Through this attachment with The Good Life Co-operative, we were exposed to the behind-the-scenes of healthcare in Singapore, especially that of eldercare, focussing on common illnesses that comes with age such as dementia and depression. With the help of chairman Dr Carol Tan, we were provided with many opportunities to talk to key stakeholders in the industry and were even given the chance to conduct a screening session for the seniors of Paya Lebar Kovan CC. This experience had not only allowed us to gain a deeper insight into the eldercare industry, but also a better understanding on Singapore's efforts to aid the rapidly ageing population.
The project which we were involved in focuses mainly on understanding and putting ourselves into the eldercare industry, specifically to help the elderly prevent common illnesses such as dementia and depression. The Good Life Co-operative, partnered with Paya Lebar Kovan CC, has had this project running since November 2019.
The task that we were engaged in for this project was screening the seniors of Paya Lebar Kovan with the MOCA test which tests for any cognitive impairment such that the seniors can be diagnosed earlier and seek treatment if necessary. We were also assigned to attend tours and briefings regarding some eldercare facilities and programmes as well as conduct interviews with the various stakeholders of the project.
This is a very valuable and relevant project with Singapore's rapidly ageing population increasingly facing more problems with ageing and unhealthy years, awareness regarding common illnesses should be raised and brought to attention, encouraging an active lifestyle to prevent falling ill.
Before meeting up with our mentor Dr Carol Tan, we were assigned to watch two videos created to raise awareness regarding dementia and depression respectively. Afterwards, we were tasked to write a 500 word reflection on what we had learned regarding either of the illnesses.
Clinical Pastoral Care
Clinical Pastorial Care is a journey of spiritual healing with patients and loved ones, encouraging them to share their story and from there providing them with support in whatever way that is meaningful at the point of time. This can be from helping patients take control of their situation to praying with or for the patients when the need to arises.
Pastoral Care is about the presence and the relationship a counsellor has committed with the patient. They are there to provide a listening ear and a shoulder to cry on. Which is why it is important that the counsellors are strong emotionally such that they are able to provide support for patients going through their various problems, without they themselves being affected. Counsellors also has to be non-judgemental, never condemning, condoning and conquering the issues raised by the patients.
One of the most important traits of a Pastoral Care counsellor is empathy. Being able to put oneself in the shoes of others and understand the patients. More often than not, it is easy to feel but hard to express. Hence Ms Rose Goh explained that at the end of the day despite being empathetic, we often are not able to understand the full depth of what someone is going through. We have to remind ourselves that everyone is different, and that despite having similar circumstances, there will be drastically different responses from different people, which is why we should learn to listen. Listening is Empowering. Sometimes all someone needs is for others to be there to talk to and by listening we can also better comprehend one's situation.
Lasting Power of Attorney
The LPA is a legal document which allows a person who is at least 21 years of age ('donor'), to voluntarily appoint one or more persons ('donee(s)') to make decisions and act on his/her behalf should he/she lose mental capacity one day. A donee can be appointed to act in the two broad areas of personal welfare and property & affairs matters.
The LPA is not the same as a will. LPA is only activated when one loses their mental capacity while a will is activated only after one has passed on.
Assisi Hospice
Assisi Hospice focuses on Palliative Care which is an approach that aims to improve the quality of life of patients and families facing problems associated with life threatening illnesses such as cancer, dementia, HIV et cetera. To ensure comfort and dignity towards their last days, Assisi Hospice aids in symptom and pain management whilst respecting the choices of patients by providing autonomy with a strict no restraint policy.
The care is delivered by multi-proffesional team with an interdisciplinary workstyle, with people such as but not limited to --- specialised doctors, nurses, physiotherapist, therapists, pharmacists, volunteers, clinical pastoral care counsellors.
The three main services aimed to cater to different patients according to their needs are home care, day care and inpatient care, however all of which requires a referral from doctors.
Silver Generation Office
Established in 2016 to help evolve the landscape of facilitating ageing in place, the main objectives of the SGO is to synergise with SGO systematic outreach, provide last-mile coordination and build Infrastructure for community care.
The SGO acts as a ‘front’ office that conducts systematic outreach by SG Ambassadors while the Community Network for Seniors (CNS) acts as ‘middle’ office, a community intergrator though building of strong partnerships across health-social agencies and tightening care coordination to ensure last mile delivery.
Ms Jina Williams
For the longest time, Jina was involved in many leadership positions, planning various admin matters from initiating fund raisers to ‘repair’ the St. Margeret's Primary School to being president/vice president for several years in the Singapore Kennel Club. However as she aged, the amount of work that she was involved in greatly decreased, eventually leaving her with nothing to work on. The sudden shift in brain engagement resulted in her cognitive ability to diminish rather quickly.
Mr Alex Yeo
Mr Yeo shared with us on what inspired him to start the Health and Wellness Programme and some challenges he had faced in implementing it such as natural resistance and reaching out, mentioning several solutions to aid the ageing population. He also encourages the youth to take on a more active role in engaging with seniors at home and through community activities.
The Montreal Cognitive Assessment (MoCA) is a commonly used screening assessment to detect cognitive impairment.
The MoCA is useful for detecting MCI or early dementia in occupational health settings, especially as the workforce is ageing.
Mild Cognitive Impairment (MCI) is a syndrome defined as cognitive decline greater than expected for the age and educational level of an individual, but it does not significantly interfere much with daily life activities. MCI incidence ranges from 3 to 19 percent in population-based epidemiological studies in adults over 65 years of age and more than half advance to dementia in 5 years.
On 11th January, we were given the opportunity to help screen the elderly resident of Paya Lebar Kovan CC.
Throughout the whole attachment we had learnt a lot about eldercare and we think that the best way to express our learning is through a video sharing our personal reflections and what made a huge impact on us individually. [video is attached on main section of TGLC]
we hope that through this video we will be able to raise awareness on eldercare in Singapore from the Lasting Power of Attorney to the need for conversations regarding health, sickness and death.
1. Dementia
Through the attachment, I was better able to understand dementia, its causes and impact. Dementia affects 50 million people around the world, of which over 80000 are Singaporeans. Alzheimer’s disease which is the most common type of dementia usually occurs in elderly people of 65 years and above, with an estimate that 1 out of 10 people over the age of 85 has AD. It can be caused by a combination of various factors such as life challenges, chemical Imbalances and diseases that results in cell damage and eventually cell death.
2. MOCA screening
During this attachment, it was my first time hearing about the MOCA test and being able to learn how to conduct it is very interesting. We were taught how to provide instructions to the seniors accurately and on top of that I learnt that speaking slower or in simpler terms can help the seniors better understand. We were also taught to provide reassurance to seniors such that they will keep as calm as possible, answering to the best of their abilities. I think this is a good skill to have and a rare opportunity to be able to pick up on outside of this attachment.
3. Interviewing
Before the interview, we had to come out with a set of questions to ask the interviewees and as we came up with many questions, I learnt how to shortlist and choose the questions that are the most relevant and are able to provide us with the best answers that aid us in our project. Aside from that, being in-charge of taking down notes for the interview with Mr Alex Yeo, I also learnt how to be more efficient in doing so, writing down what is necessary and important such that we would be able to have something to refer back to after the interview.
1. It takes a whole community to help an elderly.
Of course the expectations of taking care of an elderly often falls on their family members. However there is also the healthcare sector, from visits to Assisi Hospice and Mt Alvernia, I realised that beyond just doctors and nurses, there are also therapists, physiologist, pastoral care counsellors and many more that works behind the scenes and are sometimes undervalued because we simply do not know what they do. Along with that there are people like Mr Alex Yeo, starting the health and wellness program to encourage a healthy lifestyle for the elderly and providing free LPA services to help the elderly prepare for their future. Everyone can play their part and everyone should play their part.
2. Death should not be as much as a “taboo” topic as it is.
The stories being shared by different people that we met with, from those in the healthcare profession to the elderly, really touched my heart and make me realise the impact that life and death can have on people and that it is time for us to start having an open conversation about death, that it is okay to talk about illnesses because at some point in time we’ll all have to experience it and it is time for us to come to terms with it.
As Singapore’s ageing population is becoming more and more prominent. I realised how important it is to have an inclusive environment for both the youth and the elderly. Understanding that generation gaps can be an issue, it is necessary for us to start communicating, to create conversations that allows us to understand each other. As a youth myself, I think we should take on a more active role to engage with seniors at home and through community activities