The Nursing Home

Say the word Nursing Home, and most people in Singapore cringe. If you were to ask people to utter the first words that come to mind when they hear the word “nursing home”, you will notice that most will associate Nursing Homes with “abandonment”, “old folk’s home”, “homeless”, “left to die”.

My dad went through a triple heart bypass some years ago. After the operation, his language proficiency declined. The decline was initially very gradual. In fact, I thought it was just due to his lack of daily-use that he seemed to have forgotten his Japanese. He would call me up every time he was at the market to ask me simple questions like “What is jagaimo, ninjin? What is ichigo?” You see, my mom would write him a grocery list and he couldn’t make out what he was to buy at the market. It didn’t occur to me that something was amiss. That was because his other mental faculties were perfectly in tact. When my parents moved house thereafter, he was able to navigate and take public transport quite comfortably from their new home. But his language skills continued to deteriorate; it gradually began to affect not only his Japanese proficiency, but his English language as well. I finally knew I had to get him assessed when I found out that not only did he not know that ninjin was carrot, but that he didn’t know what a carrot was anymore until he saw one.

So, I brought him to Khoo Teck Puat Hospital where he went through a battery of tests and had an MRI of his head done. He was diagnosed with a stroke-related dementia. Fortunately, only that aspect of his brain was affected; he was still quite functional in other aspects. He was able to take public transport all the way to that hospital on a weekly basis to attend dementia support group sessions. He could still meet up with his friends and he could still surf the net.

To cut the story short, things spiralled downwards since then. When my parents moved house again, we decided not give my dad the key to the house as we saw that he was quite confused disoriented during the move. Instead of allowing him to go to KTPH for sessions by himself, my mom would accompany him there and back. Soon after, my dad could no longer benefit in a meaningful way from the support group, and so, we put my dad in a day-care centre that specialised in patients with moderate dementia.

The spiral continued downwards. By this year, even the day-care centre told me that he was too frail and demented to participate meaningfully in their activities. He got confused more often and would turn aggressive whenever he felt agitated. Even though we engaged a helper, it was a strain for my mom and the helper to look after him and keep an eye on him all hours of the day. Then, my dad had a fall at the centre, which required multiple stitches on his head. When the doctor suggested that my dad be put on a wheelchair because he was too frail to even walk aided by the helper, I knew it was time to find better around-the-clock care for him.

So, two months ago, I put my dad in a nursing home.

The solution of a nursing home was very appealing to me. Unlike having just a helper in the house to help him bathe, change, eat and put him to bed, nursing homes are staffed with nursing aides and the wards overseen by nurse managers. At the Home where I put my dad, there is a doctor who is present at the wards every weekday morning. Instead of having to make appointments and painstakingly bring my dad down to the podiatrist, the barber, the physiotherapist, etc, the nursing home provided all these services in-house.

During the initial weeks, my dad lost his appetite, we all know it was likely due to depression (feeling of abandonment?), not being used to the bland food they serve there, and probably also because of the onset of dementia related Parkinson’s. The doctor then began to fret and worry about his weight loss and initiated a meeting with us where eight key personnel (Centre Manager, Doctor, Director Nursing, Nurse Manager, Social Worker, etc) met with my family to explain the situation and to prepare us to start thinking about the option of food tube feeding eventually when he eventually forgets how to swallow (sob).

That meeting was somewhat of a turning for us all. Since that meeting, we see the staff hard at work, painstakingly feeding him. We try to bring him home cooked food, ice-cream (his favourite!) and durian cakes and Swiss rolls to whet his appetite. My sister bought a CD player and placed it next to his bed; the staff help us rotate the CDs we brought for him—oldies, ABBA, Itzhak Perlman, Rachmaninoff, etc. We bring photos to stimulate his senses. My sister wheels him out to the open when she visits him, to get him fresh air and a change of environment.

Recently, as I was passing the staff some dessert for my dad, she mentioned that my dad was very fortunate to have visitors almost every day of the week (we take turns and so, he gets a visit from us at least 5 out of 7 days in a week). Because of his lack of appetite, we’ve been trying to bring familiar and stronger tasting food for him. She told me that many of the residents there have visitors once a year, and many have no visitors at all. I am guessing that many of them could have been abandoned by their family members and are too frail, too poor and too uneducated to earn a living of their own. The government places them in nursing homes. So sad hor?

Well, the Home tries their best to make the living environment pleasant for the residents. I was very impressed when the Centre Manager gave me a sneak preview of the grand plans they were rolling out to transform the Home. I can’t say much here except Akan Datang. I am appreciative of the efforts they are putting in to make life meaningful for the residents. I look forward to seeing these plans come to fruition soon.

How has this whole experience of placing my dad in a Nursing Home been? Well, medically, I am much more assured of him getting the best care he can ever have in the Home. But, of course, we all have had to deal with adjustments. The first couple of weeks were awful—his eyes would turn red and he would tear whenever we visited. When it was time to leave, he would occasionally hang his head down and refuse to look at us.

It’s been almost two months since my dad has been admitted to the Home, and I must say he’s adapted pretty well. He’s happy when we visit and no longer looks so sad when we say goodbye. Sub-consciously, I think he’s aware that he’ll see us again very soon. In fact, I think that since my father’s been admitted to the Home, my sister and I have interacted with him far more often and more deeply than we’ve had in the past few years. In the same way my father looked after us when we were helpless babies, the tables have turned and we now hope to make his last years comfortable and happy.