Category: Life

Dr Nor’izzati Saedon Internal Medicine Specialist, University Malaya Medical Centre

Slow dancing with a stranger. That was how Meryl Comer, an award-winning journalist, once described her caregiving for her husband, who had Alzheimer’s disease. Caregiving is a noble vocation, but it is also a sacrifice borne out of love, one that can drain the caregiver both physically and emotionally. Dr Nor’izzati Saedon, an internal medicine specialist as well as a member of the Malaysian Society of Geriatric Medicine, kindly takes time from her busy schedule to address some common issues faced by caregivers today.

Dr Nor’izzati: Ramona’s predicament is actually a common one among caregivers. For caregivers in such a situation, here is my advice:

• First, accept that we are human – we cannot succeed in everything because that is impossible. Know our mental and physical capabilities, and be honest about our limits.
• Plan on how we can best provide care for our loved one both in the short term and long term. Our plan should also take into account our own needs and the needs of other people who are dependent on us. To help us plan better, we can attend short courses, talk to doctors and nurses and do some research online.
• The first three to six months of caregiving are always the toughest. During this period, we should reach out to others who are going through the same journey for support. There are caregiver support groups, in person or online, that can provide advice as well as a listening ear. I also feel that physiotherapy sessions at the hospital are a good outlet for caregivers to meet and compare notes or experiences with one another. Experienced physiotherapists and occupational therapists are often willing to share insights and ideas on how to best care for loved ones. Watching how they interact with their patients is also a good way for us to improve our communication with our loved ones.
• Studies have shown that caregivers have a higher risk of developing depression if they neglect their own well being. Thus, take an hour or two each day to recharge by doing something we enjoy – grab a coffee, take a walk, go to the gym, etc. Also, take time to tend to our spiritual needs (through prayer, meditation, etc).
• We don’t have to do anything alone. If we can afford it, we can hire a maid (full or part time) to help. Otherwise, we can enlist our siblings, our partner and even our children. They may need some time to understand how to care for our loved one, but in the long run, they will be a big help.
• To lift our spirits when we are down, we can attend motivational classes or listen to motivational speakers (there are many clips on YouTube), read inspirational books or talk to people who understand what we are going through (such as members of a support group). We can find fellow caregivers on social media such as Facebook, Twitter, Snapchat, Pinterest, etc who are willing to share and advise. Remember, we are never alone, so don’t lose hope!

Dr Nor’izzati:

When someone like Sara becomes a caregiver, he or she must accept that there will be significant, even big changes to the person’s life. However, this does not mean that the person must completely put his or her own life on hold. It just means that a little more planning needs to be done.

For example, Sara may want to go on a holiday. She can plan ahead for this, perhaps by engaging the temporary services of a nursing care facility to take care of her father while she is away. Alternatively, she can plan for staggered breaks, such as taking two or three weekends off, by hiring a helper to step in during those weekends.

When it comes to family members who leave all caregiving responsibilities to the caregiver, like Sara’s siblings seem to have done, she cannot force them to help, but she can try to slowly change their ways by bringing them along to the clinic for her father’s medical check-ups. The doctors can be good allies in helping these families understand the need for the entire family to support the caregiver’s efforts.

Universiti Malaya Medical Centre (UMMC) holds clinic sessions that bring together caregivers and their family members, encouraging them to open up, exchange opinions and discuss ways to improve the caregiving situation together. Sara and other caregivers may find such sessions useful. To check out the sessions, just drop by the General Geriatric Outpatient Clinic at Klinik Perubatan 3 on Friday afternoons.

Dr Nor’izzati:

For care-receivers who have dementia or other conditions that affect the brain, it is not uncommon for them to experience personality changes. A formerly patient and loving parent may become irrational and demanding. They may also become verbally and physically abusive.

It can be difficult to care for someone we love, only to be made to feel unappreciated and unloved. We may also feel that we no longer know our loved one – he or she is now a complete stranger.

These emotions are only natural, but we should not allow them to consume us. It is our loved one’s disease that is making him or her behave this way. Diseases that affect the brain can make our loved one say things out of frustration or without basis. Often, our loved one is not aware of what he or she is saying or doing. So, blame the disease, not the person. Doing so will help us to better cope with the situation.

Here are some things that caregivers such as Lin can consider doing:

• If a situation becomes too much to handle, take 15 minutes to calm ourselves and gather our feelings. It is fine to leave our loved one alone to do so, as long as they are in a safe environment.
• Do not concern ourselves too much with what other people think of us. We should instead take comfort in knowing that we are doing our best for our loved one.
• Having said that, we should protect ourselves if our loved one becomes violent. Keep sharp and dangerous items out of this person’s reach. We can also consult a physician for advice; some medications to calm our loved one when he or she becomes agitated and aggressive may be useful.

Dr Nor’izzati:

Caring for someone dependent on us is a very physically and emotionally demanding task – it can be overwhelming and even draining. For loved ones who are at the end stage of their life, it is normal for caregivers to feel helpless, as there is not much they can do for the loved one at that time. Sometimes, they may also be reminded of their own mortality – they are aging, and they too will pass on one day – and this realization may only add to their grief.

During this period, caregivers such as Rama should seek emotional support. Here are some suggestions:

• Find a person to talk to, in order to unload our stress and anxiety. A caregiver support group will be tremendously helpful.
• It may also be good to discover (or rediscover) spirituality (such as by joining a religious group), to find comfort when faced with issues such as the mortality of life.
• Meditative and relaxation techniques such as yoga can also be helpful.
• If we feel overwhelmed or confused by the care needed by our loved one during this period, it may be good to hire a part time qualified nurse to make daily or weekend visits.
• If our loved one needs more specialized care, we can consider locating a good nursing home for him or her. After placing our loved one in a home, we should still visit regularly to monitor the care given to our loved one. Our visits will also provide comfort to our loved one (who may need time to feel safe in a new environment), and knowing that he or she is receiving the best professional care will also be a source of comfort to us.  

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WORDS RACHEL SOON

Speaking from recent first-hand experience: moving houses is NOT FUN. Whether it’s due to a new college, a new job, or a change in family circumstances, the process of packing up and moving an entire household’s worth of possessions to a different building can be incredibly stressful for everyone involved—and potentially hazardous to one’s health. Read up HealthToday basics on how to stay both sane and safe while dealing with a big move.

1. Pack smart.

Heavy objects go in smaller boxes, lighter objects in bigger boxes. Do not under any circumstances fill a human-sized box with books just because you want them all in the same place. Unless you or your moving help are secretly a superhero, someone’s joints will end up in a bad condition, and that someone’s chiropractor will be very pleased.

For reference, the Malaysian Department of Occupational Safety and Health (DOSH) recommends a maximum lifting- and-lowering weight of 25 kg for average adult men (16 kg for women). 

Spread the weight out among large boxes by putting heavier, sturdier items (books, papers) at the bottom of the box, then filling the remainder with lighter items (bedding, clothes). If the heavy stuff is fragile (dishes, glassware), the lighter materials can be arranged to pad them as well.

When packing, try to put the box on a chair or table so that you don’t have to keep bending down to put items inside.

2. Lift with your legs, not with your back.

Bending your back over and over to pick up heavy boxes is a sure- fire shortcut to causing a back injury that could last anywhere from a few hours to a lifetime. To prevent that, make sure you lift (and lower!) objects using a squatting movement that spreads out the weight through your hips and legs.

Remember the DOSH maximum weight recommendations? That assumes you’re holding it as close to your core as possible. A box of dishes may seem manageable when you’re carrying it next to your belly, but if it’s going on the top of a stack or an overhead shelf, try to reduce its weight even further.

And as always, don’t try to carry everything on your own; adrenaline may help you in the short term to pick up that heavy end table by yourself, but you’ll feel the ache days later.

“Put heavier, sturdier items at the bottom of large boxes, then fill it with lighter items.”

3. Have some protective gear on hand (and face and feet).

Consider a face mask to keep your sinuses clear. Even if you’re not usually sensitive to everyday levels of dust, the layers of ancient dust that tend to be stirred up from forgotten corners of the house in a move can cause uncomfortable sensations in your lungs and trigger allergies you didn’t know you had.

“It’s important to keep walking paths through rooms as clear as possible.”

If you’re doing a lot of the lifting yourself, a pair of good work gloves (durable, stretchable, sweat-resistant and well-padded) will help you in both getting a good grip on heavy objects as well as protecting your hands from injuries.

Comfortable shoes are also invaluable since you’ll likely be spending a lot of time on your feet. Think about anti-slip soles, ankle protection and good arch support; your favourite old sports shoes will probably do.

4. Keep the floor clear of stepping hazards.

Moving is a messy process by nature, but it’s important to keep walking paths through rooms as clear as possible, especially if renovations are still in progress. Sweep the floor at the end of each day to clear potential splinters or other sharp debris that might end up in someone’s foot later.

Don’t leave scissors or blades  lying around on the floor, even when in the middle of packing or unpacking. Another hazard to look out for are electrical cables, loose pieces of plastic or other packaging that could trip people up while carrying items.

5. Don’t forget to rest.

It can be tempting to survive  the moving period with 4 hours’ sleep a night and enough coffee to replace half of your blood circulation, but it’s best to try avoiding this. Lack of sleep impairs your concentration, memory, and dexterity, which can lead to accidents (tripping, dropping objects), bad decisions (stacking fragile objects precariously) as well as added stressful moments (struggling to deal with five different contractors calling you at once).

You might technically have “more time” if you sleep less, but your body will process things slower, so it might not really be worth it.

If you can’t get your full 8 hours’ sleep during the night, try to find the opportunity for a nap on a chair or in a car during the day; even a short 15-minute stint can help improve your mood and your ability to process problems. If you’re unable to fall asleep, it’s still not time wasted; just the act of reclining with your eyes closed helps relax your body, and puts you in a slightly better state than otherwise.

6. Don’t forget to eat and drink water, too.

In the chaos of moving, sometimes it’s easy to forget you’re hungry or thirsty until you actually sit down for a moment and feel your stomach growl, or start to feel faint while standing. Ideally, you shouldn’t be straining yourself to that point; make a point of trying to eat and drink at around your usual meal times.

Maybe you’ve packed all your kitchen stuff already, or you just don’t have time to cook or to make a drive out and eat. Getting takeout delivered is fine, but be sure to keep some level of fruit, vegetables, lean meat and grains in your diet. Easy grab-and-go foods to stock up on like biscuits, granola bars, hard- boiled eggs, yogurt and blended juices can help keep you going.

Keep water bottles handy. As tempting as it is to grab sports drinks or soft drinks for the energy rush, your body needs to stay hydrated, especially with the amount of water you’ll be losing as you sweat while moving around all day in the heat. HT

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