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Editorial Write-Up
Self-Love is Selfless
Caregiving is a very noble role and duty that a person can perform for another as it benefits people who are unable to take care of themselves due to age or sicknesses. Yet many caregivers forget and forgo their own needs when taking care of others. This is one of the problems with people who has great empathy for others. Self-sacrifice is often mistaken for doing good for another person. Yet that is one of the acts of harm towards a human being – the caregiver himself.
Taking care of oneself is of utmost importance in caregiving. This is because by taking care of yourself, you keep the source of support ongoing for the other person who is dependent on you on a long-term basis. Only when one is safe and fine can one then go take care of others. This is like the scenario on airplane when one should put on their oxygen masks for themselves first then attend to help others. If the caregiver collapse, no one will be able to help those in need of assistance. Self-love in caregiving is not selfish. It is selfless.
So here I will share with you some self-love tips for caregivers that should be practiced often to keep the physical, mental and emotional health of caregivers in check:
1. Eat healthy meals regularly
Caregiving is hard on the body and mind so it is important to keep the body and mind healthy by reenergizing yourself with nutritious meals. Include lots of fruits and vegetables which will help to boost your immunity.
2. Keep hydrated
Keeping yourself hydrated help to keep your mind clear and keep the body as detoxified as possible. You may be tempted to go for caffeinated drinks or sugary drinks to give you the surge of energy but try to refrain from that as it will cause you to have energy dips later. Plain water is by far the best option!
3. Sleep and rest regularly
Rest is important to keep your immunity in check. So try to get enough sleep and rest as much as possible. Naps are also highly recommended.
4. Cater time for exercise
Exercise is crucial for stress release. Try to cater at least 15 minutes daily for simple exercises like taking walks in nature or some indoor exercises to get your heart and lungs pumping.
5. Ask for help
Learn to ask for help from family and friends. People are often very eager to help during difficult times. Accept the support that is offered by your friends and family. If you feel that you need to, have the courage to speak to a counsellor or a spiritual advisor.
6. Give yourself a break
Give permission to yourself for your own me time, away from the bedside of your loved one. This is especially important when you are feeling overwhelmed or exhausted.
DR Lim Xiang Jun 林香均 博士
Senior Consultant TCM Physician
PhD. Acupuncture/Chinese Medicine
BSc.(Hons) Biomedical Science
Specialised Aesthetic (Face/Pelvis) Osteopath
Metaphysics (Bazi/Fengshui) Practitioner
Somatic Yoga & Meditation Teacher
Non Linear Movement Method® Teacher
Wild Woman’s Circle™ Teacher
Intimacy & Polarity® Teacher
Reiki, Ayurveda Practitioner
Website: drxiangjun.com
Email: drlimxj@gmail.com
Contact number: +65 81278264
Why You Should Be Engaging Home Therapy For Seniors
Why You Should Be Engaging Home Therapy For Seniors
Healthcare for seniors can be challenging. As time goes by, their capabilities might decrease, and their level of care may increase.
Sure, outpatient clinics and nursing centres may help to address these accommodations. But many are also turning to a more convenient and efficient option: home therapy for seniors looking to recover at their own comfort.
What is Home Therapy?
Home therapy refers to rehabilitative services that take place in the comfort of their homes. As opposed to a clinic or a centre, the therapist travels to the patient to extend their services and support them in their recovery.
Similar to a session in the clinic, the in-home therapist provides services to:
● Find out your rehabilitative needs through an assessment. This may include some functional tasks as well to determine the severity of your condition
● Design a personalised recovery plan set to your condition and recovery goal
● Recommend modifications that may help you around the home
● Work with your family members or caregivers to manage issues or challenges that may impede your recovery
● In many cases, treatments may involve active exercise or equipments that may be provided during sessions
Home therapy can be just as effective as clinical visits. In fact, a 2016 study found that 44% of long-term care recipients opted for home therapy services, illustrating the growing popularity of convenient healthcare.
Types of Home Therapy
There are three main types of home therapy services that seniors can engage in. This includes:
Occupational Therapy
This type of rehabilitation focuses on treating people to develop, maintain or recover their capacity to manage daily living activities. For example, people who need assistance eating, bathing or walking can benefit greatly from an occupational therapist. Aside from treatment, they may suggest alternative methods to perform the task, or assist with strategies on improving the patient's environment.
Recommended for: People requiring assistance to regain independence with daily living at home and return to work
Speech Therapy
For seniors who suffer from debilitating conditions such as stroke, speech therapy can be incredibly helpful. Aside from increasing functional communication, speech therapists also work with their patients to retrain oral muscle strength. This helps with drinking and swallowing as well.
Recommended for: People with speech disorders, troubles understanding language, and problems with eating & drinking
Physiotherapy
Physical therapy focuses on developing mobility and increasing physical capacity. It also helps with improving stability and strength, improving function in all stages of life, and encouraging independence. Through the use of exercises and therapy aids, physiotherapists empower seniors to improve their balance and safety, restore their activity levels, and slow down the functional effects of aging.
Recommended for: People with all types of activity-limiting conditions or recovering from surgery and acute / chronic injuries
Benefits of Home Therapy for Seniors
Many people have found that engaging an in-home therapist can prove to be advantageous. Here are some of the key benefits of engaging home therapy for older patients.
Higher Quality of Care
Therapists in busy outpatient clinics may sometimes be overseeing a few cases at the same time. Seniors who opt for in-home therapy get to enjoy more attentive one-on-one care services.
The best part is that it is just as effective, if not more, than clinical treatments. A study found that home-based rehab programs proved to be as effective as care provided in clinics. In fact, some found that in-home plans were more intensive and focused due to the level of personalised care.
Convenience
This would probably be one of the biggest advantages of home therapy. Besides having to take time off from work, commuting to and from appointments can be a hassle. For seniors with mobility issues, it can also be an additional source of stress. In such cases, home therapy can prove to be the more prudent service.
Comfort and Familiarity
It is widely agreed that a healing environment is necessary for optimal patient recovery. Seniors may struggle with the clinical environments that tend to be noisy, harsh and confusing. An in-home service can make the process a lot less stressful for them, as they focus more on their own recovery.
Having therapy in the home environment also allows seniors to learn rehabilitation exercises using common household items. This further promotes accessibility and compliance to a home exercise programme.
Sustainable care
Rehabilitation isn't a one-and-done deal—it requires consistency. An in-home therapist will be able to assess and ensure that your environment is more sustainable and risk-free for long-term care and safety.
They would also be able to translate the rehabilitation routine according to the home environment. This makes it more practical and safer for older folks to follow through.
Support
Home therapy can also invite family members and caregivers to lend their support in the recovery process. Those working from home may also find it easier to be part of the care process and stay in the loop with new developments. The additional presence and participation of their loved ones could also be useful in keeping seniors motivated towards improvement.
Conclusion
For elderly patients experiencing limited mobility or chronic medical issues, in-home therapy services may be the best solution. Effective, accessible and functional, it simplifies the recovery process in a familiar environment. At the same time, patients are encouraged towards a higher quality of life by making use of their known environment to be more independent.
To read more health-related content from Rehab & Beyond, please click HERE.
Shirouz Elango
Health Content Coordinator at Rehab & Beyond
Finding Our Anchor Amidst Caregiving Anxiety
Anxiety often sneaks in amidst our caregiving. Naturally, we want to provide the best care for our family member. As a result, we want to be on top of the many tasks and errands. We find ourselves multi-tasking, monitoring in detail the care for our loved ones and identifying possible emergencies that may arise. Before we know it, we find our mind churning worries. Unknowingly, anxiety has joined us in our caregiving journey.
As caregivers, we also adapt to our loved one’s illness progression. Our loved ones may have new symptoms that require us to change the way we care for them. We may need to change their diet or activities. We may be more involved in helping them with their daily activities like moving about, showering etc. These constant changes are uncertain and contributes to caregivers’ anxiety.
Having been a caregiver to both my parents for the past 17 years, I had fair share of experiences with caregiver anxiety. In my clinical work with caregivers, many have also struggled with anxiety related symptoms like difficulty sleeping, irritability and panic. Fortunately, there are ways we can tap into to manage our anxiety better. Here are some strategies adapted from psychological interventions of Cognitive Behavioural Therapy that may be helpful for you:
1. Identify What You Are Most Anxious About
Often times, we feel anxious because we are overwhelmed by many issues that we have to handle. All issues seem urgent and important. The issues seem impossible to manage.
One helpful way is to slow down, give ourselves space to take a moment to ask ourselves what we are most anxious or concern about amongst the varied issues. Once we identify what we are most concern about, it’s like hitting the bull’s eyes of the target, we can identify effective actions to manage the core issue. Once the core concern is managed, the other concerns will seem more manageable.
Earlier in my caregiving journey, I felt stuck and helpless about how to care for my father with dementia and Parkinson’s Disease. I worry he will fall when he gets up in the dark at night. I worry if I leave the lights on it will affect his sleep. As you can see my worries snowball and I was actually not problem solving. Only when I identify that my core issue was safety for him in the middle of the night, was I able problem solve that I could get motion activated lights for him.
2. Realistically Estimate The Probability
When we are anxious, we tend to overestimate the negative consequences. We underestimate our ability and resources to cope. When we are anxious, we may also overestimate the probability of the negative consequences happening.
If we ask ourselves about the odds of the negative consequences happening, we may realize that it is not as high as we thought. This does not mean that we do not take any actions to manage the situation, it just free us from excessive anxiety, puts things in perspective so that we are in a better position to problem solve.
A caregiver I work with was worried about her mother losing her way and not able to find her way home. However, when we realistically evaluated her situation, her mother had a helper and other family members who looked after her. It is unlikely that she will be venturing out alone. This helped to allay her anxiety. Nonetheless, we still help her to explore how she could register her mother with a digital platform to ensure safe return for her mother should she wonders about alone.
3. Focus On Solving, Coping, Accepting
When we are anxious, we tend to focus on the problem. As the problem becomes the spotlight, it makes it difficult for us to engage in effective problem solving. Instead, our mind will generate more and more negative consequences and more problems. Focusing on what steps can be taken in the direction of solving the issue. If it cannot be solved, focus on what can be done to help you cope better. Or, focus on what you need to help you accept the situation better.
A caregiver shared with me that she was initially very anxious about how to manage her father’s incontinence. She feels torn about using diapers. Eventually she tried to solve her father’s issues of wetting himself by using diapers when they go out. If they are at home, she tries not to use diapers and she also copes with it by monitoring the time that her father typically needs to go to the washroom. She will remind him every few hours to go to the washroom. To help herself accept the situation better, she mentally prepares herself that despite all she does, he may still wet himself sometimes due to his condition.
4. Identify Who Can Help You
Sometimes we get anxious because we get stuck in coming up with solutions and feel the situation cannot be changed. It may be helpful to seek help from others to brainstorm for possible solutions. You can seek the advice of medical professionals. You could take references from other caregivers by joining support groups, activities or online platforms.
To experience anxiety in caregiving is normal. But that
does not mean that we cannot do anything about it. Managing our anxiety puts us
in a better position and frame of mind for caregiving.
Mr Lew Yuen Foong, Henry.
Registered Psychologist and Approved Clinical Supervisor (Singapore Psychological Society)
Why Caregivers Need Mindfulness
When my grandmother was diagnosed with advanced dementia, my family and I unexpectedly fell into the role of being her primary caregivers. We spent a good number of years scrambling to meet the needs of our loved one, whose illness brought about a 180-degree change in temperament.
Before her dementia set in, my grandmother's demeanor was mostly gentle and calm. She enjoyed gardening, cooking, and making traditional Teochew kuehs for her children and grandchildren.
When her memory began to falter, she lost all interest in what she used to love doing. Over the course of two years, her illness took over, and we witnessed the once-placid old lady become highly anxious, agitated, and angry. She was severely underweight, yet embodied the physical strength that the entire family collectively could not handle. On top of having to deal with her constant screaming and increasingly violent tendencies, as caregivers who took turns watching her round the clock, we often found ourselves exhausted, confused, and feeling helpless.
In the midst of her illness, I had just embarked on my journey of learning mindfulness, and I consider our family extremely fortunate to have had the practice and skills of mindfulness at hand to support us through the seemingly endless days of caregiving.
Caregiving can be an overwhelming experience, which drains us physically, mentally, and emotionally. Sometimes there seems to be no end in sight, thus leaving us feeling depressed, anxious, and hopeless. Caregiver burnout is a very real phenomenon, with our determination to persevere and devotion to care giving way to resentment, withdrawal, and even numbness and apathy. When there is no other option but to keep going, sustainability becomes the key to navigating some of the most stressful and difficult moments that may come our way.
Mindfulness has indeed received much attention over the past decades, in large part due to strong research evidence on its efficacy in improving our personal effectiveness and quality of life. Mindfulness can be integrated into the caregiver's life as a proactive and preventative approach to our health and wellbeing. Research has shown that practicing mindfulness consistently and effectively improves our focus, reduces anxiety and depression, as well as hones our ability to manage stress, build resilience, and prevent burnout, so that we can not only take good care of ourselves, but also improve our quality of care for the people who need us.
Caregiving is a highly emotional experience, especially when we are taking care of our loved ones. When we meet with difficult and intense emotions such as sadness, anger, or grief, and when negative thoughts hijack our mindspace, they can quickly overwhelm and even debilitate us. Having mindful awareness of what is arising within the mind helps create space between ourselves and our experience, so that we can step back and see our thoughts and emotions more clearly, understand that they do not need to consume us, and learn to work with them.
The role of caregiving also encourages us to neglect our physical health and overwork our body's capabilities for the wellbeing of someone else. When we practice paying attention to our body, our attention becomes a physical barometer that offers us a better understanding of what the body is experiencing in each moment, and whether we should take rest or seek medical attention for ourselves.
These skills of self-awareness and self-observation are what we need to keep a gentle watch over our own mind and body, and remind ourselves to take a pause when necessary, so that we can return to a state of balance, before moving on again from a better place.
Mindfulness also lays the groundwork for cultivating self-compassion, which is the willingness to turn our attention towards our own struggles and suffering, and attend to ourselves with more gentleness and kindness. Many caregivers are also living with feelings of guilt and the perception that they are never doing enough. With mindful self-compassion, we will be better able to mitigate any unnecessary thoughts of self-criticism and self-judgment, and learn to embrace our limitations and award the necessary care for ourselves.
One of the more surprising discoveries of mindfulness is that when practiced regularly, it not only benefits our emotional and mental health, but also our physical health as well. Studies have shown that mindfulness improves our sleep quality and strengthens our immunity, thus making us more physically resilient as caregivers.
The most important insight I have gained from my ongoing mindfulness practice is that having a purely intellectual understanding of mindfulness is definitely not enough. We should see mindfulness as a set of skills that we need to develop in order to reap the benefits of this wonderful practice. It is not difficult at all to get started with mindfulness, and for a beginner, a little practice every day goes a long way.
As we persist in our learning and practice of mindfulness, and as we improve our capacity to attend to the present experience, we will eventually be able to witness positive shifts in how we navigate our caregiving journey.
Caregiver support group
Ms Erin Lee
Erin Lee is Founder and Mindfulness Coach of Mindful Moments. She is dedicated to supporting individuals and communities in improving their mental health and wellbeing, and developing skills of mindful awareness and self-regulation for better resilience, mental flexibility and emotional balance, through the integration of attentional skills in both personal and professional lives.
Erin founded Take A Pause, a regular online mindfulness practice community, as well as co-initiated The Big Sit, a global community that inspires the use of urban spaces for the collective practice of mindfulness and the fostering of good mental health.
Erin works with organizations to design and introduce mindfulness-based initiatives and interventions as a preventative approach to mental health, as well as encourage a culture of wellness at the workplace.
Our Legacy
They say the two occasions where one gets to meet everyone in our family network are weddings and funerals. When I was younger, it seemed like every year we will all congregate at some wedding banquet and catch up with relatives and guess who is next to walk down the aisle. Those were happy celebratory moments.
As a sign of the times, and how rapidly our generation is aging, these days I am more likely to meet relatives at a funeral wake. The topic of conversation often relates to what next for the family members and this is where it dawned on me that as much as we prepare for the welcome home of a new-born baby, we often neglect the preparation for our eventual demise.
This was particularly pertinent when the caregiver passes on before the one who is being cared for. We all assume that as caregivers we will outlive our loved us, unfortunately Life is not always so predictable and throws us curve balls.
This is not the most comforting topic to talk about, but it is a practical reality for every caregiver to plan for especially if your loved one has special needs. As I was doing my research, it became evident that death and estate planning can be a complex tedious affair if we do not prepare for it.
Supporting our loved ones financially after we are gone
Funeral wakes are busy times for the immediate family, it invokes a conundrum of emotions, stress and fatigue. I am particularly concern about the caregiver for whom the loved one is totally dependent on, what happens when the caregiver passes on? The responsibility has to shift to someone else, and in some instances to institutional care as a last resort. As uncomfortable a topic to talk about death, it is nevertheless crucial for all caregivers to make estate planning for their loved ones as the next phase of care.
There are practical steps we can take to ensure that our financial assets can be liquidated to support our loved ones after we are gone.
i. Every Singaporean has a sum of money in their CPF and Medisave account, this is perhaps one of the more accessible funds to disburse after our demise. The important point is to make a CPF nomination to your loved one so that these funds can be disbursed directly to the nominee.
ii. Make a will. Consider this the caregiver’s ‘to-do list’ for the assigned person(s) of how to carry on looking after your loved one. It is similar to how we prepare for a long journey where we leave behind instructions for someone responsible to take over.
iii. You are the best person to draft this list of instructions and it will also give you peace of mind that no matter what happens, or when it happens, your loved one will be well taken care of according to your care-plan. We should not assume that any family member will know what to do in your absence. I have personally witnessed family conflicts when well intentioned motives are misunderstood simply because nobody knew what exactly was needed.
iv. Look for resources how to do estate planning, and a good reference can be found at the government website aptly named as my legacy (www.mylegacy.life.gov.sg)
What happens next after I am gone?
I have started to ponder on this during my quiet time, for many of us who have dependents, their lives carry on, it is in our innate nature to want to ensure that our surviving family and loved ones make the transition to the next phase of their lives as stress free as possible. For them they have to face the inevitable grief that comes with the demise of their caregiver.
We can alleviate the stresses that may come later, by ensuring that we have left sufficient instructions both in legal documentation as well in personal written form so as that whoever takes over the role as the next caregiver understands our loved one’s needs as well as we did.
Caregiving is a journey, that journey will end someday, let us ensure that when our caregiving journey ends, the next leg of that journey continues seamlessly for those we love and care for the most.
Dr Daniel Tan
Board Member
Editorial Sub-Committee: Editor-in-Chief
Caregiving Welfare Association
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Keeping Wellness in Check!
Caring our dependent loved ones at
home is already a massive task in normal days. Caring our dependent loved ones
during a pandemic can sometimes be the last straw to break the camel’s back.
Caring our dependent loved ones in a pandemic that has lasted the past 2 years,
I am at loss for words at what all these caregivers have been through.
Not only the fear of getting ourselves Covid, and thus unable to care for our dependent loved ones, many caregivers fear their love ones, already being high risk group for infectious disease, might one day get infected.
As a long-term care physician, I have heard many of these worries and sometimes cries for help. To be resilient in such a difficult period, sometimes, caregivers should focus on their own mental and physical well being in order to tackle the whole situation at hand.
Wellness is not something that is a given, when nothing is happening in one’s life. Wellness needs to be pursued, maintained, and practiced.
There are 7 dimensions of wellness, namely physical wellness, emotional wellness, intellectual wellness, social wellness, spiritual wellness, environmental wellness and occupational wellness.
I will be mentioning on 2 of these 7 dimensions which are affected greatly by this pandemic.
In midst of the current pandemic, social wellness has taken a big hit,
due to the many social restriction policies and social distancing campaigns
from many governments. With technology, smart phones, WIFI, 5Gs and many other
modern services, the word ‘social distancing’ has been a terrible choice of the
message given to the masses. Physical distancing and social integration should
have been the focus.
Caregivers should as far as possible, maintain good social interaction through technology use, from the everyday phone calls to tele-presence robotics. ZOOM meetings has replaced many traditional company meetings, hence, Tele-gatherings should be made more available and get caregivers more involved in such tele-support groups.
Social wellness should be maintained, if not enhanced for all the caregivers during the course of this current pandemic.
The next wellness will be emotional wellness, which can be very fragile in the midst of this pandemic. There are many restrictions and caregivers are often very afraid of any quarantine orders, which will fracture the already difficult care system in place for their loved ones.
There are definitely many ways to reduce to the stress and anxiety for caregivers. Seeing a wellness coach or attending yoga sessions will be great, if time can be afforded. However, most of the time, caregivers are too busy with day-to-day requirements and the caring work that no much time is given to personal wellness practices.
Hence, new solution such as digital
apps like InMIND will be interesting to patch the gap up on supporting
caregivers in maintaining their wellness. InMIND can track the stress level of
the caregiver just by downloading an app from the smart phone. After tracking
the level of stress, using 
A.I. algorithm, it will recommend an in-app management plan for the
caregiver to follow. In this way, caregiver can be reminded to do wellness
practices daily and as and when needed. It is a digital “band aid” for stress.
Caregiver Welfare Association will be trialing such cutting-edge solution this year as well for her members.
Taking time daily to do some wellness practices not only benefit the caregivers, it will also benefit the care recipients as well. In fact, both caregiver and care recipients can be doing such wellness practices daily to maintain mental well-being in these uncertain times.
In Summary, care givers need to keep their own welfare and mental wellness in check first, being they can give proper good care to their loved ones. Without a strong emphasis of personal wellness, it will be difficult to enjoy the journey of caregiving to our very most loved ones.
Dr Tan Jit Seng
Board Member (Co-opted)
Caregiving Welfare Association
Founder and Director for Lotus Eldercare Health Services.
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Letting Go
Dr Daniel Tan
Board Member and
Editorial Sub-Committee: Editor-in-Chief
Caregiving Welfare Association
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CWA Caregivers' Week 2021 - 'Finding Resilience in Caregiving'
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5 Sleep Mistakes You Don’t Know You’re Making and How to Fix Them!
Behavioural Strategies To Manage Pain
We may experience aches and pain in our body from time to time when we overwork or overtax ourselves. We may also experience pain due to an injury or a medical condition. And as caregivers we may also experience pain when we overstrain ourselves while helping our loved ones.
5 Vegetables to Avoid for Better Sleep in TCM
Sleep is an inherent part of healthy living but an activity that is much deprived for many in society today. Getting into sleep and staying asleep seems to be almost unachievable by many people as they struggle to even get through the night in peace. This is especially so for caregivers who may have to break their sleep to serve the person they are caring for during the wee hours of the night. 
Nutrition and Immunity
Adequate nutrients and water are vital for the functioning of all your organs, and it is a huge part of keeping your immune system functioning at an optimal level. Think of your immune system as your “personal bodyguards”, protecting you against infections and other harmful elements. 
Physiotherapy Management of Osteoporosis
CWA 17th Anniversary - 'OF CHANGE & HOPE'
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WHY SHOULD WE LOVE OUR SLEEP?
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Music Listening for Health and Well-Being
Mr Jonathan Tang
Music Therapist - Board
Certified MA, MT-BC
Extraordinary People Limited
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