Madam Aw Choy Kum, 76,

Widow with no children
A homebound stroke patient with hypertension, diabetes and cellulitus

Her desire to grow old at home unfazed by stroke

Madam Aw’s mind was still dazed and reeling with the debilitating effects of stroke when she had her third fall at home. Her niece had found her lying on her bedroom floor, soaked in her own urine, and smeared by faeces that had toppled out of the soiled bucket.

That was about two years ago when suicide as a quick way out of her misery was never far from her mind.

Today, the 76-year old widow enjoys pottering around her spartan two-room flat; her bespectacled eyes scanning like a hawk for the tiniest stubborn food stains in her spotless kitchen.

She makes slow measured steps forward; her stronger left hand clutching a quad stick, and her stroke-weakened right hand hanging limply at her side. The strain from a lower back pain shows on her face but she much prefers this to a life of dependency in a nursing home.

Loss of mobility a big blow

Madam Aw had already fallen twice at home before she was hospitalized for five months in a community hospital for rehabilitation. A third fall after her discharge from the hospital was a big blow to her desire to continue living independently in her own home.

Coming to terms with her loss of physical mobility was a bewildering experience of frustration, grief and loss for a woman so accustomed to active independent life. She felt caged like a prized bird in her home.

 

“I couldn’t go out because of the stroke. I cried myself to sleep every night. Life had lost it meaning for me,” recalled Madam Aw who lived alone. Adding to the loss of mobility was the fear of being sent to a nursing home when she could no longer manage her daily activities.

“I fear going to a nursing home. I remembered sitting on my bed the whole day, doing nothing. It felt like a prison. There was no privacy, no personal freedom. You can’t choose your food. You can’t bathe at a time you wish. When you called for help, the nurses ignored you. The experience frightened me,”

said Madam Aw in Cantonese, on her brief stay in a community hospital and nursing home.

Hua Mei home care team turned her life around

Stabilising her medical condition

The home care team from the Hua Mei Mobile Clinic started visiting Madam Aw in her home in July 2003 after she was referred to the clinic.

Following a full assessment of her physical, medical, social and financial needs, the Hua Mei home care team decided that stabilizing her medical condition was the first priority as she was in obvious pain.

A persistent pain from a swollen right leg – a condition caused by cellulites, a skin infection - further slowed down her limited movements. During the early stage of medical intervention, a Hua Mei doctor or nurse visited her every two weeks. Now, a nurse visits her weekly and a doctor, every two months. Because she was illiterate, the nurse would carefully label her medications with symbols and pictures, and made sure she followed instructions when taking her medicine.

Making her home safe against falls

The clinic’s social worker approached a few community services for help, on Madam Aw’s behalf.

The Khoo Foundation’s Community Rehabilitation Programme was contacted to assess Madam Aw’s home safety. Grab bars were installed in her house at no cost to Madam Aw under the Ministry of Community and Youth Services (MCYS) Grab Bar project.

The clinic’s nursing staff also bought non-slip bath mats to reduce the risk of her falling in the toilet or bathroom. Commodes were put in place in her bedroom and toilet. They also arranged for medication to be delivered to her home monthly by the Moral Home Help Services.

Income security for old age Another big worry for Madam Aw is money. The former hawker who has no children, is relying on her fast-depleting savings for her daily needs. She does not qualify for public assistance because she has a two-room purchased flat whom she and her deceased husband had saved hard to pay up. She cannot bear to sell the flat because the flat holds fond memories . “I’d rather die in my own home. I have lived here for over 40 years,” she said. With the help of a Hua Mei social worker, she was able to convince a niece to support her financially until her flat is sold upon her death.

With her home, medical and financial needs sorted out, she slowly regained her confidence and learnt to adapt to her physical limitations and a modified home environment. Today, Madam Aw is a picture of peace and calm, An Le, as we call it at the Foundation.

She has peace of mind as she knows that her medical condition is closely monitored by a nurse and a doctor, and that she will not be abandoned without care.

When her meagre savings run out, she knows that she can rely on Hua Mei’s social worker to help her apply for public assistance.

“I am happy now. I have no worries, no sadnesss now. People visit me – the doctor, nurse, social worker. My niece visits me once every fortnight. An old neighbour drops by for a chat. My church friends visit me. And I know I can call Hua Mei when I’ve an emergency,” said Mdm Aw Choy Kum

“ The doctors and nurses at Hua Mei are so caring and respectful towards the elderly. One of the nurses even took the trouble to cover the ear of a non-slip mat with a plastic sheet because she was afraid that I might trip over it. I am very grateful to Hua Mei. Without Hua Mei, I’ll feel very lonely and I’ll probably die,” said Madam Aw

Hua Mei’s Care Plan for Madam Aw Madam Aw has been a Hua Mei Mobile Clinic patient since July 2003. The clinic’s home medical team has provided Madam Aw the following care: • controlling her medical conditions with effective and regular medications • monitoring her medical conditions through monthly nurse visits and bimonthly doctor visits • fortnightly home physiotherapy to strengthen her limbs • connecting her with free community services, e.g. the free grab bar installation in her home • making her home aged-friendly with simple modifications to her living environment, e.g. non-slip mats in bathroom, commodes in her toilet and bedroom • providing her with social support

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Madam Aw Choy Kum

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