At some point in our lives, we would have heard a senior say they’d rather die than live in a nursing home. I’ve also wondered: are nursing homes really that bad in modern day Singapore?
Awhile back, I visited Moral Home for the Aged Sick (Moral Home) on my quest to understand the problems that our elderly face in their golden years. I met two sisters who had, surprisingly, chosen to sell their house and to live there at the nursing home.
The unexpected decision came after one of them fell, making them rethink their living arrangement—two frail woman would not be able to cope should any emergency situations arise. After considering the risks and for their own safety, they decided to put themselves in a nursing home they trust.
Initially, they even chose to hide this from their family members as they knew that it will be met with disapproval, and they didn’t want to be persuaded to go home.
One of the sisters said “Back then, my nephew tried to stop us from coming here. They encourage us to stay with them, because they can take care of us. We tell them not to worry, because we are very happy here.”
The other sister added: “I tell them, youngsters nowadays should work hard, don’t worry about us.”
I was brought up to see nursing homes as a terrible place, yet there I was, speaking to two 80 plus year olds who tells me that they like it there. I was in mild disbelief, but also heartened to know that I may be wrong about my impression of nursing homes.
There’s a stigma that we attach to placing loved ones in nursing homes. Nobody will want to send their parents to homes if they can afford to and any decent Singaporean will tell you that they will only consider it a last resort.
A part of this stigma comes from our strong attachment to our cultural values of being responsible for our parents welfare. As Asians, old adages like “Never forget your roots,” and “Don’t bite the hand that feeds you” continue to form the backbone of what is essentially our emphasis on filial piety.
We hold ourselves accountable for our parents’ lives when they grow old, and because of that, we associate sending a loved one to a nursing home as abandonment. We think of it as the most unfilial and shameful act one can do to our parents.
But is it really?
I remember only ever being in a nursing home or old folks home twice. The first was a compulsory CIP programme in primary school, and the second was to me, just a fun activity with a bunch of my polytechnic friends who organised it.
The only thing I remember taking away from those volunteering stints was also that I never want to send my parents there, ever, if I could. The ambiance there was just so dull, sad, and dreary. At least, these were the only parts that stuck out in my memory.
For most of us, these volunteer experiences will also probably be the only firsthand experience we base our impression upon. That is, until we are actually faced with having to consider these homes for our own loved ones.
However, when I was at Moral Home, I had the opportunity to speak to its Chief Executive Officer, Winnie, who changed my perspective.
At 72, she is well into her retirement years, but has been serving there for more than 15 years. Despite being at an age comparable to the residents in her home, she tells me that this job has become a commitment she made as she has grown attached to the residents.
Some families put their loved ones in a nursing home due to their inability to provide adequate care for their elderly parents who are ill, disabled, or require 24/7 attention, which is where nursing homes like hers come in.
“Nursing care is to give comfort. To ensure that in the last phase of [the residents’] life, we can make them happy before they pass on.”
However, Winnie acknowledges that there are cases of abandonment. In her home, these make up about a third of her residents.
“They don’t have a direct next-of-kin. Some of them don’t have children. Some may have nieces or nephews who aren’t close to them.”
There are also residents who struggle with coming to terms with being put in a home.
“Some don’t want to talk to their children when they do visit. There are also residents who would pack their stuff and want to go home everyday.”
To alleviate such unsettling feelings in her residents, Winnie dedicates time to make her rounds every morning. This is also her way of giving residents “the comfort and hopefully a little strength” in knowing that there are still people who care for and love them.
Alvin, a social welfare worker who has been working in elderly homes, shared that such cases of abandonment happen more often than we would like to think. Over the years, he has seen numerous cases of family members doing their best, to place their parents in shelters homes, only to disappear.
“An unforgettable experience was this very well spoken and groomed lady, whom over the course of a couple of months, did her best to admit her dad, making frequent visits to the nursing home to speak to staff and to show us that she has a loving relationship with her dad.
Yet, less than a month after admission, she lost contact with us. After trying to contact her, we realised she had migrated with her family members to Canada.”
It is exactly such cases that makes a mockery of nursing homes and undermines its bigger purpose.
Besides the 24/7 general and medical attention, another aspect of nursing homes is to provide residents opportunities for social interaction.
In Singapore, it is “estimated that 83,000 elderly persons will be living alone by 2030, compared with the 47,000 seniors aged 65 and above in 2016.” There have been many reports highlighting the higher risk of social isolation and depression in elderly persons living alone.
Even elderly persons who live with their family face the risk of loneliness and depression, because most adults spend a large part of our days at work, leaving our elderly parents at home alone.
The extroverted ones aren’t a problem, but the ones who do not venture out to engage in their own community of friends at neighbourhood spaces or through community centre activities will face problems with healthy aging. The lack of social stimulation could easily cause their cognitive and physical abilities to deteriorate.
On my way to the Home, I also happened to meet Mr Lim, my Grab driver, who bemoaned about his wife and his painful decision to send his mother-in-law to a nursing home.
They had tried looking after his ailing mother-in-law as best they could, even hiring a maid to ensure that there was someone around when they were at work. However, his mother-in-law’s worsening dementia condition and erratic behaviour continued to overwhelm the couple.
For instance, they had to attend to his mother-in-law rattling their door and asking for help to find all sorts of the things in the middle of the night. The need for constant care and attention took a toil on them over time as they were both juggling a full-time job. It was with a heavy heart that they put his mother-in-law in a nursing home, which he emphasised “it was really, really hard for my wife.”
Mr Lim’s story is the classic case of the many Singaporeans who have taken to nursing homes as a last resort. For them, what makes it even more difficult is the stigma, judgment, and shame that they would have to face when they put their parents in a nursing home.
Of course, as with the case of any service-oriented industries, there have been and will always be real cases of mistreatment and abuse at nursing homes. It isn’t to say that all nursing homes are negligent or abusive.
At the end of the day, there are also cons to institutionalised care like nursing homes, like a loss of freedom or autonomy, because residents will be restricted to the confines of what the home draws out for them.
However, there are many other aged care facilities like senior activity centres, daycare and healthcare centres, and in-home care.
29-year-old Mel, who have volunteered at day care centres and nursing homes before, said, “I think the most ideal scenario would be for those in old folks’ homes to have volunteered to go there, be it for companionship or having medical support.”
Are We Accountable For Our Elderly Persons’ Happiness?
It does get complicated if the elderly persons refuse to be put in a nursing home, and it’s never easy to have to decide what’s right and wrong when it gets so personal. It’s even harder when you have to deal with the torment and guilt of having to go against your parents’ wishes.
Regardless, the purpose of nursing home is to make the last journey of elderly’s life safe, comfortable, and ensure their needs and wants are taken care of as much as possible.
As much as we have to complain about, these homes are another avenue for us to provide care for our parents.
People say that it’s a terrible place as it’s where children abandon their parents. But if a child has already got the intention to abandon their parent, isn’t it as sad for these elderly persons to continue living in a home where they are unwanted? How much better will such a life be?
Similarly, if one really has to put one’s parents in nursing homes for the genuine good of one’s parents and family, it doesn’t mean we’re any less of a decent person and a filial child.
(Header Image Credit: Kanal 247)