Understanding the Needs of Caregivers: Exploring Ethical Tragedies and Long-term Care Solutions

2023-10-01 20:34:02

Ethical tragedies involving caregivers appear in the news from time to time, reflecting that caregivers are under great pressure and are in urgent need of help. “Care·Caregiver” attempts to understand the needs of different caregivers through their stories.

Children take care of their elderly parents, which is considered an unshirkable responsibility. Faced with various difficulties in taking care of them, many people silently shoulder the burden and walk step by step. Until their parents are dying and their children have entered an advanced age, taking care of them has become more and more difficult, and daily life has become more difficult. Life seems to be at a dead end. Experts remind that you cannot wait until the problem worsens before resorting to measures. You must have a long-term plan from the beginning, discuss it with your family, and make good use of various supports in the community, so that you can be smooth on the road to care.


Started washing clothes and cooking for the family at the age of 8

Brother Qin, 61, has been a family caregiver since he was a child. He has been responsible for the meals for the family since he was 8 years old, and regards taking care of his family as his job. Brother Qin has an older sister who is 2 years older and a brother who is 4 years younger. When he was young, his parents worked as mobile vendors selling fish and vegetables in Mong Kok Market. Brother Qin took care of the household chores such as washing clothes and cooking. “Someone has to do the work. The most important thing is to buy food cheaply. Just ask for it to be cooked.” My father died young and the family was financially strapped. My elder sister had already devoted herself to social work. Qin Ge, who was 17 years old at the time, studied part-time at night school until Form 6. He worked as a mechanical apprentice, a bicycle LPG delivery driver and a delivery driver. His bones were deformed due to long-term transportation and he suffered from frozen shoulder. He also suffered from diabetes. Over the past 10 years, his condition has worsened, and he has high blood pressure and high cholesterol. He takes more than 10 pills a day and has been off work for many years and lives on his meager savings.

Mother is sick, withdrawn and strong-willed

Brother Qin has lived with his mother since 2000. In recent years, he has been taking care of his mother, who is over 90 years old. Although the mother suffers from high blood pressure and high cholesterol and needs regular follow-up visits, she can move freely. Brother Qin drinks tea and goes to the park with his mother every day; his younger brother Ah Shou occasionally drives his mother to a temple to eat food. However, my sister, who works as a security guard, has fewer visits due to her long working hours.

However, in the past three years, my mother has become increasingly frail, suffering from back pain and weakness in her legs. Brother Qin takes his mother to restaurants and parks in a wheelchair every day. He first takes the elevator down to the first floor of the building, helps her walk the 10 steps to the street, and then picks her up in a wheelchair. Although he thought his mother was picky, he still tried his best to accommodate her. For example, she did not like to use a wheelchair to get on and off the bus, so he pushed the wheelchair and walked from his apartment in Mong Kok to the Yau Ma Tei Jockey Club Clinic, where he accompanied his mother to complete more than 10 skin treatments.

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His younger brother, Ah Shou, said that his mother had many friends when she was young. After she retired, she often played mahjong with her neighbors at home. However, as she got older, she suffered from many illnesses, and her friends passed away one by one, her personality became more and more withdrawn and strong-willed. Getting along with her brother was like ” “Mars hits the earth”, and often complains: “Can’t go anywhere, leaving behind ‘sacrifice’.”

Brother Qin admitted that taking care of him was stressful, and he had considered hiring a maid to help with care. He said, “My mother thought that I didn’t take good care of myself, so she once asked for a foreign helper, but good workers were hard to find, so she didn’t hire one. Currently, she can still do it herself.” Cool.” When asked about the future when her mother’s ability to take care of herself diminishes, what are her plans? Brother Qin admitted that he had never thought about it.

Difficulty swallowing, weight loss, diagnosed with gastric cancer

“My younger brother spends two nights a month with my grandma, so I feel less relaxed.” Brother Qin rarely takes a “vacation”, so he takes the opportunity to go to Shenzhen to get a massage from a blind person to relieve his shoulder discomfort. Since Ah Shou was not good at cooking, he took care of his mother, so he mainly had takeout for three meals. He tried buying steamed meat cakes with rice, but his mother found the rice too hard to swallow. He felt that his caring skills were not as good as his brother’s, so he bought different foods for her to try, but they were never to her liking, and sometimes she would vomit after eating them. When the two brothers saw their mother losing weight day by day, they thought it was a common difficulty in swallowing among the elderly, but they never thought of seeking care skills or professional support.

Brother Qin said that because his mother has no teeth, he usually cooks tofu, fish, and delicious rice noodles for her, but in recent months the two brothers have noticed that she is eating abnormally and vomiting frequently. (Social welfare agencies) don’t always deliver meals, so they are a bit stubborn.” In August this year, my mother took the initiative to see a private doctor, who was diagnosed with gastric cancer and was referred to Kwong Wah Hospital. She was bedridden, fasting, and relied on intravenous injections of glucose water to supplement her nutrition. She only tried to eat a few spoonfuls of porridge at a time.

Regarding the future care of his mother, the brothers were at a loss and had no plans, saying they could only take care of themselves.

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On the day of the visit, the doctor will make an appointment with them to explain their condition, and they are very worried. Brother Qin learned that his mother was worried and agitated after she became ill and had difficulty sleeping. He said that he would first listen to the doctor’s treatment arrangements before considering it, or that he might need to arrange for his mother to stay in a nursing home, but his mother was probably unwilling to do so. The reporter sent the “Care Tips” produced by the Hong Kong Women’s Center Association and suggested that they contact the hospital’s medical social worker for help.

■Words from experts

Understand the long-term community support plan early

Just like the two brothers Qin Ge and Ah Shou, many children do their best to take care of their elderly parents within their capabilities. However, as the elderly’s health deteriorates, from being able to move freely and take care of themselves in daily life at first, they gradually need crutches to assist walking and wheelchairs to get in and out. At the same time, they may have difficulty swallowing, incontinence, and even cognitive impairment. When the demand for care becomes higher and higher, many family members will only think of residential care homes for the elderly. However, in fact, in addition to residential care homes, there are many day centers and door-to-door services that can reduce the pressure on caregivers.

The waiting list for residential care often takes three or four years.

Ma Hoi-yin, program manager of the Hong Kong Jockey Club Care Center of the Lutheran Church of Hong Kong Ma On Shan Elderly District Center, pointed out that when parents get older and their physical and mental health begins to decline, or even develop long-term illnesses, caregivers should get to know the various types of elderly people in advance. To provide services, make long-term plans, otherwise you will often not be able to keep up with changes.

Take Qin Ge’s family as an example. When the elder’s health declines, he suffers from pain, and even begins to rely on assistive devices, Ma Kaiyin suggests that he can go to the neighborhood elderly center or district elderly center in the district for evaluation to understand his needs. Care services include home services such as meal delivery, medical companionship or rehabilitation services. You can also apply for and wait for day care centers and residential care homes as needed. The center will follow up on the elderly’s situation on a case-by-case basis.

In addition, if the patient has a long-term illness, as soon as the doctor makes the diagnosis, he or she can contact the medical social worker to find community resources and waitlists for long-term care services. Taking Brother Qin’s mother suffering from cancer as an example, many organizations provide support to cancer patients and caregivers, such as the Hong Kong Cancer Foundation, the Hong Kong Anti-Cancer Society, the Jockey Club Cancer Patient Support Program, Mengqi Cancer Care Center, etc. . These include emotional counseling, sharing with fellow travelers, Chinese medicine services, and even aid and taxi money subsidies.

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Many caregivers are very resistant to sending their parents to institutions, but Ma Kaiyin believes that when necessary, they should let professionals take care of them, so that their children can continue to provide psychological care and reduce the pressure of care. Most government-subsidized residential care homes have a waiting list of 3 to 4 years. Family members can apply first. If the elderly do not want to move into a nursing home too early, there is a freezing mechanism. For details, please consult social workers.

Launch of male carer group service

Ma Kaiyin also mentioned that more and more men are taking on the role of caregivers. The center launched a male caregiver group service two years ago. There are men over 50 who retire early to take care of their sick wives or mothers. There are also reasons Take care of your brothers and put down your work. Although many men are willing to take care of them, they seem irritable because they don’t know how to do housework. “I really want to help, but I don’t know how to help. I didn’t have to cook before, but now I don’t even know how to cook. I don’t know how to do it. I feel like ” useless””.

As of the end of August this year, there were 1,097 caregiver members in the center, about 25% of whom were men, and more than half of them were children, followed by spouses. Ma Kaiyin pointed out that men believe that taking care of their families is their responsibility and do not want to leave it to others or nursing homes to take care of them. Only when the family members are unable to take care of themselves, such as being weak, unable to take a shower, or incontinent, do they seek urgent help and want to arrange for a high-quality accommodation. However, due to the long waiting time, we were unable to do so.

In addition, it is not easy for men to share their feelings, hide their low emotions, and cannot vent their stress. “Some men were shocked when they found out that their mothers had oral cancer. They did not dare to express their emotions in front of their mothers and sisters to avoid worrying them, but when they entered the professional counseling room, they burst out shouting. ”. Ma Kaiyin said that only by finding the right person to talk to and letting your emotions flow can you deal with things rationally.

Text: Liang Shuzhen

Editor: Liang Xiaoling

Art: Xie Weihao

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