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Caring for Our Caregivers

Written by : Eileen & Denzel


With the recent unfortunately suicide cases by caregivers, this article spotlights the other side of the story, the caregivers and their plight. First case study is with the caregivers for dementia patients and second with the caregivers for the autistic. Accompanied by relevant statistics and research about the stigma that these caregivers face.




Remodeling the norm: Recent cases of victims that committed suicide have one common factor which is the caregivers usually suffer from a mental illness. Singapore’s society tends to avoid speaking out about their illness due to stigmatisation. Photo: Megan Koh Yi Ting

On the 19th of October 2020, Mdm Nami Ogata ended her life together with her son during the wee hours of the morning near Bukit Batok Nature Park. It was soon found out that her son suffered from Attention Deficit Hyperactivity disorder (ADHD) and Autism and Mdm Nami herself was suffering from major depressive disorder.


This is not the first time such an incident has occurred. On 12th October 2020, Mr Tan Tian Chye was sentenced to two years and nine months in jail after being on trial for two years. He fatally wounded his daughter out of defense in 2018 when she pointed a knife at him.


According to a Channel News Asia’s article, She suffered from an unspecified anxiety disorder after she fainted one day in the Mass Rapid Transit (MRT) and refused any psychiatric medication due to “self-perceived fears of psychological dependence on it.”.


This sparked a conversation amongst netizens in Singapore about an overlooked group of people in society that needs the plight of Singapore like the caregivers of the elderly and people with disabilities. They, who may be shouldering much burden in silence, may suffer from mental health conditions as well.


The topic of mental illness in Singapore is often avoided due to the social norms of our society. According to Caregivers Alliances SG, the number of caregivers in Singapore is higher than previous estimates. Assuming that there is one caregiver for every person with mental health issues, this would mean an increase of approximately 70,000 to 496,000 caregivers in total.


According to a Psychiatry Research done by Yun Jue Zhang of ScienceDirect on quality of life among caregivers of relatives with mental illness in Singapore, a proportion of 94.5% primary caregivers reported experiencing affiliated stigma about mental illness and dealing with people with disabilities since their care recipient developed psychiatric problems. Parents usually have to deal with the burden of taking care of their child and thus may develop stress or anxiety.


Caregivers by definition, are people who are a family member or paid helper who regularly looks after a child or a sick, elderly, or disabled person. A question that is seldom asked is, who takes care of these caregivers?


We will delve deep into Singapore’s mental issues, the causes and situation as a whole especially towards these caregivers.These caregivers have to deal with a myriad of problems on a daily basis. Let us find out more about the lives of two caregivers.


 

Caregivers for Elderly

A study in 2018 reported that dementia has affected 50 million people worldwide, it is set to rise to 82 million in 2030 and then 152 million by 2050. Another study closer to home, according to Well-being of the Singapore Elderly (WiSE), led by the Institute of Mental Health shows that in 2015 one in 10 aged 60 and above has dementia. The number is expected to exceed over 100,000 in a few years time.


81 year-old homemaker, Mdm Lee Choon Lan is one of the many elderly that has been diagnosed with Alzheimer Dementia early this year. Her daughter, Mrs Lim Siew Suan, 52 year-old homemaker has been taking care of her needs ever since.




Losing Identity: Mdm Lee’s dementia has worsened since May of 2020 which affects her everyday life, mixing up dates, sugar with salt ,etc. She still tries her best to make the effort to help around with household chores as she did so in the past. Photo: Megan Koh Yi Ting


“She kept asking me to buy salt even after I had already bought the salt.” said Mrs Lim, when asked about how she came to realise that her mother was suffering from dementia. “She gets confused about dates and days. She keeps asking the same questions over and over again.”


With her mother’s diagnosis, Mrs Lim has an added burden as a primary caregiver to her mother, in addition to taking care of her two other children who are still schooling and being a homemaker of the family. Because of the stress from being a caregiver, she has been seeing the therapist once a month to help with her depression.


“I miss the way she supported me when I needed her, she used to be my pillar but now our roles are reversed.” lamented Mrs Lim when asked about what she missed about her before her diagnosis. ““I have to treat her like another person, she is no longer the same mum that I used to know.”


With the ongoing Coronavirus pandemic, it has also taken a tremendous toll on caregivers. The plight of caregivers has exacerbated as assistance has been limited due to the closures of help centres.


This limitation of help to caregivers is not only limited to the caregivers for the elderly alone but also to caregivers across the board, including the ones catered to Autism.





LOOKING BACK: Mrs Lim, 52, reminisces the time where her mother, Mrs Lee, 81, would help her with preparing dishes when she needed help. More often now Mrs Lim needs to attend to her throughout the day. Photo: Megan Koh Yi Ting


 

Caregivers for the Autistic


According to data analytics from the KK Women’s and Children’s Hospital and the National University of Singapore, 1 in one-hundred-and-fifty children in Singapore are diagnosed with Autism, a higher rate than the World Health Organisation’s global figure of 1 in one-hundred-sixty-hundred children.


Fourteen-year-old Samuel Tan, which is not his real name, is one of such children that has been diagnosed with Autism since the age of 3. His mother, 43-year-old Mrs Caron Tan, which is also not her real name, has been his primary caregiver.


“The school principal spotted the difference in him. He made no eye contact, no response when his name was called out.” Said Mrs Caron Tan, who is the primary caretaker and mother of Samuel. “So she advised me to see a specialist and that she could no longer keep him in the school.”


“At that point of time also I didn’t take it seriously because I didn’t know what it was all about.” Said Mrs Caron Tan when asked how she felt about the initial diagnosis. “But after hearing about his condition and how he can never be a normal child. I was really devastated.”


As she sought for help from a specialist, that was when Samuel was diagnosed with mild intellectual disability and Autism. Children’s condition with Autism includes difficulties with social communication and social interaction. They will also have repetitive behaviours or restricted interests.


“If we do something that’s outside his comfort zone or something different from his normal routine, he doesn’t like it.” Said Mrs Caron Tan, when describing the challenges she faces as a caregiver for Samuel. “ When he gets angry, he can get pretty aggressive, both physically and in terms of his choice of words.”


Not only do the family need to deal with the struggles of understanding and raising a child up with Autism, they also have to deal with the society’s stigmatisation against Autism.


“At times, people even think they’re a threat to society, when in actuality people just don’t understand their actions.” described Mrs Tan. “When in actual fact they might be merely reacting to something around them that makes them uncomfortable, and the way they express it comes off as aggressive at times.”


Mrs Caron Tan pleads the public to remain impartial and not jump to conclusion when met with such situations.


With the help of Samuel’s specialists, they were recommended a list of special needs schools that Mr Tan was able to enroll Samuel into. Now, Samuel is an avid learner in Grace orchard school and has also been recently appointed Assistant Monitor for his good conduct in school, however Mrs Caron Tan still has her worries for her child.






Striving for excellence: Currently, studying in Grace Orchard School, Samuel has been given the right guidance in order to learn the skills he needs as he grows older. He has picked up verbal skills and some motor skills and is well liked by his teachers. Photo: Siti Athirah


“As a parent of an autistic child, you worry about how the public might treat him when he goes to work, how his colleagues might treat him, what if he acts up on public transport and we’re not there to explain to people why he’s behaving a certain way.” said Mrs Tan. “ I have to worry about a multitude of things and it’s exhausting.”


This year, Mrs Caron Tan has also quit her job as an Accounts Executive, a job that she has had for over a decade, to care for Samuel Tan full-time.


“Although Samuel is now fourteen-year-old, I am still struggling on how to handle my own child.” laments Mrs Tan.


 

There is still prejudice and stigmatisation towards people that deal with medical conditions, such as Dementia and Autism. People are often quick to point fingers at the caregivers when things go array in public with these patients.


While it is still considered a sensitive issue in Singapore to openly talk about mental issues, mental health issues faced amongst these caregivers are slowly coming to surface as evident from recent cases in Singapore.


Awareness efforts for such problems have been sparse but the situation for these issues are starting to change. These heroes not only deserve the recognition for their efforts but also to encourage their peers to check up on them once in a while. For you, it might just be a simple question, but for them, it might change and alter their life entirely.


If you or someone close to you is dealing with any mental health issues, please contact the following helplines:


SOS 24-hour Hotline: 1800-221-4444


Singapore Association of Mental Health: 1800-283-7019


Institute of Mental Health: 6389-2222 (24 hours)


Care Corner Counselling Centre (Mandarin): 1800-353-5800




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