Caregiving of the elderly or bedridden takes various forms:
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physical
care
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home
chores
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financial
support
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emotional
support
Caregiving of the elderly or bedridden can take various forms
such as:
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The
actual physical care
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Less
direct work such as cleaning the house and running errands
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Giving
financial support, regular visits and phone calls
If all this is done by one carer over a prolonged period, there
will be great physical and emotional strain. Shared tasks among
family members are not easy to arrange especially if there are
pre-existing relationship problems.
Caregiving is made more difficult when the elderly person has
depression, fatigue, frustration and anger. It is important for
the family to understand the illness, and its impact on the
elderly, the family and the carer.
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Illness impact |
While the elderly is in hospital, the family should keep in
close contact with the staff to understand the illness and how
it affects the elderly person. They are encouraged to
participate in the rehabilitation programme.
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It is
traumatic when the onset of illness is sudden; especially
when it affects his mobility and the ability to take care of
personal hygiene.
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The
person is often shocked to find himself having to be fed and
having his personal hygiene and toilet needs attended to by
others.
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He can be
confused, even angry and very often depressed when recovery
is slow or not noticeable.
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There
will be anxiety about eventual recovery and he will not be
able to respond enthusiastically to rehabilitation.
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A lot of
support will be needed in coming to terms with his illness
and reduced functional ability.
Sometimes, the person cannot appreciate the goals of
rehabilitation. Usually he is very anxious to start walking
again. It will therefore be useful for the relative to
understand and help to encourage him.
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Understanding the person |
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The
family is usually very protective towards the elderly person
sometimes even to the extent of restricting the elderly
person’s freedom.
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It is a
question of how much to let go and allow the elderly to have
self determination versus how much care and control the
carers should exercise on them.
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Instructions to the elderly not to walk around in the house
when no one is at home because of your fear of falls can
have a debilitating effect on him.
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In many
instances, the elderly person becomes fearful and refuses to
walk when he actually can. Yet the risk of a fall is real if
the elderly is allowed to walk on his own.
The decisions made can be painful and are often fraught with
feelings of guilt, fear, anxiety and frustration. Until you have
come to terms with these emotional conflicts, it will be
difficult for you to manage the elderly at home.
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Effect of the illness |
On the family
The sudden onset of illness is a crisis to the family and can
often cause disruption to family life and daily routine.
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Prior to
the hospitalization, the elderly might have been performing
one or multiple roles as housekeeper, childminder, income
earner, helpmate and companion to his spouse.
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With the
illness and the resultant disability, he can no longer
perform these functions. Far worse, he becomes an additional
burden to the family.
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Before
you have adjusted to the changes and vacuum that the elderly
leaves, you are required to assume care of the elderly.
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If all
family members are working, there will be no one at home to
care for the elderly.
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It may
not be feasible for a family member to give up a job to look
after the elderly as it can mean substantial lowering of
standard of living or experiencing acute financial pressure.
If you are caring for your parent,
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Remember
your parent is always your parent – providing care for a
mother or father does not mean you have reversed roles, and
the adult child has become the parents’ parent.
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Neither
has your parent become your child and should not be treated
like one.
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The
responsibility of care may change, however. For example as
your parent ages, you may need to care for him in contrast
to his caring for you as you grew up.
It is helpful to understand these changes, and the effects they
have on you and your family.
On One’s Life And Feelings
These changes can sometimes make you feel helpless, angry,
guilty, or depressed about the loss of what is familiar. Painful
questions arise:
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Should
the person live with you?
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Should
you resign or employ a maid?
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Should
you take full responsibility?
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How will
it affect your own life?
You can control your response to these changes.
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Know
yourself, your values, strengths, limitations and goals.
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The next
step is to learn coping skills.
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These
include evaluating yourself and your situation, setting
goals, getting support, listing opportunities, and taking
action. Have a positive attitude.
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Understanding your elderly relative and his needs, learning
specific skills and developing positive attitude.
On The Family’s Resources
Even if the person is unable to talk, he will still benefit from
the company of family members.
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Being
there with the elderly person, providing physical care or
bringing food and continuing to give pocket money are ways
of showing care and concern.
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He is
bound to experience moments of depression and despair. At
such times, encouragement and patience are most required.
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Members
of the family can perform different roles and functions.
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This will
relieve the carer as well as meet the physical, social,
emotional and even spiritual needs of the elderly person.
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Family
members who are cooperative and supportive of one another
ensure continuous and good care of the elderly person.
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Appreciating your own needs |
Caring for an elderly person can place considerable restriction
on the carer’s social life. The carer may worry about leaving
the elderly alone and may choose to remain at home with him.
This usually ends in isolation and loneliness. Carers must know
their limits and stop before they reach burnout. You cannot take
good care of him unless you take care of yourself first.
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Carers
must seek help and support from other family members, as
well as from professionals.
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Family
members can relieve the carer so that she can take regular
breaks.
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It is
very important that the carer is aware of all available
sources of help and knows how to make use of them.
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Care arrangements |
The family needs to understand what the person can do and what
assistance he will need on discharge. Care arrangements need to
be made.
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Foreign maids
It is not uncommon for families to employ foreign maids.
Employing a maid is cheaper than paying for a nursing home.
It also has the added advantage, of having the elderly
person remain in the comfort of the home and having someone
to do household chores.
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Day care
The elderly person can attend a day care centre. He can
benefit from the mental, physical and social stimulation
that the activities at the centre provide and the carer can
have a break when the elderly is away at the centre.
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Community
hospital
The elderly person can
benefit from a stay in a community hospital for
rehabilitation or convalescence. It also gives time for the
family to work out the care plan when the elderly is finally
discharged.
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Nursing homes
Admission to a Home is another option. On entering a Home
however, the individual begins to lose his or her identity
and becomes an inmate in an institution. Often,
accommodation is in shared rooms or in a large dormitory
style ward. There is also the feeling of being abandoned.
This is made worse if the carers feel guilty and avoid
visiting the elderly at the Home.
Intermittent respite care is an alternative care arrangement
that provides an elderly person with either day care or a
short-stay in a Home or community hospital. It can help the
carers by giving them a break for a short while.
It will be useful for the family to discuss care arrangements
among themselves. They can also discuss these issues with the
doctors, nurses, therapists or medical social workers in the
hospital.
Relatives' Support
Group
Join a relatives’ support group or get to know other carers.
The group gives each of the carers an opportunity to share their
feelings and experiences with others in the same position and
having similar problems. Through this group you may find the
answers to the problems you encounter. Sometimes the group can
invite professionals who can inform and advise on the various
aspects of the illness and the services available to you.
Community Resources
We have a list of services according to zones which you may find
useful. We hope you and your family can have a rewarding
experience of caring for your elderly relative and that the
elderly can have a dignified life.
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Inpatient
Services
These are the hospitals
providing medical, nursing, rehabilitation and respite care
and for patients who are chronically ill.
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