Ageing at Home

What is Home Care all about?

Living in peace in a warm and familiar home until the end of our lives is probably how we hope to grow old in the future.
When Fatigue Kicks in on the Long Journey as a Caregiver
Nobody knows how long her journey as a caregiver is going to be, but Ho Ngit Wah still looks forward to her golden years.
When Fatigue Kicks in on the Long Journey as a Caregiver
Nobody knows how long her journey as a caregiver is going to be, but Ho Ngit Wah still looks forward to her golden years.

She stays close to her mother at night to care for her and helps her mother into the wheelchair as soon as she wakes up in the morning. After that, she showers her mother, has breakfast with her and feeds her medicine with the help of a maid. Lastly, she buys a packet of chee cheong fun for her mother before rushing out for her part-time job. On the way home from work at 5 p.m., she would takeaway freshly made chee cheong fun. Upon reaching home, she would patiently wait for her mother to cut them up with scissors and eat them bit by bit.

All the above are the daily routines of 63-year-old Ho Ngit Wah, who has been caring for her 102-year-old demented mother for four years.

For several years, Ho Ngit Wah has been buying freshly made chee cheong fun for her mother for every meal because the latter likes the dish very much.

Having parents who live long is seen as a blessing. In 2019, the average life expectancy of Singaporeans was 83.7 years, with the average life expectancy for women reaching 85.9 years, one of the longest average life expectancies in the world.

However, as people live longer, a 2019 report pointed out that the time spent by the nation’s sick and unhealthy population has correspondingly increased to 10.5 years. This implies that the last decade of one’s life is generally spent in conditions requiring care such as being disabled, bedridden, unable to speak etc., and this number of years will continue to climb year on year as the population ages. 

While Ngit Wah has other siblings, as the unmarried child in the family, she sees herself as the natural caregiver for her mother. After her mother started developing multiple chronic illnesses combined with dementia, Ngit Wah decided to quit her job and stay home to better care for her. That decision altered her life forever.  

Fearing that her mother would get up in the middle of the night and accidentally hurt herself, Ngit Wah used to sleep for only three hours every night. As soon as the maid took her rest at midnight, she would take over to care for her mother, helping the elderly to go to the toilet every one to two hours and be on guard almost without rest until the following day.

Such days of severe sleep deprivation lasted for more than a year. Deep into the nights, Ngit Wah would sit in a chair and watch episode after episode of Master Sheng Yen’s teachings on her phone to calm herself down. She said: “Master Sheng Yen provides the answer to facing the challenges in life as his teachings are very close and relevant to daily life.”

Caring for the elderly with dementia is both physically and mentally demanding. Ngit Wah, whose hair has turned slightly grey, cannot forget her mother’s previous behaviour: refusing to take medication, refusing to cooperate in many situations, becoming paranoid and cursing nonstop when agitated.

She said: “She scolded me so badly that I wanted to run away from home.”

Further aggravating her situation, Ngit Wah uncovered a shocking fact at the point when she was physically exhausted and mentally drained — her dementia-stricken mother unwittingly revealed the truth about her being an adopted daughter. Heartbroken and devastated by what she heard, she sought confirmation from her elder sister.

Ngit Wah has been devotedly caring for her mother for several years. She doesn’t have much of a life of her own. When feeling emotionally distressed and depressed, she couldn’t see the end of such days in her long journey of looking after the elderly and couldn’t find an outlet to release her emotions. All these factors had driven her towards depression.

Fortunately, a Tzu Chi home care personnel visited her home at that time and provided her with mental support, so she did not have to bear the physical and psychological strain alone.

The home care team visits Ngit Wah’s mother at least once a month to check on her and monitor her health indicators. They also listened patiently to Ngit Wah to understand her feelings, thoughts and needs. The medical staff taught Ngit Wah ways to care for her mother and herself, even encouraging her to volunteer in Tzu Chi’s medical missions.

These gestures may appear insignificant and simple, but they have saved Ngit Wah’s life by pulling her back from the brink of collapse.

“It is reassuring to be able to ask any questions at any time,” Ngit Wah said. “There is no way to express such gratitude in words.”

Ngit Wah later followed the medical team to serve as a volunteer, visiting several homes to accompany the patients and their families. The various patients she saw made her realise the similar suffering she and others shared.

Even though it was only for a few hours a week, the simple, unadulterated effort of volunteering calmed her unsettled mind.

“I hope to transfer the merit and virtue to my mother as well.”

Ngit Wah always reminds herself that it is a rare affinity to be born as mother and daughter. She said: “Where there is a cause, there will be a consequence. This is our previous karmic affinity before we became mother and daughter, and I hope to put an end to it in this life.”

In the past four years, Ngit Wah has been relearning the meaning of caregiving. She finally realised that the most challenging part of caring for her mother does not lie in handling the daily routines but in noticing and finding out her mother’s feelings and needs amid communication barriers.

Ngit Wah gave an example of her mother’s habit of needing to eat chee cheong fun twice a day. She would still buy them twice daily because she noticed that her mother looks forward to the feeling of “someone deliberately bringing home food”.

On the day of the interview, we ran into Choo Mei Mei, a home care nurse, who had come to Ngit Wah’s house to check on her mother’s lung inflammation condition.

While inspecting, Ms Choo chatted with Ngit Wah to check in on them. During the process, Ms Choo found that Ngit Wah’s mother’s skin was unusually dehydrated and fragile and noticed that the elderly was hesitant to apply lotion because she disliked the feeling of oiliness on her skin.

Ms Choo took Ngit Wah’s body lotion and gently pulled over the elderly woman’s hand to persuade her, secretly rubbing the body lotion on the elderly woman’s arm as she spoke. The next task was to trim the nails. However, the elderly refused to have her nails trimmed this time, possibly out of fear of pain. Ms Choo did not insist on doing that and decided to try again during the next visit.  

“Grandma, do you remember my name?”

Diverting the attention of the elderly, Ms Choo intimately held hands with the old lady and gently patted her face. She would ask the same question each time she visits her patient.

“Mei Mei ah?”

Seated in a wheelchair, Ngit Wah’s mother thought for a while and answered with a slight hesitation.

“That’s right!”

Ms Choo came up to the old lady who has hearing difficulty and answered her loudly. They then held hands and started chatting and laughing.

On the surface, it may seem troublesome and time-consuming for the daughter and nurse to persuade the elderly several times just to trim her nails and apply lotion. However, instead of treating the mother as a “troublemaker” or getting the elderly to give in by force, Ngit Wah and Ms Choo combined their knowledge and experience to find different ways to interact with the old lady.  

Seeing all that happening in front of me, I couldn’t help but ponder the value of a demented elder and the purpose of the caregiving process.  

Dark eye circles started to form on Ngit Wah’s face after her mother’s accidental fall in 2021. Her mother became completely disabled as a result of the accident, and she had to rely on others for almost everything except eating.  

No one knows how much longer Ngit Wah’s caregiving journey will be. Ngit Wah, on the other hand, is optimistic about her elderly life in the future. She is now working part-time as a medicine dispenser in a TCM clinic and has already decided to spend her life serving others by assisting with medication dispensing at Tzu Chi’s free clinic in the future.

She said: “I don’t feel comfortable leaving my mom alone for now, but my mom will leave one day. When she’s no longer around, I will start doing volunteer work.” 

(Photos/ Wong Twee Hee)

Home Care Tips: 10 Important Suggestions for Caregivers

You need to rest and take care of yourself so that you can take good care of the people around you.

It Takes More than One to Care for an Elderly Person at Home

Having family members who are hospitalised keeps people on their toes, but it turns out that the greater challenge awaits them at home as they face even more caregiving challenges in a home setting.
It Takes More than One to Care for an Elderly Person at Home
Having family members who are hospitalised keeps people on their toes, but it turns out that the greater challenge awaits them at home as they face even more caregiving challenges in a home setting.

70-year-old Madam Tan was a multiple award winner in various singing competitions and an active person who went to the park every day to do Yuanji dance. However, her wonderful and orderly life was abruptly disrupted by a lung infection following a fall, resulting in a sharp downturn in her health.

One month after she was admitted to the hospital, Madam Tan was repeatedly sent into and out of the intensive care unit. When she was eventually discharged after her condition stabilised, she remained bedridden and had to be tube-fed.

Despite hiring a professional caregiver at home, Madam Tan and her family were still anxious as they had no experience with caregiving. They were worried about how Madam Tan was going to live at home after being discharged and afraid that she would never stand up again should she suffer another fall. 

“When she first came home from the hospital, it was a real headache,” recalled Madam Tan’s daughter of the overwhelming days.

Many of the things which were taken for granted at the hospital became doubly difficult to implement at home.

Madam Tan’s daughter meticulously recorded the doctor’s instructions in order to properly care for her mother. One of the doctor’s instructions was for the family to give Madam Tan milk and medicine six times a day. The doctor also wrote down the feeding time in an orderly sequence.  

However, the daughter and caregiver were torn between following the doctor’s instructions and allowing Madam Tan to continue sleeping in the evening and early morning as she was usually sound asleep during these times of the day. They were also worried that not following the instructions might adversely affect Madam Tan’s recovery.   

Despite only taken care of the elderly for just a few days, these repetitive and extremely trivial processes had already confused the daughter and the foreign caregiver and kept them very busy. Madam Tan’s complicated condition also made her daughter worried that she might get reinfected if they didn’t do everything correctly.   

Fortunately, a community medical team was there to lend a helping hand when they were in the midst of loss and helplessness.

Tzu Chi’s home care team of doctors, nurses, and physiotherapist visited Madam Tan at her home on different visits after she was discharged and brought peace of mind to the family. The family was given more personalised medical advice and guidance, including follow-up checking, nasogastric tube replacement, wound care, learning to walk and live with assistive devices, etc., while adhering to the doctor’s instructions.  

Several months have passed since Madam Tan returned home. She is recovering well thanks to the constant monitoring by the hospital and community medical team, as well as the family’s meticulous care. Her desire to dance has been driving her to exercise hard. With that, she made rapid progress under the supervision of the physiotherapist, and she can now get out of bed and walk with a walking aid.

Seeing her mother’s rapid progress and remembering the days of taking turns to care for her mother at hom, her daughter said with mixed feelings: “I’m really touched!”

No one can stay young forever. Creating a friendly ageing environment is not the sole responsibility of hospitals. It takes the involvement of the entire community for elderly patients to recover with ease at home.    

(Photos/ Chan May Ching)

Nurses, the Saviours in Home Care Services

Not only is the nurse a regular visitor, but she also plays an important role as a saviour who can save the day.

Nurses, the Saviours in Home Care Services
Not only is the nurse a regular visitor, but she also plays an important role as a saviour who can save the day.

As soon as we entered the main door, we were greeted by a neat and empty living room with a recliner where a 94-year-old elderly was seen curled up and sleeping. 94-year-old Madam Koh suffers from multiple chronic diseases, including stroke, heart failure, and dementia.

Madam Koh’s arms are curled and stiff as a result of the chronic disease condition and other comorbidities. Her long-curled fingers have become embedded in the flesh of her palms, and she has multiple bedsores on her back.  

Madam Koh would frown and scream in agony every time she was treated for her wound. Madam Koh’s daughter is grateful to Tin Tin Oo, a foreign maid, for providing one-to-one attentive and close care of her mother.  

Treatment varies according to the recovery stage of the wound. Different dressings, gauze, liquid solutions and nursing methods are used depending on the state of the skin, whether dehydrated or moist, and also the location of the wound. However, with the help of Ms Pan, Tin Tin can now use a small mirror, a small flashlight, gauze, cotton swabs, gloves and small scissors with ease.

The entire nursing procedure took more than 30 minutes. However, the process became harder after most people started sweating due to the stuffiness of the room. Madam Koh, on the other side, was shivering slightly in pain. Despite so, Tin Tin and Ms Pan could only keep comforting and pacifying her by saying: “Sorry, sorry, just a bit more to go, please hang on.”   

“We don’t just treat the patient; we need to teach them how to look after themselves too.”

Ms Pan did not leave immediately after providing nursing care. She would share with the family members about the various methods to care for old and new wounds. In home care, nurses often spend a lot of time giving care instructions to caregivers. Ms Pan gave thumbs up to Tin Tin, whom she said is a model caregiver.

To Tin Tin, Ms Pan is more than just a nurse who visits them regularly but also an important saviour who always comes to her rescue every time urgent help is needed.   

In July 2022, Madam Koh, her daughter and Tin Tin were all diagnosed with COVID-19 one after another within a week. The daughter, who was in her 60s, was admitted to the hospital due to breathing difficulties, leaving only Tin Tin and Madam Koh at home.

Left alone to take care of Madam Koh, Tin Tin who was also infected with COVID-19 panicked and immediately texted Ms Pan via WhatsApp for help.  

After receiving the call from Tin Tin, Ms Pan swiftly arranged for a home visit with a physician. She even personally brought the medications and hung them at the door. Despite suffering from multiple diseases at her advanced age, Madam Koh managed to survive the infection, leaving everyone greatly relieved.   

With lingering fear in her heart, Tin Tin recalled: “I called the 995 hotline. They asked for Madam Koh’s oxygen level reading before telling me that she need not be admitted to the hospital and asked me to continue to monitor her situation. On the contrary, the doctor from Tzu Chi gave very detailed instructions and suggested what I can do in different situations, such as what to give Madam if she coughs and to call the ambulance when her oxygen level is too low.”  

“Han Ni even purposely sent us the medicine.”

Tin Tin repeatedly expressed her gratitude, saying: “No matter what the situation is, I can ask them by sending photos, texting them or calling them. It helps a lot.”  

The nursing care for this day was finally completed. Tin Tin slowly pushed Madam Koh to the living room to feed her newly cooked cereal, teasing her and asked: “What do you want to eat? Hokkien mee, Char kway teow, or Wanton mee?”

Not only is Tin Tin professional and meticulous in caring for Madam Koh, she can also speak Hokkien fluently after learning it from the latter.

During the teasing and joking, the two of them were seated very close to each other. This type of intimacy is typically found between close family members. Madam Koh, who had been frowning for a long time, finally smiled.  

In 2022, Tin Tin (right) and everyone celebrated Madam Koh’s birthday (left) with a cake bought by Madam Koh’s daughter. (Photo by Pan Han Ni)

Anxiety and helplessness are inevitable on the long journey of caregiving. With the warm companionship and empowerment of community services, there is a glimmer of sweetness amid a million wisps of bitterness. 

(Photos/ Chan May Ching)

Home Care Tips: Skin care tips to prevent bedsores in long-term bedridden elderly

Severe bedsores can take months or even years to heal, so it is important to have the right nursing care skillsets to prevent it.

Ageing in the Community
With fewer children and a rapidly ageing society, elderly people are having a tough time looking after each other. The community’s varying degrees of medical care and everyday living care services are critical to an elderly couple’s “survival” at home.
Ageing in the Community
With fewer children and a rapidly ageing society, elderly people are having a tough time looking after each other. The community’s varying degrees of medical care and everyday living care services are critical to an elderly couple’s “survival” at home.

“I don’t need to take high blood pressure medicine?”

“When do I need to start eating again?”

“Tell my husband that I don’t need to take it anymore.”

Mrs Toh kept double-checking with her home care nurse Ms Choo ever since she reminded her to suspend the hypertension medication.

“Yes, you don’t have to eat. Your husband will remind you.”

Lightly patting Mrs Toh’s hand to soothe her, Ms Choo has been answering the same question since she entered the house, leaving Ms Choo unsure whether to laugh or cry.  However, it was a warning sign that Mrs Toh’s memory has further deteriorated.

At that moment, 88-year-old Mr Toh was sitting on the other bed, quietly waiting for his turn to receive nursing care.  

Mrs Toh has been bedridden after suffering a fall. Mr Toh has since been taking care of her basic needs, such as making her breakfast, bathing her and doing her laundry. However, the seemingly tough Mr Toh had also suffered injuries from two falls last year.   “

Although their only son visits them on his off days and regularly picks them up to stay at his place, having two elderly people alone at home during the week can be very unsettling.

Currently, the Tzu Chi home care team visits Mr and Mrs Toh once a month and provides them with weekly physiotherapy.   

A 24-hour charging iPad sits on the cabinet in the room and can be used to make emergency calls at any time with one click on the app. It turns out that the old couple also receives care services from two other community agencies, including having two meals delivered to their homes daily and weekly cleaning services.  

The shrinking of family sizes has dramatically changed the structure of our society, making it common for the elderly to look after each other. The community’s varying degrees of medical care and everday living care services are critical to this couple’s “survival” at home.

To Mrs Toh, there is perhaps one benefit of staying home, and that is she can do whatever she wants. After all, battling illnesses is just one part of her life.

In early 2022, Mrs Toh accidentally fell while using the toilet. She was taken to the hospital and recovered well. She was able to eat and sleep and had no major health problems. It was not difficult to care for her.

However, she became afraid of walking after the incident and had since been bedridden for more than six months. Mrs Toh would rather wear an adult diaper than leave her bed and she would spend her days at home watching TV.

Despite being bedridden for a long time, Mrs Toh still loves to look pretty. When she sees visitors approaching her house, she would comb her hair, put on makeup, and dress in brightly coloured clothing. Her greatest desire was to visit a hair salon for hair wash and hair styling.

Aware of Mrs Toh’s wish, Ms Choo brought along a dry-cleaning hair spray and tried to dry clean Mrs Toh’s hair.

“I help you comb nicely,” said Ms Choo. From the look on Mrs Toh’s face, we could tell that such a thoughtful gesture made her very comfortable and glad.

Trust slowly developed between the nurse and her patient. After several months of persuasion and encouragement, and witnessing the remarkable progress made by Mr Toh after his fall, Mrs Toh was finally willing to try physiotherapy.  

Both Mrs Toh and the physiotherapist had to make adjustments and compromises during the first two sessions of rehabilitation.

Mrs Toh was still reluctant to leave her bed and preferred to do rehab exercises in her bed. Lim Beng Kooi, her physiotherapist, kept encouraging her and tried to lower her goals and expectations. He told her to start simple — just practice getting out of bed into her wheelchair, and refrain from standing exercises for now.  

Despite her doubts and fears, and eagerness to end the session early, Mrs Toh completed the week’s exercises with the encouragement and assistance of her physiotherapist.

Eventually, Mrs Toh made an effort to operate the wheelchair herself, and even went around the corridor on her own, regaining some motivation and confidence due to her successful movements.

Physiotherapist Lim Beng Kooi said that pain makes people afraid to move. And by not moving, one’s physical fitness will deteriorate, turning it into a vicious cycle. The role of a physiotherapist becomes critical at this point.

There is no yardstick to measure the effectiveness of encouraging the elderly to undergo rehab and change their health habits. It is a process that requires a great deal of patience and trust from both sides.

“We can only keep advising and persuading, but ultimately we have to respect the patient’s choice of a lifestyle deemed acceptable to them,” Ms Choo said.

(Photos/ Chan May Ching)

Home Care Tips: Rehabilitation techniques for getting up from the bed and moving from bed to a wheelchair

By using safe and practical rehabilitation methods, bedridden elderly who can’t walk and are weak at the early recovery stage can gradually become accustomed to sitting up and shifting their positions. This not only reduces the burden on the caregivers but also increases their body strength and prevents continued disablement.

The Spiritual Navigator by the Bedside

Patients and families may be going through a turbulent time. It is the wish of the home care team to accompany them through this journey and help them materialise their desired living environment and return to a peaceful life as soon as possible.

The Spiritual Navigator by the Bedside
Patients and families may be going through a turbulent time. It is the wish of the home care team to accompany them through this journey and help them materialise their desired living environment and return to a peaceful life as soon as possible.

Petite-figured but full of vitality, Ms Choo always greets her elderly patient first when she arrives at their home, even if the patient is unconscious or unable to communicate.

Seeing how Ms Choo laughed and casually chatted with her patient and the patient’s family members from time to time, the entire interaction felt warm and natural as if they had known each other for a long time

Her cell phone usually rings the moment she arrives at work. And if a patient develops an unexpected medical condition, Ms Choo would immediately arrange for a trip on that day. She usually leaves the afternoon slot open on purpose in case of an emergency.

Before setting off to visit the patient, she would check that her trolley case is fully stocked with the required drugs and medical tools. Whether rain or shine, Ms Choo always arrives on time and spends an average of one hour per household for nursing services such as wound care, general health checks, changing nasogastric tubes, medication injections, and changing urine bags.

The patient would sign a form acknowledging receipt of service after the home care service is completed. Ms Choo, on the other hand, must continue to write reports, schedule appointments, assist patients with medication dispensing, and respond to messages. She often leaves her house at 7.30 am and gets home between 5 pm and 6 pm.

In home care, nurses are usually the ones closer to the patient than the doctor.

Ms Choo, who used to work in a hospital’s Paediatric Department for seven years said that, unlike specialised nursing work, the scope of work for home care nurses can be described as “doing everything from A to Z”. Not only must they solve the patient’s medical problems, they must also care for the family members who are looking after the patient at home.  

Singapore is rapidly ageing as a result of low birth rates. Middle-aged children caring for elderly people, who are unable to speak, bedridden, or have dementia, are overwhelmed by the burden of juggling work and caregiving responsibilities. Some elderly ended up having to care for the other elderly, thus exhausting the aged caregiver.  

Ms Choo frequently acts as a stabilising force handling the various emotions of her patients and their families. Among the many cases she has handled is one involving an old lady who had repeatedly complained in front of her husband. She is often heard saying: “Why hasn’t he left yet? I told him not to wait for me.”

Their son and a social worker would come twice a week to assist them, but the elderly lady, who strives for perfection in everything, still feels overwhelmed by the stress of caring for her husband.  

At this point, Ms Choo was like a spiritual mentor, stabilising and relieving the negative emotions of the family. Ms Choo said to the caregiver: “His time is not yet up. Don’t say that, you will upset him. You are strong and doing great. Let us know if you need anything.”  

Just a few simple words of encouragement and support was sufficient to put a smile on the old lady’s face. She even patted her arm and said: “Look how muscular I am now. Taking care of him has made me so strong.”

By finding better support in the community, one does not have to struggle alone on the long journey of caregiving.  

(Photos/ Chan May Ching)

Having worked in a hospital’s A&E department, home care physician Dr Ho Xin Qin understands the dilemma of family members caring for chronic patients at home. Many of the hospital care techniques are no longer applicable when the patient returns home.  

Dr Ho said: “Caregivers have to be very independent when the patient is discharged from the hospital, there is no one else but the caregiver. The hospital setting is ideal; there are tables and plenty of light. However, because some rooms at home can be very small, it is difficult for a caregiver to arrange so many drugs and utensils in an orderly manner.”  

Dr Ho has also unexpectedly discovered that many people actually do not know how to properly take care of patients, including basic tasks such as feeding medicine. Sometimes patients take home the medication prescribed by the hospital but do not know how to consume it.   

She said: “Many patients are not taking the right medicine; some would mix up the new batch of drugs with the previous batch. There have also been cases where patients have been discharged from the hospital for several days and have not even opened the medication prescribed to them. The family member would give the patient the previous medication, with the changes made by the hospital not followed.”  

“It’s not that the patients refuse to take the medicine, they are really very ‘blur’ (can’t distinguish the old and new medicine),” Dr Ho said. 

“Although the hospital pharmacist will explain, some family members just can’t get it. Or the one who goes to the doctor with the patient is person A, but person B is the one who lives with the patient. As a result, the incorrect message is transmitted. There have also been instances where the maid is unable to comprehend the instruction. All of these issues are fairly common.”

Often patients would also have a bag consisting of items such as wound care medications, but they did not know how to use them. Some patients also learned a lot about how to manage bed sores and wounds at the hospital, but their wounds worsen after they returned home.

Dr Ho explained: “The hospital does teach the family members how to look after the patient at home, but it’s like teaching a student, you cannot expect to learn a lot in one class.”

Through Dr Ho’s analysis, she feels that it is not that the patient’s family is making a mountain out of a molehill by sending the patient to the hospital on a regular basis, but because they have been facing the problems alone for a long time and cannot find professional help when they need it. That has piled up a lot of mental pressure on them over time. As a result, whenever a patient is discharged from the hospital for a period of time, sending the patient back to the hospital becomes the only way out when the patient’s family members are in a state of panic.   

She revealed that her doctor friend’s mother was diagnosed with terminal Parkinson’s disease at the height of the pandemic last year. Despite the fact that she had already decided not to be hospitalised, Dr Ho sent her an oxygen tank and medication because her lungs were infected to the point where she was low in oxygen level and had difficulty breathing.

Dr Ho said: “Even doctors would have moments of panic and helplessness when taking care of patients at home, let alone the general public.”

She pointed out that in recent years, there has been a growing awareness in the medical community of the need to connect with the community in preparation for patient discharge. This has led to the launching of the “Hospital to Home” referral service. Nursing guidance is an important part of home care, and this includes everything from providing caregivers with knowledge and skills in caring for patients to dispensing daily medications and ensuring that they are taken correctly.  

Talking about the experience of providing medical services in a clinic, Dr Ho opined that the contact between doctors and patients in a home care setting is closer.

“When you visit a patient’s home, the patient becomes someone with a family. You see their living conditions and are better able to put yourself in the shoes of the patient and think about ways which can really help the patient.”

After witnessing the daily life of the patient at home, one will realise that daily life is more important than disease treatment.

Dr Ho said: “When you visit a patient at their home, you are more likely to empathise with the patient. When you notice that he does not even take care of his home, wouldn’t you be asking too much of him to care for himself medically? In such instances, we need to help him to become more hygienic first.”

Home care services not only eliminate the need for family members to travel to and from the hospital but also save the waiting time for medical appointments and queuing time for checkout, resulting in a better quality of care for the patient. Relatively speaking, the readmission rate is also reduced, thus greatly reducing the burden on the family while saving hospitalisation and societal costs.


Ms Choo said that home care is not just about meeting material needs but also giving love and care. Patients and their families may be going through a period of illness and turmoil, and what home care can do is to work with them through this journey to restore their lives as soon as possible and help them create the living environment they desire.

“The most valuable and heart-warming aspect of serving as a caregiver is not how good you are at giving injections or how knowledgeable you are, but the warm interactions between people.”

“In the end, it taught me that we don’t need to be overly obsessed with fame and fortune, because health and joy are the true fundamentals of life.”

Ms Choo lamented that many people have life planning, but who would have thought that their old bodies would become sick and weakened like shaky leaves when they grow old?

Adopting the attitude of “treating the sick like one’s own family”, Ms Choo reminds herself: “We often comfort and advise people to let go, but if it happens to our loved ones, are we able to let go so easily?” 

Nevertheless, she hopes that she can be the guardian of that remnant leaf. She said: “Master Cheng Yen once said that the value of a nurse lies in treating her patients with compassion. Everyone should aspire to have more power to shoulder more responsibilities and achieve more in life.”

(Photos/ Chua Teong Seng)

The Key to Growing Old at Home

The Key to Growing Old at Home

Visiting the homes of various patients with home care professionals and seeing how the patients had been bedridden for a long time, it felt as if the surroundings were also dramatically transformed. The passage of time became slower, and the world slowly shrunk, collapsing into a space as small as a home.

These elders want to be close to people, but sometimes they feel guilty and powerless because their illness is dragging their family members down. Some patients may appear agitated and skeptical because they are worried that they will not be able to recover, or that their chances of recovery are extremely slim.

Almost all home care professionals agree that to relieve the anxiety and suffering of patients’ families, they must be treated as people with thoughts and feelings, not just “sick bodies” to be monitored and “fixed”.

However, in a high-pressure and time-critical medical environment, treating illnesses without neglecting patient care is easier said than done. According to some home care professionals, the home setting provides them with better conditions and environment for them to expand their care. Other than treating the illness, they can also care for the emotional needs of the patient and their family.

Many people hope to grow old peacefully in their warm and familiar home till the end of their life journey, but only after experiencing being a caregiver do they realise that there are often many unexpected hurdles in geriatrics and the long-term care for the elderly.  

Only when the government, community healthcare and services, and the patient’s family all complement each other, can we achieve happy ageing in the community and grow old at home with ease.  

Do you have a family member or friend who is caring for an elderly family member? Or are you a caregiver yourself?
We have put together a list of practical caregiving tips to hopefully make things easier for caregivers. 

Share with friends & family 

Tzu Chi’s medical team’s mission is to “cure the body, the disease and the heart.” Master Cheng Yen, the founder of Tzu-Chi, discovered in her charity work more than fifty years ago that “sickness is the cause of poverty,” so she set up free clinics followed by hospitals in Taiwan’s remote villages. Tzu Chi’s medical mission in Singapore has evolved over two decades, from the early days of providing free medical services in neighbouring countries to establishing a community medical network locally, providing Traditional Chinese and Western medicine treatments, dental treatments, rehabilitation treatments, home care services, home palliative services, and so on without deviating from the original intention, which is to relieve the suffering of sickness and put smiles back onto people’s faces. 

Planning:Holly Foong,  Mavis Yeow
Compilation & writing:Holly Foong
Photography:Chan May Ching, Wong Twee Hee, Chua Teong Seng
Web design and creation:Tey Inn Ping
Art design:Goh Kee Hoe
English translation & editing:Chong Sin Yin, Pan Zai Xiang
Publicity (social media):Mavis Yeow

07.04.2023 A Tzu-Chi Foundation (Singapore) Production