BACKGROUND INFORMATION OF THE ORGANISATION:

The Good Life Co-operative (TGLC) is a non profit social enterprise that aims to reach out to seniors 50 years and above and their families. As Singapore grapples with issues such as ageing population and rising healthcare costs, the launch of TGLC in 2014 was deemed a timely move. The Good Life’s mission is mainly to provide quality healthcare to members so they are able to live long, well and carefree. They do so by working together with reputed medical professionals to create programmes that make healthy living desirable, attainable and fun. The approach TGLC takes is more preventive in nature so as not to be over-dependent on public resources. As such, they focus more on educating the public on healthcare. Through which, they hope that the public can take greater responsibility for their own health and age gracefully.

TGLC is also one of the registered cooperatives in Singapore under the Singapore National Co-operative Federation (SCNF). The SCNF was established in 1980 as Singapore’s collective representation of the co-operative movement. These co-ops have a common goal of achieving social and economic end to benefit the community at large.

Background information of the projects/ tasks which I WAS involved in:

This project aims to equip us with knowledge on seniors’ health (mainly depression and dementia) and to communicate with seniors to have a deeper understanding on issues they may be facing. At the end of our attachment, we were tasked to create a video regarding our thoughts on the entire programme.

The following list includes the tasks we were assigned to do:

1. Watched a video on dementia/ depression and do a 500 word write-up of what it is
2. Watch Turn Back the Clock — managed to learn more about reminiscence therapy
3. Research on screening tools for dementia/ depression
4. Familiarise ourselves with Montreal Cognitive Assessment (MoCA) screening procedure (screening for dementia) in preparation for an event we had
5. Film a video containing our reflection (takeaways from this whole experience)

Elaboration/ record of the activities done

On 9 January, we went to Lundbeck office and met Dr Keira in preparation for the MoCA test screening we were involved in that Saturday. During our visit there, she familiarised us with the screening procedures and the flow of the programme on 11 January. She also gave us time to test each other to ensure that we fully understand what was going on.

On 20 Jan, the group met with Mrs Gina Williams, where they uncovered stories of the elderly and her experience on her health condition (signs of dementia) to understand her needs better. Following which, they also made a trip to Assisi Hospice, where they managed to learn more about palliative care and the management of the Hospice.

They also made a trip to visit Mr Alex Yeo (chairman of PAP branch at Paya Lebar) for the interview. The main purpose of the interview was to find out more about the community work done at Paya Lebar, and this encompasses the Health and Wellness Programme which they implemented there. However, I was on MC those two days and didn’t manage to attend those events.

Elaboration of record of results/ deliverables/ impact of work done:

Video:

For our final project, we were assigned to do a video that contained our thoughts/ reflection about the entire attachment thus far. We gave ourselves some time to reflect individually then came together as a group to film the videos. For our reflection video, it was filmed in 4 different languages -- English, Chinese, Malay and Hindi as we wanted it to be as relatable as it can be for the public. (english subtitles included too) Following which, we proceeded on to edit the video and the final product is uploaded under the TGLC page (on this site).

In addition, our mentor, Dr Carol Tan, also told us that this video may also be shown to guests during the Paya Lebar Fundraiser event which is happening in late February!

3 content knowledge/ skills learnt:

1. Screening test for dementia — Montreal Cognitive Assessment (MoCA)

When we visited TGLC (at Mount Alvernia) on our first day of attachment, I was first introduced to the MoCA screening procedure. Ms Alice, one of the staff at TGLC, briefly walked us through the procedure.

Initially, I had no prior knowledge about MoCA and thought that the test would involve mainly memory work, but it also incorporated several other aspects such as visuospatial/ executive. This portion of the test involved the seniors having to spot a pattern and connect the correct numbers accordingly. In addition, a picture of a cube was also given to them and the seniors had to copy the cube as accurately as possible in the space given to them. Other parts of the test made me realise that asides from testing their memory, they were also testing how aware seniors were of their surrounding/ environment they were in.

In order to give us a greater understanding of what MoCA really was, we met with Dr Keira, who was involved in crafting the MoCA test. She walked us through in detail how to screen seniors for dementia using the test, and the precautions we should take. For instance, in order for results to be as accurate and reliable as possible, we should not be assisting the seniors in answering the questions. This was especially so for questions which tested their memory, as many seniors tend to ask us to repeat our instruction once they forget what was told to them. To ensure that we were fully prepared, she also gave us time to conduct a trial run, in which we tested our peers.

On the day of the screening, some of us were assigned to screen the seniors while some were assigned to help with more admin related stuff (e.g. registration). As for me, I was involved in helping to screen the seniors. Having firsthand experience of communicating with/ screening the seniors allowed me to realise the full gravity of the situation and how this was becoming a growing concern in society.

Picture of MoCA test:

2. Pastoral care and spiritual healing

Prior to this attachment, I did not hear of pastoral care and spiritual healing before and thus was a relatively new concept to me. When we visited TGLC on the first day, Dr Carol arranged for us to meet with Ms Rose Goh, who is in charge of clinical pastoral care. She shared with us the importance of pastoral care not just for patients, but also for their family. She shared with us stories where majority of the patients initially had no hope for life at all, and how pastoral care helps them to accept the reality of the situation they are in. Pastoral care mainly encompasses giving support to patients in any way that is meaningful (be it emotional, spiritual and/or religious needs). The most memorable thing she shared with us was that “presence precedes words” for it made me realise the importance of listening to empower. More often that note, listening can give clues to concerns that trouble the patient, and how one can support that accordingly. It is also essential to recognise that everyone is different and take a step back to understand others regardless of whatever situation they may be in.

2 interesting aspects of My learning:

Dedication

Over the course of this attachment, we had wonderful opportunities to meet with many people and one main takeaway I have would be the importance of dedication. In considering the healthcare aspect, it is definitely really tedious to have to look after patients. From the sharings, I could tell that Dr Carol Tan and Ms Rose Goh were very dedicated in their work and are very thoughtful towards their patients. They really give their best effort in trying to understand patients and this is something I find very admirable. As we had the chance to screen seniors for dementia using the MoCA test, I personally found it rather hard to communicate with some seniors as they could not quite comprehend the instructions. Thus I had to find different ways to explain myself and while it was slightly challenging, the entire experience was very fulfilling.

Asides from healthcare, we also met Mr Alex Yeo, the chairman of PAP branch at Paya Lebar. He shared with us things such as LPA and the Health and Wellness Programme. Through further research and an interview with him, we found out that such an initiative was based on feedback gathered among residents and based on understanding their needs. To see people reaching out to the community and going beyond what their role requires, it struck me that their dedication is what enables seniors to lead better lives.

Mental strength

While we went out to meet many different groups of people, the one that really left an impression on me was the sharing by Ms Rose Goh (in charge of pastoral care). She shared with us how pastoral care helps both the patients and his/her family and also what spiritual healing is about. Beyond that, she also gave us some real life stories to help illustrate her point better and allow us to have a greater understanding of the whole system. However, looking beyond those stories, I realised how strong of a person she is. As they work closely with Assisi Hospice, they often receive cases where patients are terminally ill/ coming to the end of their life. To many, death is a rather abstract and complex topic that many tend to shy away from as they often don't even want to think about it. Nonetheless, people like Ms Rose Goh often have to deal with such situations and have to just keep going no matter how tough it might get. It was then I realised how much mental resilience one requires to work in such a field, and I truly admired her for that.

1 takeaway for life

Appreciate life

As we were attached to TGLC, we were bound to meet many seniors and those in charge of this area of healthcare. Hearing the various stories from different people made me realise how unpredictable life can get and how we should always treasure the time spent with our loved ones. As I did the screening for the MoCA test, it was rather saddening to see people not perform as well, especially since many of them came with their families. I was met with various kinds of people and it really made me reflect alot on my journey home. Regardless of whatever situations we may be put in, as long as we look at it through a different lens, we will be able to find the good in it.

It also made me realise the importance of taking care of one's health especially in later years, as more health problems are bound to arise. As long as we keep our minds active and live healthily, ageing gracefully wouldn't be as big of a problem. One's health is truly their own asset, and it is important that we are responsible for our own health too.