hollowed empty eyes at the ceiling above them made my heart ache with sorrow. It made me wonder if this is what they wanted, is this what their family would want for them? Is this how they want their story to end, is this how they would want to leave the world. I can’t imagine the physical pain they would feel, people around appear sometimes oblivious to the fact that people with dementia can feel pain and can be hurt. I can’t even being to imagine the mental torture that they must be in. I came across Yeo Kai Wen’s work one day and when I laid eyes on the photographs, it was like Alice through the looking glass.

By Yeo Kai Wen

However, one of my colleagues told me that they did the same in Australia back in the day, she mentioned that she knew how to restrain her patients in various ways. It sounded terrifying to me but perhaps in history, there must be a time such as this for everyone.

By Yeo Kai Wen

I hope my studies can make a difference and improve the care of people with dementia, not just in Singapore but potentially around the world. In the world with so much suffering, I think we can all do more, to make it better when we first began.