Mum and Dad were married for 58 years - both met when they were in their mid 20s. Theirs was a marriage of love - not arranged or match-made, common in those days.
Dad had come from China when he was six. Mum was born in Singapore as a British subject. They met at a market along Geylang Lorong 25. Dad was helping Grandfather with his fabric business while Mum was peddling vegetables for her father.
Our maternal grandfather had disapprove of their relationship - in part due to gossipy friends who warned him that Dad comes from a complicated family (in-law issues specifically). Mum used to tell us, she stayed the course - we never got to ask why - but she always alluded to us, the kids for her remaining in the marriage.
We grew to understand that besides the 6 kids they had, it was their mutual love for each other that made them stick together for so long. In more than slightly half a century of marriage, they were plenty of instances of this strong and binding love. Somehow, after each tiff they had, they would always find ways to make peace - the meals, the eating out or the buying lottery - any gesture to make up after a quarrel no matter how heated.
A piece of bread delivered to the hair salon
This was related to us by Mety, our helper. She had brought Mum to the hair dresser and there was a long wait. Dad was at home. When he realized that both of them had not return, he prepared a piece of wholemeal bread and brought it to Mum - as she was diabetic, he was worried that she would be hungry while waiting her turn.
Travels
13-Day China Trip
I traveled with both my parents in 2003 for 13 days to various southern cities in China. The final leg was at Dad's hometown in YongChun, Fujian Province. It was during the trip that I witnessed how much they both basically love each other. At each stop, Dad would gather Mum's laundry to wash - even after I suggested we could let the hotel do them. Mum had never believed in letting others do her laundry - of course, she would also take turns to do Dad's laundry too during the trip. How did I know, the laundry lines would be extended in their hotel rooms.
Jakarta to visit Geok
When Geok was based in Jakarta with her family, we planned a trip to spend one weekend - we also took the opportunity to visit Khiam who works there. Our Brother in law planned a day trip by car to Bandung (the highway had by then been completed). We did not think Mum would like the journey so she stayed back in the city with Geok.
Throughout the journey, I could sense that Dad missed Mum - and when I came back to Jakarta - Geok told me that Mum kept asking if Dad was returning from Bandung. She kept asking her if someone was knocking at her door.
Choosing our new house
When we sold our jumbo flat, it was done before I found our current one. In the course of our search for the new flat, Mum's recurrent instruction to me was to make sure it was in the same estate as our previous one - where bus services would be available so that Dad could still make his regular trips to the clan Association where he spent much time - meeting with his friends and playing mahjong with them. This simple instruction spoke volumes of how much she really cared for him.
New Year, New Home-made Boxers
There was a ritual during lunar new year when we were young that also spoke of Mum's love for Dad. She would buy pyjama-patterned fabric to make Dad's boxers. Being new year means new clothes - to the finer details of the boxers. She was always a good seamstress - she even sewed the older siblings' school uniforms (Mattar East Primary School).
These are but only some examples that I could recall of how, in their simple but practical ways, both of them showed their affection and love for each other. I am sure my siblings especially the older ones would remember even more.
Happy Holidays !
Wednesday, December 6, 2017
Sunday, August 13, 2017
Car-less Whispers
I went car-less for 3 weeks recently. It was by choice. I had in the past went car-less but only for selected trips, for example into town to avoid hefty car park charges or crazy traffic (especially during exhibitions or fairs like IT or PC Shows.
So, this round it was a real simulation of no longer owning a car.
I used mainly buses to travel to SAFRA for my daily swims or into town to catch lunches with Geok or friends. Since classes have not started, those were my primary travel needs. Its home-SAFRA and vice versa; home-Bedok or Tampines (grocery shopping or Soka activities) Ez-link card was my mode of payment. Though I had driven a private hire car for almost 7 months, the past three weeks I saw no need for using either Grab or Uber save once when I had to travel to pick up a parcel at night from Tampines to Upper East Coast.
My main peeve about public transport is primarily about crowds during peak hours. As my travels were mainly non-peak, they were pleasant enough. I have to however say that bus drivers do need more training on not being brake-happy. the swerving and hitting of brakes can cause a lot of discomfort for passengers, not to mention dangers of falling for the elderly or those with kids. The other complaint is the condition of some buses. Some were wobbling and the engines sounded like they had been really overworked.
Reminded of my traveling days in the 70s on those non-aircon buses. Come on - Comfort Delgro - we are in the 21st century. If we are going to move large crowds around, we should make their journeys more pleasant or bearable, right? Fortunately, I did not encounter any MRT breakdowns though there were many instances of these over the three weeks. Personally, being car less had some inconveniences - I had to lug my swim bag and stuff around (made a mistake once of shopping for quite a few bags of groceries and the arm was hurting the next day).
Waiting time for buses can be also unpleasant in the hot weather but otherwise quite manageable using the MyTransport App. Of course my 'smell' karma does become quite pronounced during peak hours or on crowded services when fellow commuters with less hygienic habits share seats with me. We should seriously have a campaign on this.
Did I miss my car ? Yes, momentarily when I suddenly thought of going certain places and realized it was not with me. Would I go car-less permanently ? The jury is out on this. My Hyundai Avante has been very useful and somewhat sentimental to me I had used it for both Mum and Dad over the last 7 years.
I still remember bringing them to collect the car when it arrived in 2009. Some of my nephews and siblings have also used it over the course of its life. Its fully paid up and has a good 26 months more to the expiry of its COE. The running expenses are standard and I had also recently spent a bit to replace some really old parts and it feels quite new.
In my attempt to sell it on some online sites, I had met with the old tricks of dealers which make the experience less than pleasant. In the course of my working life, I had driven 7 different cars (bear in mind there were years when COE was non-existent as a policy or concept). For the time being, I would savour the experience of mobility and freedom with my car. Now when I drive past buses or commuters walking towards MRT stations or even though hailing private hire cars - I can truly say - I know how you feel.
I used mainly buses to travel to SAFRA for my daily swims or into town to catch lunches with Geok or friends. Since classes have not started, those were my primary travel needs. Its home-SAFRA and vice versa; home-Bedok or Tampines (grocery shopping or Soka activities) Ez-link card was my mode of payment. Though I had driven a private hire car for almost 7 months, the past three weeks I saw no need for using either Grab or Uber save once when I had to travel to pick up a parcel at night from Tampines to Upper East Coast.
My main peeve about public transport is primarily about crowds during peak hours. As my travels were mainly non-peak, they were pleasant enough. I have to however say that bus drivers do need more training on not being brake-happy. the swerving and hitting of brakes can cause a lot of discomfort for passengers, not to mention dangers of falling for the elderly or those with kids. The other complaint is the condition of some buses. Some were wobbling and the engines sounded like they had been really overworked.
Reminded of my traveling days in the 70s on those non-aircon buses. Come on - Comfort Delgro - we are in the 21st century. If we are going to move large crowds around, we should make their journeys more pleasant or bearable, right? Fortunately, I did not encounter any MRT breakdowns though there were many instances of these over the three weeks. Personally, being car less had some inconveniences - I had to lug my swim bag and stuff around (made a mistake once of shopping for quite a few bags of groceries and the arm was hurting the next day).
Waiting time for buses can be also unpleasant in the hot weather but otherwise quite manageable using the MyTransport App. Of course my 'smell' karma does become quite pronounced during peak hours or on crowded services when fellow commuters with less hygienic habits share seats with me. We should seriously have a campaign on this.
Did I miss my car ? Yes, momentarily when I suddenly thought of going certain places and realized it was not with me. Would I go car-less permanently ? The jury is out on this. My Hyundai Avante has been very useful and somewhat sentimental to me I had used it for both Mum and Dad over the last 7 years.
I still remember bringing them to collect the car when it arrived in 2009. Some of my nephews and siblings have also used it over the course of its life. Its fully paid up and has a good 26 months more to the expiry of its COE. The running expenses are standard and I had also recently spent a bit to replace some really old parts and it feels quite new.
In my attempt to sell it on some online sites, I had met with the old tricks of dealers which make the experience less than pleasant. In the course of my working life, I had driven 7 different cars (bear in mind there were years when COE was non-existent as a policy or concept). For the time being, I would savour the experience of mobility and freedom with my car. Now when I drive past buses or commuters walking towards MRT stations or even though hailing private hire cars - I can truly say - I know how you feel.
Sunday, October 2, 2016
A Mother's love and her lesson on self-preservation
Today's report about '5,000 teachers leave service over 5 years' brought back memories of how I left full time work. In particular, a conversation Mum had with me in 2006 showed me her love for her children and therein also a lesson in self preservation.
I had an unpleasant telephone conversation with a superior at work - over the telephone in my bedroom. It was over some HR issues that we both disagreed. In the conversation, my voice was raised when accusations were made. Mum as usual was in my room, seated at the edge of my bed. She was unable to make sense of the episode as the call was in English. However, the gesticulations, the tone and expression on my face must have conveyed the unpleasantness of it all.
After the call ended, she spoke in Hokkien - "Guan, mai cho la. Bo hua hee, mai cho. Mother bo su yao ler ae lui."(roughly translated - don't continue at this job since you are unhappy - I don't need your money (allowance).
I was taken aback as I didn't expect her to have absorbed so much of a telephone chat that she could not have possibly made sense. I regained my composure and told her it was fine - just some work issue and I was talking loudly as the other party could not hear me.
I then went out for drinks with some friends - in my drive, I thought and was overwhelmed by the love Mum showed me - she was not interested that I kept the job that brought the money home - she was more concerned with how I was treated and taking care of myself - in other words - my self preservation.
It was one of the key reasons why I decided to leave corporate. I needed to assure her that taking care of myself was important as it also meant I was able to care of them too.
For those who are stuck in unhappy jobs - take a breather - do some reality checks about your expenses and needs. Ask yourself, have you been fair to your colleagues and employer - are you doing the job because you have to - and not that you want to anymore.
Remember - you mean a lot to people who truly love you. Your well being is most important because it is a vital function of what you can do for them and those you love too. Having a well paying job means you can provide materially but not having a happy you pains them even more.
Stay happy !
I had an unpleasant telephone conversation with a superior at work - over the telephone in my bedroom. It was over some HR issues that we both disagreed. In the conversation, my voice was raised when accusations were made. Mum as usual was in my room, seated at the edge of my bed. She was unable to make sense of the episode as the call was in English. However, the gesticulations, the tone and expression on my face must have conveyed the unpleasantness of it all.
After the call ended, she spoke in Hokkien - "Guan, mai cho la. Bo hua hee, mai cho. Mother bo su yao ler ae lui."(roughly translated - don't continue at this job since you are unhappy - I don't need your money (allowance).
I was taken aback as I didn't expect her to have absorbed so much of a telephone chat that she could not have possibly made sense. I regained my composure and told her it was fine - just some work issue and I was talking loudly as the other party could not hear me.
I then went out for drinks with some friends - in my drive, I thought and was overwhelmed by the love Mum showed me - she was not interested that I kept the job that brought the money home - she was more concerned with how I was treated and taking care of myself - in other words - my self preservation.
It was one of the key reasons why I decided to leave corporate. I needed to assure her that taking care of myself was important as it also meant I was able to care of them too.
For those who are stuck in unhappy jobs - take a breather - do some reality checks about your expenses and needs. Ask yourself, have you been fair to your colleagues and employer - are you doing the job because you have to - and not that you want to anymore.
Remember - you mean a lot to people who truly love you. Your well being is most important because it is a vital function of what you can do for them and those you love too. Having a well paying job means you can provide materially but not having a happy you pains them even more.
Stay happy !
Wednesday, November 5, 2014
怀念追忆母亲的一生
怀念追忆母亲的一生
陈亚圆 追悼会
我的家人、亲戚朋友和创价协会的会员们,大家晚上好。感谢你们出席我母亲,陈亚圆的追悼会。
我妈妈在英国殖民时期的一个大家庭里出世，她是家里的长女。她向我外婆学了很多好手艺，下厨、缝纫和持家。她煮的东西简单又健康但是她也会确保我们有机会吃到她拿手的咖喱鸡、炒面、酸甜虾。我还记得过节拜拜时她包的粽子。
为了省钱，妈妈会亲手帮哥哥们缝校服。不需要再穿时，她会送给经济能力和我们一样不太好的邻居。她也会帮我们缝短裤，也一定确保我爸爸新年有新裤子穿。这都体现了她对我们的爱。
妈妈在旧芽龙25巷卖菜时认识爸爸，我爸当时在卖布。爸爸和妈妈23岁结婚，一起生活了大半辈子，给了我们六个兄弟姐妹,一个温暖的家。
因为来自一个比较传统的家庭，妈妈因为是女儿所以没有机会上学，但她知道只有受教育才能摆脱贫穷。虽然我妈没读书，但她很有智慧，很懂得人情世故。
她全力支持鼓励我姐姐要受教育， 妈妈告诉姐姐要读书将来才能支持弟弟的教育。妈妈相信家和万事兴，所以她要家人同心团结，因此她从小就教导我们要互相关心照顾家人。
在家里，妈妈对数字特别敏感，她心算速度非常快，我们都很惊讶。是从和她玩牌，我们才发现这点，她过世的前几个月还能玩牌。她也能从亲戚的生肖清楚说出亲戚的岁数。
我妈妈不怎么喜欢旅行，因为她更享受和家人在一起的时间。可是我爸爸喜欢旅行，所以她会迁就。结婚大约60年里，他们去了不少国家和地方。
我妈很有好奇心和也很风趣. 妈妈也会记住感恩别人对她的好。照顾她时,妈妈常会对我和家里的帮手Mety 说谢谢。
她给我们的教诲是：“做人不要太计较，生命无常；做人要看开点。”“工作得老老实实做’ 她也常提醒我们：“宁愿被人占便宜也 不要占人便宜”。
我妈是在1986年开始唱诵南无妙法莲华经。她的信念很单纯，她的祈求常是为别人，尤其是为家人，和她共同生活了58年的老公，她的孩子和孙子们。和她唱诵时，我常听到她为家人祈求健康平安。她一生也知足常乐，懂得感恩， 她常说 “我活够了，我已经很满足了！”
这几年，面对年老和死亡这个自然过程她很坦然，她会祈求让她自己平静地离开。我很欣慰，妈妈在九月二号这天如愿平静地离开人世,而且她脸色粉嫩平静地离开了。
在她临终时，感恩我们能陪伴在她身边,为她献上她爱喝的可乐（coke zero），将她每天唱诵念经的珠链放在手里。然后我轻声告诉她：”妈妈，安心地走，去和爸爸会合”。
在我们唱诵南无妙法莲华经时 ，妈妈给了我们的最后一份礼物：她脸上带着一丝笑容与我们道别， 妈妈85年的生命平静终结了。
陈亚圆 追悼会
我的家人、亲戚朋友和创价协会的会员们,大家晚上好。感谢你们出席我母亲,陈亚圆的追悼会。
我妈妈在英国殖民时期的一个大家庭里出世，她是家里的长女。她向我外婆学了很多好手艺，下厨、缝纫和持家。她煮的东西简单又健康但是她也会确保我们有机会吃到她拿手的咖喱鸡、炒面、酸甜虾。我还记得过节拜拜时她包的粽子。
为了省钱，妈妈会亲手帮哥哥们缝校服。不需要再穿时，她会送给经济能力和我们一样不太好的邻居。她也会帮我们缝短裤，也一定确保我爸爸新年有新裤子穿。这都体现了她对我们的爱。
妈妈在旧芽龙25巷卖菜时认识爸爸，我爸当时在卖布。爸爸和妈妈23岁结婚，一起生活了大半辈子，给了我们六个兄弟姐妹,一个温暖的家。
因为来自一个比较传统的家庭，妈妈因为是女儿所以没有机会上学，但她知道只有受教育才能摆脱贫穷。虽然我妈没读书，但她很有智慧，很懂得人情世故。
她全力支持鼓励我姐姐要受教育， 妈妈告诉姐姐要读书将来才能支持弟弟的教育。妈妈相信家和万事兴，所以她要家人同心团结，因此她从小就教导我们要互相关心照顾家人。
在家里，妈妈对数字特别敏感，她心算速度非常快，我们都很惊讶。是从和她玩牌，我们才发现这点，她过世的前几个月还能玩牌。她也能从亲戚的生肖清楚说出亲戚的岁数。
我妈妈不怎么喜欢旅行，因为她更享受和家人在一起的时间。可是我爸爸喜欢旅行，所以她会迁就。结婚大约60年里，他们去了不少国家和地方。
我妈很有好奇心和也很风趣. 妈妈也会记住感恩别人对她的好。照顾她时,妈妈常会对我和家里的帮手Mety 说谢谢。
她给我们的教诲是：“做人不要太计较，生命无常；做人要看开点。”“工作得老老实实做’ 她也常提醒我们：“宁愿被人占便宜也 不要占人便宜”。
我妈是在1986年开始唱诵南无妙法莲华经。她的信念很单纯，她的祈求常是为别人，尤其是为家人，和她共同生活了58年的老公，她的孩子和孙子们。和她唱诵时，我常听到她为家人祈求健康平安。她一生也知足常乐，懂得感恩， 她常说 “我活够了，我已经很满足了！”
这几年，面对年老和死亡这个自然过程她很坦然，她会祈求让她自己平静地离开。我很欣慰，妈妈在九月二号这天如愿平静地离开人世,而且她脸色粉嫩平静地离开了。
在她临终时，感恩我们能陪伴在她身边,为她献上她爱喝的可乐（coke zero），将她每天唱诵念经的珠链放在手里。然后我轻声告诉她：”妈妈，安心地走，去和爸爸会合”。
在我们唱诵南无妙法莲华经时 ，妈妈给了我们的最后一份礼物：她脸上带着一丝笑容与我们道别， 妈妈85年的生命平静终结了。
Eulogy for Mum - delivered on Friday 5 September
Remembering & Celebrating Mother’s Life…..
Good evening family, friends and members of the Singapore Soka Association. Thank you for joining us this evening as we remember and celebrate my Mother, Mdm Tan Ah Ee’s life.
Mum was born during the British colonial days. She grew up as the eldest daughter of a big family. She learnt many useful skills from our grandmother – cooking, sewing and home keeping. Her food was always simple but healthy though she also made sure we never lacked the experience of her signature curry chicken, fried noodles, and sweet and sour prawns We also remember the annual ritual of making dumplings for the whole family.
To save money, she sewed the uniforms of my older brothers. When those were no long needed, she gave them to our equally poor neighbors. She sewed shorts for us but her labor of love was to make sure Dad had new ones every Lunar New Year.
She met Dad while peddling vegetables at the old Geylang Lorong 25 market while he was selling fabric there. They married at 23 and spent most part of their lives giving the 6 of us a home.
Coming from a traditional family, Mum as a daughter did not receive an education. But she knew the importance of education to get out of poverty. What she lacked in education, she more than made up for in her observations of human behavior and worldly wisdom.
Even when our finances were tight, she encouraged and fully supported Geok , our only Sister to have a university education. She told Geok that with an education, she would be able to support me. Mum believed in strength from unity and harmony. As we grew up, she taught us to look out and look after each other.
In our family, she was well known for her numeracy skills – she could do mental calculation fast and she surprised many of us. We found this through playing cards with her even till her last few months. She could tell the ages of relatives by their year of birth in the Chinese horoscope.
Mum did not like travelling much as she always enjoyed the comfort of being home with her family – but she always made exception because Dad loved to travel. In the almost 6 decades of her marriage, they went to many places.
Mum had a curious mind and a wry wit – she was always grateful for small gestures that others do for her. She understood the challenges of caregiving for an elderly, and she would often thanked me and Mety who is our helper, whenever we did things for her.
Mum’s greatest legacy for us is her words of wisdom. Do not be calculative (cho lang mai keh kao – 做人不要记较) as life is short – in her Hokkien, Cho Lang Hum Hum （做人 看开点）. Her other words of wisdom include – Chiau Kee Kang Lai Cho (never cut corners when working to earn your keeps). She also reminded us not be vengeful – Hor lang pni, mai pni lang 宁愿给人便宜也 不要佔人便宜）. (This portion was delivered in Hokkien)
Mum started chanting NMHRGK in 1986. Her faith in the Gohonzon was pure – her prayers were always about others – particularly her family – her husband of 58 years, her children and grandchildren. Often, while chanting with her, I would hear her praying for our safety and our well-being. She had also expressed contentment with her full life. In her own words, (wa wa-kow liao - I have lived enough).
In the later years, she became more stoic about aging and death as a natural process – she chanted for it to be peaceful and pain free. Our prayers for her was also highly focused - that she should be in the highest life condition to transform her karma; to lessen her karmic retribution and to attain Buddhahood.
She achieved this ultimate victory on the 2nd September in our presence.
We are grateful for sharing her final moments – after offering her drops of her favorite Coke Zero and putting on her chanting beads. I whispered to her that it was alright to move on and to join our father.
With the strains of our chanting NMHRGK, Mum gave us the ultimate gift when she broke into a small smile and concluded her full 85 years of life.
Good evening family, friends and members of the Singapore Soka Association. Thank you for joining us this evening as we remember and celebrate my Mother, Mdm Tan Ah Ee’s life.
Mum was born during the British colonial days. She grew up as the eldest daughter of a big family. She learnt many useful skills from our grandmother – cooking, sewing and home keeping. Her food was always simple but healthy though she also made sure we never lacked the experience of her signature curry chicken, fried noodles, and sweet and sour prawns We also remember the annual ritual of making dumplings for the whole family.
To save money, she sewed the uniforms of my older brothers. When those were no long needed, she gave them to our equally poor neighbors. She sewed shorts for us but her labor of love was to make sure Dad had new ones every Lunar New Year.
She met Dad while peddling vegetables at the old Geylang Lorong 25 market while he was selling fabric there. They married at 23 and spent most part of their lives giving the 6 of us a home.
Coming from a traditional family, Mum as a daughter did not receive an education. But she knew the importance of education to get out of poverty. What she lacked in education, she more than made up for in her observations of human behavior and worldly wisdom.
Even when our finances were tight, she encouraged and fully supported Geok , our only Sister to have a university education. She told Geok that with an education, she would be able to support me. Mum believed in strength from unity and harmony. As we grew up, she taught us to look out and look after each other.
In our family, she was well known for her numeracy skills – she could do mental calculation fast and she surprised many of us. We found this through playing cards with her even till her last few months. She could tell the ages of relatives by their year of birth in the Chinese horoscope.
Mum did not like travelling much as she always enjoyed the comfort of being home with her family – but she always made exception because Dad loved to travel. In the almost 6 decades of her marriage, they went to many places.
Mum had a curious mind and a wry wit – she was always grateful for small gestures that others do for her. She understood the challenges of caregiving for an elderly, and she would often thanked me and Mety who is our helper, whenever we did things for her.
Mum’s greatest legacy for us is her words of wisdom. Do not be calculative (cho lang mai keh kao – 做人不要记较) as life is short – in her Hokkien, Cho Lang Hum Hum （做人 看开点）. Her other words of wisdom include – Chiau Kee Kang Lai Cho (never cut corners when working to earn your keeps). She also reminded us not be vengeful – Hor lang pni, mai pni lang 宁愿给人便宜也 不要佔人便宜）. (This portion was delivered in Hokkien)
Mum started chanting NMHRGK in 1986. Her faith in the Gohonzon was pure – her prayers were always about others – particularly her family – her husband of 58 years, her children and grandchildren. Often, while chanting with her, I would hear her praying for our safety and our well-being. She had also expressed contentment with her full life. In her own words, (wa wa-kow liao - I have lived enough).
In the later years, she became more stoic about aging and death as a natural process – she chanted for it to be peaceful and pain free. Our prayers for her was also highly focused - that she should be in the highest life condition to transform her karma; to lessen her karmic retribution and to attain Buddhahood.
She achieved this ultimate victory on the 2nd September in our presence.
We are grateful for sharing her final moments – after offering her drops of her favorite Coke Zero and putting on her chanting beads. I whispered to her that it was alright to move on and to join our father.
With the strains of our chanting NMHRGK, Mum gave us the ultimate gift when she broke into a small smile and concluded her full 85 years of life.
Monday, June 30, 2014
Stop Prolonged and Unnecessary Medical Procedures....(Achieving a consensus on the right care for our elderly)
(This was sent to ST Forum Page but was unpublished. I think it is relevant in view of the many things happening to our healthcare system : - overcrowding in hospitals; high medical costs; untold pains of both patients and loved ones caused by risky and unnecessary medical procedures)
The medical care of an elderly patient is a complex one involving both clinical and non clinical considerations.This arises from the interactions amongst patient, loved ones and physician - each with at times differing intentions. I therefore agree that the highest level of care and comfort should form the paramount basis for any and every decision. The ultimate goal must be to help patients regain a reasonable level of functions - physically, mentally and emotionally.
In many surveys, elderly patients have indicated that they wish to spend their time (particularly the final hours at home where care should be made available. I think it is laudable that finally, efforts are being made to review the use of CPF for palliative care, and more resources (hopefully without too much bureaucratic delays) are being planned to invest in home care training of professionals etc.
The wishes of patients and their primary care givers should always take precedence. These must be determined at the outset. Since the clinical inputs of professionals are important, it is therefore vital that a comprehensive discussion of any recommendations pertaining to medical procedures be conducted before any action is taken. Such discussions should cover clinical as well as post procedural care and living condition. In the event that there is a conflict of opinions regarding the options for the patients - their wishes or those of their loved ones must prevail. This is to prevent decisions that will result in unnecessary pain to the patients, undue anguish to loved ones and financial hardship to the families.
The advice of physicians while to be respected must be subserved to those of the patients and their loved ones. Physicians should also be wary not to draw exceedingly alarmist scenarios that present loved ones or patients with only dire outcomes that force their hands on some of these decisions.
I feel very strongly that patients, their caregivers and loved ones should begin to take responsibility for medical decisions. I have heard of too many sad cases when these were prevailed by professionals at the expense of the dignity, care and comfort of patients
Monday, April 28, 2014
Care of our elderly Mum
I am writing this to help those who have to look after their elderly parents (frankly most of us would have this opportunity sometime in life). Our elderly parents are individuals and they are all different. However, certain aspects of care for them should be quite universal. I hope this post will start a conversation and sharing amongst friends and others who are in similar situations. Through it, we make our collective journey more bearable and theirs, easier too.
Mum's medical history- a hypoglycemia (low sugar level) episode
Mum is 84 years old. She has had a few hospitalizations lately - mainly for infections of the urinary tract/kidneys etc. She has been a diabetic since her 40s - we are grateful that with her underlying conditions, she is in the main good for her age.
This is in large part due to Dad's meticulous care - after she had a hypo episode when I was in my late 20s. I still remember vividly what happened. While sleeping late one Saturday morning, I was awoken by a commotion in the kitchen. Dad was washing a small towel at the sink. Mum was sitting on a chair - extremely pale and had a deep cut on her forehead.
Dad told me Mum fell and hit the raising on the floor of the kitchen. I changed and quickly brought her to her doctor. She had apparently not been monitoring and had low sugar. One of the more serious symptoms is fainting spells and the worst is of course shock and death.
Anyway, after the scare - Dad took it upon himself to very closely monitor Mum's medications and conditions. Of course Mum had a few other health issues during those years - she had diabetic retinopathy - bleeding of the veins in her eyes (which if untreated would have caused blindness). Her diabetes was so badly managed earlier on - at one point her reading was close to 40 (?) (our normal is 7).
After Dad passed away, I have kept her medical appointments and established a routine so our helper is able to assist in doing the necessary. This includes getting a medicine box with day/noon/evening/night slots as well as a list of her medications with instructions on the dosages. I also made sure she understood the purpose of each type of medicine.
Our helper is really a great help indeed. She also administers the insulin jabs for mum. I could never bring myself to do it :(
Mum had a fall
Mum had a fall two years ago while going to the toilet. She had walked and slipped. Luckily she did not fall backwards. Our helper was behind her and took her fall - Mum sat on the floor and fell on her.
She did not feel any pain and went back to bed. At about 3.40am, the helper woke me to let me know that Mum complained of pains in her groin.
I had returned from a late meeting and went straight to bed - so I slept through the fall too. I was afraid it was organic and quickly asked if she had any blood discharge or medical conditions during the day. The helper then told me about the fall.
I called for the ambulance and got her admitted right away. At the A & E, doctors did an x-ray and it showed a hair line crack of lumbar one - her back bone. Pains had surfaced in her groin/hip area. The only thing they could do for her was pain killers until the ward doctors took over.
I consulted my cousin who is an ortho surgeon - he gained access to mum's x rays and told us that she was lucky as ordinarily, a fall like this would have caused many splinters of the bones in her body. Given her age - her bones have in fact collapsed due to osteoporosis. I attribute her 'protected' condition to her regular intake of milk - that gave her ample calcium to ward off more serious damage from the fall.
After the fall, mum did complained of backaches - but she recovered quite quickly and well. We decided to let her wear adult diapers to avoid the risks of her waking up and falling in the middle of the night. She at first resisted but after our explanation, she relented.
How culture and superstition works on an elderly
Mum is not educated and her behavior is also driven by superstitions and old folks' tales about western medication etc. After we started chanting and became Buddhists - we began the process of letting her unlearn many of these - for example, not taking medicine during festive occasion like CNY. Not taking medicine for fear that it is too strong and damaging to her organs.
Her glucose readings now fluctuate between 7.7 to 8.6 now - with her regular insulin jabs and medicines. She goes for her quarterly polyclinic check-ups and yearly eye check plus kidney & liver panel tests. Everything being equal, she is good.
Beliefs and superstitions play a major role as far as medical care is concerned - particularly for the elderly and unfortunately also passed on to their care of their young too. The refusal of medication by caregivers for their loved ones has caused much anguish and unnecessary pain to everyone. This is something that education and hopefully wisdom will prevail.
Family's wish, Doctors' mandate
Our mandate to her doctors whenever she is admitted for any condition is simple - she must not be in any unnecessary pain - or major discomfort. If these are unavoidable, then whatever is allowed medically must be done to alleviate it.
Hallucinations
As she ages, Mum's sense of her surroundings and her timings are not in-tuned. She has lapses of memory and her lucidity also waxes and wane. After her recent two bouts of urinary tract infections, she had started to have episodes of wakefulness in the middle of the night (rather early hours of the morning). Our helper who sleeps with her told us she woke up and asked to go home (Paya Lebar - her childhood home). At times, she would asked for my Dad and mistook her for Geok.
In the morning, she would be lucid again - and was unable to recollect anything about the night before. We are monitoring the situation and am prepared to activate night care if this worsens. In the meantime, she is her smiley self during the daytime.
Her routine, gadgets and all
She still chants twice a day and goes for her garden strolls in the evening. Her weekday visits to the Foo Hai Elderly Lodge at marine parade still continues. This is where she has her fellow elderly friends and her exercises. We explored this some 8 months ago after she became restless at home and have been pleased with this arrangement. She goes there from 930am till 4.30pm, weekends and public holidays excluded. This has given me a good 6-hour respite. Geok plays cards with her every Sunday. We also give Mum a deck of playing cards to play by herself and occasionally she gets to do that with her elderly friends at Foo Hai. We also bought her a Acer tablet to let her watch her Hokkien drama series (with headset as her hearing is quite hard now).
Home-doctor care
During her recent hospitalization, the doctor at her ward discussed with us about getting home care - via the Agency For Integrated Care (AIC). Nurses and doctors (St Andrew's is her assigned hospital - the other available is Home Nursing Foundation) will make periodic visits at home to monitor her chronic conditions such as diabetes and high cholesterol. She would not be required to visit the polyclinic for her check ups and medicine. These would be done at home. I think this is a good measure and certainly helps to lighten the load of caregivers.
She receives subsidies based on means testing done some two years ago - so the costs of these are manageable.
Thanks
Mum's medical history- a hypoglycemia (low sugar level) episode
Mum is 84 years old. She has had a few hospitalizations lately - mainly for infections of the urinary tract/kidneys etc. She has been a diabetic since her 40s - we are grateful that with her underlying conditions, she is in the main good for her age.
This is in large part due to Dad's meticulous care - after she had a hypo episode when I was in my late 20s. I still remember vividly what happened. While sleeping late one Saturday morning, I was awoken by a commotion in the kitchen. Dad was washing a small towel at the sink. Mum was sitting on a chair - extremely pale and had a deep cut on her forehead.
Dad told me Mum fell and hit the raising on the floor of the kitchen. I changed and quickly brought her to her doctor. She had apparently not been monitoring and had low sugar. One of the more serious symptoms is fainting spells and the worst is of course shock and death.
Anyway, after the scare - Dad took it upon himself to very closely monitor Mum's medications and conditions. Of course Mum had a few other health issues during those years - she had diabetic retinopathy - bleeding of the veins in her eyes (which if untreated would have caused blindness). Her diabetes was so badly managed earlier on - at one point her reading was close to 40 (?) (our normal is 7).
After Dad passed away, I have kept her medical appointments and established a routine so our helper is able to assist in doing the necessary. This includes getting a medicine box with day/noon/evening/night slots as well as a list of her medications with instructions on the dosages. I also made sure she understood the purpose of each type of medicine.
Our helper is really a great help indeed. She also administers the insulin jabs for mum. I could never bring myself to do it :(
Mum had a fall
Mum had a fall two years ago while going to the toilet. She had walked and slipped. Luckily she did not fall backwards. Our helper was behind her and took her fall - Mum sat on the floor and fell on her.
She did not feel any pain and went back to bed. At about 3.40am, the helper woke me to let me know that Mum complained of pains in her groin.
I had returned from a late meeting and went straight to bed - so I slept through the fall too. I was afraid it was organic and quickly asked if she had any blood discharge or medical conditions during the day. The helper then told me about the fall.
I called for the ambulance and got her admitted right away. At the A & E, doctors did an x-ray and it showed a hair line crack of lumbar one - her back bone. Pains had surfaced in her groin/hip area. The only thing they could do for her was pain killers until the ward doctors took over.
I consulted my cousin who is an ortho surgeon - he gained access to mum's x rays and told us that she was lucky as ordinarily, a fall like this would have caused many splinters of the bones in her body. Given her age - her bones have in fact collapsed due to osteoporosis. I attribute her 'protected' condition to her regular intake of milk - that gave her ample calcium to ward off more serious damage from the fall.
After the fall, mum did complained of backaches - but she recovered quite quickly and well. We decided to let her wear adult diapers to avoid the risks of her waking up and falling in the middle of the night. She at first resisted but after our explanation, she relented.
How culture and superstition works on an elderly
Mum is not educated and her behavior is also driven by superstitions and old folks' tales about western medication etc. After we started chanting and became Buddhists - we began the process of letting her unlearn many of these - for example, not taking medicine during festive occasion like CNY. Not taking medicine for fear that it is too strong and damaging to her organs.
Her glucose readings now fluctuate between 7.7 to 8.6 now - with her regular insulin jabs and medicines. She goes for her quarterly polyclinic check-ups and yearly eye check plus kidney & liver panel tests. Everything being equal, she is good.
Beliefs and superstitions play a major role as far as medical care is concerned - particularly for the elderly and unfortunately also passed on to their care of their young too. The refusal of medication by caregivers for their loved ones has caused much anguish and unnecessary pain to everyone. This is something that education and hopefully wisdom will prevail.
Family's wish, Doctors' mandate
Our mandate to her doctors whenever she is admitted for any condition is simple - she must not be in any unnecessary pain - or major discomfort. If these are unavoidable, then whatever is allowed medically must be done to alleviate it.
Hallucinations
As she ages, Mum's sense of her surroundings and her timings are not in-tuned. She has lapses of memory and her lucidity also waxes and wane. After her recent two bouts of urinary tract infections, she had started to have episodes of wakefulness in the middle of the night (rather early hours of the morning). Our helper who sleeps with her told us she woke up and asked to go home (Paya Lebar - her childhood home). At times, she would asked for my Dad and mistook her for Geok.
In the morning, she would be lucid again - and was unable to recollect anything about the night before. We are monitoring the situation and am prepared to activate night care if this worsens. In the meantime, she is her smiley self during the daytime.
Her routine, gadgets and all
She still chants twice a day and goes for her garden strolls in the evening. Her weekday visits to the Foo Hai Elderly Lodge at marine parade still continues. This is where she has her fellow elderly friends and her exercises. We explored this some 8 months ago after she became restless at home and have been pleased with this arrangement. She goes there from 930am till 4.30pm, weekends and public holidays excluded. This has given me a good 6-hour respite. Geok plays cards with her every Sunday. We also give Mum a deck of playing cards to play by herself and occasionally she gets to do that with her elderly friends at Foo Hai. We also bought her a Acer tablet to let her watch her Hokkien drama series (with headset as her hearing is quite hard now).
Home-doctor care
During her recent hospitalization, the doctor at her ward discussed with us about getting home care - via the Agency For Integrated Care (AIC). Nurses and doctors (St Andrew's is her assigned hospital - the other available is Home Nursing Foundation) will make periodic visits at home to monitor her chronic conditions such as diabetes and high cholesterol. She would not be required to visit the polyclinic for her check ups and medicine. These would be done at home. I think this is a good measure and certainly helps to lighten the load of caregivers.
She receives subsidies based on means testing done some two years ago - so the costs of these are manageable.
Thanks
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