I don't know about you but don't you think caregiving is often a thankless job? Imagine the work required for an immobile, bed-ridden patient at home: feeding through tubes, replenishing the drip, monitoring meal and poo/pee times, turning his body to avoid bed sores, massaging his joints and muscles, changing his diapers, moderating room temperatures, cooking for the patient.
Caregivers receive little thanks because often, the work done is monetarily immeasurable and takes place in the private domain of the home; beyond what others can recognise and valuate. I personally know one contact who previously took a few years off so that she can take care of her mother suffering from Alzheimer's Disease; the work done is tremendous: finding ways to stimulate cranal activity, encouraging patient to move into physical mobility, preparing food which boosts memory, moderating mood swings, cleaning up after patient and so on. It's not a 9-to-5, but a round-the-clock routine.
True, caregiving is born out of love, of filial piety, of selfless care and concern for someone else, but where many responsibilities are expected of an active Singaporean as prescribed by the government, how can Singaporeans be compensated (or even rewarded) for their efforts? For the time loss which could be directed at bringing home bread and butter? For the gap to fill in returning to the workforce? How can one catch up?
Take for example, the role of the Singaporean woman. She plays the dual role of staying economically active, i.e., employed, as well as caring for the elderly and her children. These are expectations set out by many instances of national rhetoric. Families can't be just single-income but dual income (wives have to work too); Baby bonus packages (give birth and take care of her kids); hospitals cannot support our elderly population, it has to be cascaded to home care (who else but the wives to take care of her in-laws?).
Face it, caregivers in Singapore are overstrained. To what quantifiable extent can workfarism work for caregivers here? It's time caregivers get their due welfare.
.
Monday, September 14, 2009
Subscribe to:
Post Comments (Atom)
32 comments:
Caregivers are always not appreciated. It is the fact of life. I mean would you thank God for being awake everyday? It's the small things which mattered that often goes unappreciated and more than often taken for granted.
Take for example, the role of nurses as caregivers. How many patients actually remember us? Or not talking about apreciation, are we treated as humans at times, where we are at the mercies of unreasonable and easily angered patients?
Having said that, to put a foot down and to quantify and dish them out if tatamount of impossibility.
I guess the bottom line of still love.
There should not even be talks about rewarding caregivers. I persoanlly feel that whatever care rendered should be done out of one's own freewill, not motivated by rewards or welfare, but the basis that of stems from love.
Love scattered does not ask ask for anything in return so i guess mix rewards and welfare with caregiving is immisible.
Don't you think so?
Yaya, to some extend I think what Raphael said is true.
I personally have seen people who sacrificed all they had (i.e. quite their jobs, given up personal social life and time, etc) to just provide care and shower love to their aged family members.
I have also seen volunteers who gave of themselves selfessly but never asking fro anything in return.
I guess these people really have a heart for people and all's done out of the notion of Love, per se.
Since care and concern birth forth from love, then maybe the question is, why can't we love others more? Is there something which the society have overlooked?
To answer Jessica's question, yes, this is largely a societal issue that has surfaced, resurfaced again and again, repeated itself through generations and different continents. In the pursuit for selfish gains and economic dreams and desires, we have to marginalize some in order to push others forward. And meritoracy is good at doing just that. Not to say that merits awarded are bad, but rather is there a balance of such policies?
The young go about their jobs at attaining achievements, neglecting those around them and giving excuses or reasons for not caring for their family members in the name of lack of time and priorities.
Think about this: If our young were brought up to love, show care and concern to everyone, would their now be an issue of having the need for caretakers -- Everyone is a caretaker himself or herself! And if this is so, would there be an issue of whether caregivers are appreciated and rewarded?
We have Weberian and Marxist theories on how the society should be run. Perhaps in light of an ageing world population where caregivers and caretakers will be put under the spotlight again, there would be some sociological theories to guide us on this very issue on welfare and caregiving.
Emotions, love and education for the young aside, I personally feel that there might be a chance for the governing bodies to look into awarding and rewarding such positive behaviors. When you reward a correct and good behavior, it itself is already a form of education to the mass public. But just how should it be done such that you do not cross the fine line of doing-for-the-sake-of-rewards-kind of behaviors?
To that extend, it becomes hard to quantify to qualify the policies.
So, unless these issues can be anticipated, discussed and address, i guess what Jessica, Raphael and Mr K.K Lee said is not entirely skewed.
I agree with Ruth!! Caregivers are always not appreciated. Say for the nurses, they offer their care and love endlessly, but many a times, they are not very appreciated by the patients. But I believe they are always willing to offer their help, care and concern, always there for the patients.
Gambatte!
Raphael, sorry but I humbly disagree, because, the issue here is not solely abt the motivations of caregiving but in the context of S'pore (or most Asian societies), how caregiving is [expected to be] a part of our lives that men who are supposed to focus on their career are 'encouraged' to take care of their elderly parents, women who are supposed to take care of young children are do so for senior in-laws. And because caregiving forms the bulk of day-to-day functions for a handful of people, how are caregivers expected to perform optimally and with the least stress when there are no formal reward or compensate systems for them?
There IS a space and opportunity to help caregivers, if we put our mind to it.
Knowing why people give care helps but it doesn't necessarily remedy the situation; the steps to take in alleviating caregivers' perennial burden.
Personal interactions with so many Singaporean families have taught me that it is not uncommon to find these families fraught with issues of giving care to elderly parents. Fallouts among children, shirking of responsibilities, resistance to co-pay, issues over shifts in giving care, finger pointing... think we've seen and heard quite enough, right?
Thanks for the article. It's nice to hear that there's actually a topic on caregivers. I have been a social worker for 1 year for now, I have faced many problems, my pay is not very much, i have spent alot of time outside of my family and friends. However, I feel happy, it's difficult to describe, but each time i helped somebody, I feel I am needed, I am of use to this society.
I feel thankful that I am able to help somebody out there.
God bless.
It's alright to disagree, I see where you are coming from, but like what Keith has mentioned, unless issues like motivation only under rewards are adequately addressed, any form of incentivization may only act to sow discord amongst the families as well as on the society as a whole.
Perhaps voluntary self-help groups or NGO might help do the trick for a start?
In response to Raphael's suggestions, there is already a self-help group available, as far as Singapore context is concerned. The Association is named "Caregiver Counselling Welfare Association"(CCWA).
One of its main aim is to improve the quality of the lives of the care recepients are well as the Caregivers, showing evidence that the job of caregivers aren't a breeze and as what SG HealthCare Blogger says, sometimes families do fall apart trying to delicate caregiving duties to a ailing patient.
This support group, CCWA, says that the isolation faced by the caregiver in providing care and love for an impaired individual can be "devastating". What the association does is to provide value and give tips and talks to help these distaught caregivers manage the stress experienced.
For more information, please visit: http://www.ccwa.org.sg/
Yes, Singapore has the CCWA support group but if you look carefully at the nature of the organization, it relies soley on the donations of the public and all acts are of a voluntary basis. There are no obligations to serve nor are there any to give. There are corporate sponsers and donors but in light of economic downturn, just how sustainable are these self-help groups?
Perhaps for a sustainable approach, self-help groups and NGOs as such cen be turned government-aided if this proves to be supporting a true cause which reflects the trends of the current societal needs.
It is also interesting to note that the CCWA does online and face-to-face interaction. And i agree with what Keith said about the sustainability part. Currently the sponsers are Shaw, Lee and Tan foundation and Schools like Dunearn and Gan Eng Seng are being specially thanked but if this is really the only avenue that the caregivers can turn to in times of needs, isn't it quite pathetic that Singapore aren't doing much to address this?
Is this discussion on Caregiving rather myopic such that it does not include the larger defination of Caregivers as a whole?
Child Caregivers are also a subset of caregivers and I think they should also be given equal or more important standing.
I've reproduced an article i found online as below, on Kinship Caregivers and te Child Welfare System:
A number of grandparents and other relatives find themselves serving as parents for children whose own parents are unable to care for them. Sometimes, the arrangement (referred to as "kinship care") is an informal, private arrangement between the parents and relative caregivers; in other situations, the child welfare system is involved. This factsheet is designed to help kinship caregivers - including grandparents, aunts and uncles, and other relatives caring for children - work effectively with the child welfare system.
The child welfare system varies from State to State, but it generally includes public agencies such as departments of social services or family and children's services. These State agencies often work with private child welfare agencies to provide services for families and children. Caseworkers at these agencies are required by law to ensure the safety, well-being, and permanent living arrangements of children. Their responsibilities include investigating reports of child abuse and neglect and arranging for services for children and families.
This factsheet addresses a number of topics relevant for kinship caregivers:
Different types of kinship care, including private, voluntary, and foster care
How and when the child welfare system becomes involved in kinship care
What kin caregivers might expect from the child welfare system
Services that may be available and how to access them
Involvement of the courts
Permanent living arrangements for the children
Further resources
Bibliography
Adapted from: http://www.enotalone.com/article/10063.html
This is the continuation:
Different Types of Kinship Care
Children may come to live with their grandparents or other relatives in a number of ways, and only some of these ways involve the child welfare system. Kinship care arrangements fall roughly into three categories: (1) private kinship care, (2) voluntary kinship care, and (3) kinship foster care.
1. Private kinship care, sometimes called "informal kinship care," refers to arrangements made by the parents and other family members, without any involvement from either the child welfare system or the juvenile court system. A parent may leave children with a grandparent while he or she is sent overseas, or an aunt may care for nephews whose parents are ill or otherwise unable to care for them. In this type of arrangement, the legal custody of the children remains with the parents, and the parents can legally take back the children at any time. The kin caregivers in these circumstances may have difficulty enrolling the children in school, obtaining health insurance, authorizing medical care, and obtaining some other benefits, because they do not have legal custody of the children. Generally, the only type of financial assistance available to kin caregivers in this type of arrangement is the child-only TANF benefit.
Physical custody refers to where the child lives. If your grandchildren or niece and nephew live with you, you have physical custody of them. You may feed and clothe them, help them with their homework, and take care of them when they are sick.
Legal custody refers to the legal right to make decisions about the children, such as where they live. Parents have legal custody of their children unless they voluntarily give custody to someone else (e.g., the parent is sent overseas) or a court takes this right away and gives it to someone else. For instance, a court may give legal custody to a relative or to a child welfare agency. Whoever has legal custody can enroll the children in school, give permission for medical care, and give other legal consents.
The same person does not necessarily have both physical and legal custody. For instance, as a grandparent, you may have physical custody of your grandchildren because they live with you, but their mother may still have legal custody or the State agency may have legal custody.
2. Voluntary kinship care refers to situations in which the children live with relatives and the child welfare system is involved, but the State does not take legal custody. In some cases, children have been placed with relatives by a court, and in other cases an arrangement is made by the child welfare agency with no court involvement. This type of kinship care covers a wide variety of circumstances and varies greatly from State to State. Some situations that might result in voluntary kinship care include:
Child welfare workers find signs of abuse or neglect by the parents, but the evidence is not serious enough to take the children into State legal custody; instead, the caseworkers, parents, and kin work out a voluntary kinship care arrangement where the children move in with the kin.
Under the guidance of child welfare workers, parents voluntarily place their children with relatives while they (the parents) receive treatment for substance abuse or mental illness.
Some jurisdictions will require the parents to sign a voluntary placement agreement with the child welfare agency when the children are placed with relatives. In many situations, the kinship care arrangement comes about because the parents understand that if they refuse to voluntarily place the children with kin, the child welfare agency will go to court and ask the judge to remove the children from the parents' care and award legal custody to the State.
In voluntary kinship care, the children are in the physical custody of the relatives but they may remain in the legal custody of the parents, or the parents may sign over temporary legal custody to the kin. Some States have consent forms that parents can sign to allow kin caregivers to have some temporary decision-making power regarding the children (for instance, to seek medical treatment or enroll the children in school).
3. Kinship foster care, also known as "formal kinship care" or "public kinship care," refers to cases in which the children are placed in the legal custody of the State by a judge, and the child welfare system then places the children with grandparents or other kin. In these situations, the child welfare agency, acting on behalf of the State, has legal custody and must answer to the court, but the kin have physical custody. The child welfare agency, in collaboration with the family, makes the legal decisions about the children, including deciding where they live. The child welfare agency is also responsible for ensuring that the children receive medical care and attend school. If the court has approved visitation with parents, the child welfare system is responsible for making sure that the visits occur between parents and children. In kinship foster care, the child's relative caregivers have rights and responsibilities similar to those of nonrelative foster parents.
Hi everyone, I was invited to join this platform. I am currently doing some research work as my day job and I've just read through some articles which I found to be interesting.
Thanks for sharing the insightful article, Ruth.
And Welcome, Josh! Looking forward to reading your comments and suggestions!
Thanks for the perspective on kinship care--indeed insightful.
Caregivers are a forgotten lot in Spore. They spent much time quietly behind the scenes, taking care of the aged and disabled. Due to their heavy responsiblities, they're effectively excluded from paid employment. Maybe the govt can take note and offer some monetary rewards for them?
I agree with Jessica.. its quite pathetic to see just that handful of corporate sponsors. Granted that there may be more anonymous donations, I'm concerned with the lack of help from the govt side. They should play a more active role and live up to their promise of "Staying together, moving ahead"!
I would really applaud nurses for their endless toiling in hospital. They although are getting paid have to devote tons of time, effort and concern for the patients under their care. In addition, the patience that most nurses exhibit is amazingly super human, especially to families of patients who are overly anxious and thus making a huge fuss.
I once again would like to express my admiration and respect for hospital caregivers, NURSES
Hey, found out that the Singapore Cancer Centre Singapore also offers caregiver support in form of counselling. At least there is recognition for these marginalized group of people.
If there are those who are having doubts about the distress caregivers sometimes go through, I thought this article as below would be able to shed some light into the lives of at least a caregiver.
Gary Barg, founder of the Caregiver Media Group, which is a leading provider of information, support and guidance for family and professional caregivers wrote about the distress he faced at home whilst caring for his father, his story as follows:
I heard it in her voice. She never asked me to return and help, but I knew by the distress in her voice that things were not as rosy back home as I had thought. The year was 1994, and I was living in Atlanta, Georgia. My mom had been primary caregiver for my Dad and my grandparents over the past few years and over those years, I would return home as often as possible to help in whatever way I could. But, this late August night, I heard something in her voice that made me realize that more was needed of me, and fast. I thought I would spend about a month in Miami, where my mom and the rest of my family lived; help my mom care for my grandparents and then return home to Atlanta. Simple, right?
Not really. Within minutes of returning to Miami, I found myself wondering how my mom was able to do all she had been doing as a caregiver. It was in and out of doctors' offices, endless hours on the phone with insurance companies, midnight dashes to the hospital, life and death decisions, heartaches and stress. And we were not alone. Not by a long shot. We would find plenty of other people like us, rushing around trying to do the best for their loved ones with little or no information, but always with enough time to share whatever information they learned which they thought would be of value to fellow caregivers. We decided to do something to help others as they were helping us. The first issue of Today's Caregiver magazine debuted July fourth, 1995 (our own independence day), caregiver.com was born shortly thereafter and the "Fearless Caregiver" annual caregivers conferences began in 1998. We have met thousands of dedicated professional and family caregivers, interviewed over twenty celebrity caregivers and hopefully helped a few caregivers along the way. I know that the caregivers we've met have been of invaluable help to us as family caregivers.
Even though we have been "out here" for over 11 years, we know that this is just the beginning. We are proud to have been able to bring together some of the brightest and most caring people to write for caregiver.com and Today's Caregiver magazine and to speak at our conferences. We invite you to take advantage of their wisdom and e-mail us your questions, join our free internet newsletters and interact with the other caregivers visiting caregiver.com. We welcome you to our home on the Internet, hope you stick around a while and look forward to helping you in any way possible.
http://www.caregiver.com/aboutus/index.htm
Yes, although I may think that welfarism may not be the way to go, I acknowledged that the distress caused by caregiving may be really strsseful. Here's 10 tips for those of you who are in that category:
1. Caregiving is a job and respite is your earned right. Reward yourself with respite breaks often.
2. Watch out for signs of depression, and don’t delay in getting professional help when you need it.
3. When people offer to help, accept the offer and suggest specific things that they can do.
4. Educate yourself about your loved one’s condition and how to communicate effectively with doctors.
5. There’s a difference between caring and doing. Be open to technologies and ideas that promote your loved one’s independence.
6. Trust your instincts. Most of the time they’ll lead you in the right direction.
7. Caregivers often do a lot of lifting, pushing, and pulling. Be good to your back.
8. Grieve for your losses, and then allow yourself to dream new dreams.
9. Seek support from other caregivers. There is great strength in knowing you are not alone.
10. Stand up for your rights as a caregiver and a citizen.
Hope this helps!
Ya, I personally cared for someone before and I can understand the the roller coaster kind of emotions that one have to go through. I don't have much advice to offer, but what I can say is, approach the situation with an open heart, stay positive and manage your time effectively between the many priorities you may have.
It's not easy, but it is definitely worth it.
And just a side note, whilst doing the caregiving, do not think about rewards, but know that a smile and a simple thank you for the patient would be the happiest things you would ever hear.
Hey all, found this on the website of MCYS, check it out:
From April 2006, AWWA piloted a two-year Caregivers Centre for the
elderly and disability sectors. The programme aims to raise general awareness
and develop support services for caregivers to better care for their loved ones.
Services include helpline information and referral, support groups, training for
caregivers and service providers, promotion of networking and collaboration and
public education.
http://www.mcys.gov.sg/enablingmasterplan/report/EM_Chapter5.pdf
Apparantly, Singapore has more agencies tackling this issue than we all initially thought.
Yes Josh, i agree with what you mentioned. I deal with patients everyday and sometimes hearing a 'Thank you' from these patients is all I need to motivate myself to move on, and it gives me reasons to stay on and to persevere.
Welfare and incentives may sound tempting and may serve as a reward for the love and kindess shown, but nothing beats seeing the appreciation on the patients' face.
Trust me, you won't forget this kind of feeling.
I am not sure if monetary reward is sifficent to be given as a form of welfare, but for all those who is considering, here's a quote i found:
by Christopher K. Germer, Sharon Salzberg - 2009 - Psychology - 306 pages
"The intrinsic satisfaction derived from helping others may compensate somewhat for the relative lack of monetary rewards in caregiving professions"
A penny for your thought?
Perhap monetary rewards may not be the answer to caregiver wealfare, here's another piece of information I've found:
The associations between self-reported rewards and difficulties of caregiving and burden were examined in a sample of 200 informal caregivers to older post-rehabilitation patients. Sixteen percent (16%) of caregivers reported that caregiving was physically difficult only, 15% reported emotional difficulties only, 11% reported social difficulties only, 17% reported multiple difficulties, and 40% had no difficulties. Each type of difficulty (e.g., social, emotional, and physical) was significantly associated with burden in univariate and multiple linear regression analyses, controlling for confounding characteristics. Caregivers reporting multiple types of difficulty experienced higher levels of burden than caregivers who reported only one type of difficulty. Caregivers who received more rewards from caregiving reported fewer difficulties. Caregiving rewards had no independent effect on burden but modified the associations between social and emotional difficulties and burden. In summary, caregiving rewards and difficulties were not mutually exclusive, and their relationship in turn affected burden.
http://psychsoc.gerontologyjournals.org/cgi/content/abstract/53/3/P165
Hey, came across this article in Today on 19sep, "The nurse comes to day care" NTUC Eldercare Trust gets $1.1 million boost. "The push by Government to improve step-down care has galvanished NTUC Eldercare, which has introduced basic nursing services for its social day care centre attendees and is hoping to raise awareness of it's homecare arm." This is a great initiative, there are always available medical care and support. Perhaps, could have such support to the elderly's homes?
Post a Comment