Supporting caregivers and persons without mental capacity

When someone loses his or her mental capacity, it is sometimes up to loved ones to make important decisions on his/her behalf.

As a geriatric nurse, Priscilla Tan, 38, has seen some family members of her patients caught in disagreements about their loved one who had lost mental capacity. They were missing an important legal document – a Lasting Power of Attorney (LPA).

An LPA allows a person (known as a donor) to appoint someone he or she trusts such as a family member or close friend (known as a donee) to make decisions for them if they lose mental capacity one day.

Knowing the importance of an LPA, Priscilla spoke to her parents about it when her father was diagnosed with dementia in 2016. She explained to her parents the purpose of an LPA and convinced them that it was necessary. This was followed by a six-week wait for the LPA to be registered. This process has now been shortened with the amendments to the Mental Capacity Regulations in August 2019, which halved the waiting period from six to three weeks.

The application fee waiver for Singaporean Citizens making an LPA Form 1, which grants general powers to the donee, has also been extended till 31 August 2020.  For all LPAs received by the Office of the Public Guardian (OPG) from 1 August 2019 onwards, donors and donees can access the registered LPA online through OPG’s e-services portal. They may also request to share a soft copy with third parties like banks.

Priscilla advises everyone to make an LPA early, before a serious condition like dementia occurs.

For cases where an LPA has not been made, and the person has lost mental capacity, family members will need to apply to the Court to be appointed as a “deputy” so that they can make decisions for their loved ones. Sometimes, this process can be long-drawn and complicated.  Hence, to avoid this situation and start the planning process early, Priscilla will also be making an LPA for herself.

To better support caregivers like Priscilla and safeguard persons without mental capacity, the Committee to Review and Enhance Reforms in the Family Justice System (RERF Committee) has made several recommendations which include:

  1. Making counselling available to those facing caregiver stress, and mediation in the event of disputes between family members;
  2. Training and support for appointed and prospective deputies.

Since her father’s diagnosis, Priscilla says their roles have reversed. “I have become more like his parent instead,” she shared. She observes that often, caregivers share similar concerns. For instance, they face stress caring for their loved ones and worry that they may run out of leave to accompany their loved ones to medical appointments. To help both herself and her father, Priscilla sought community support by enrolling her father in the Memories Café programme at the Alzheimer’s Disease Association. Here, her father keeps active and engages in activities like music and drama, while Priscilla gets to meet other caregivers for peer support.

Priscilla is passionate about raising awareness on dementia and caregiving. She created the Instagram hashtag #MyOrthodoxDementiaTherapy to share her experiences with her father and their journey together.

“I hope to use this platform to reach out to more caregivers,” she says. “The journey can be lonely sometimes and I don’t think anyone would truly understand until they have gone through it.”

To caregivers who are apprehensive about seeking support, Priscilla says, “Don’t suffer alone. Ask for help and don’t stress yourself out.”

Caregiving does not need to be a lonely journey.  You can join support groups which offer a safe and comfortable space to share experiences and learn.

Honouring extraordinary employees with disabilities

In the course of a typical day at the Registry of Marriages (ROM), Angalamma d/o Marimuthu meets about 12 to 15 couples, verifying their documents and answering their queries.

Seeing the happy faces of those about to tie the knot is the highlight of her job, says the 56-year-old customer service officer. After 27 years at ROM, she remains an “extremely hardworking staff” who is always cheerful and smiling, says ROM Registrar Penny Tham.

Angalamma first joined ROM as a typist, before working her way through four promotions to her current position. She is seen by many of her colleagues as an elder sister and mentor at the workplace.

In recognition of her contributions and dedication, she was one of five winners of the Exemplary Employee award at the Enabling Employers Awards (EEA) in July 2019

The EEA, launched in 2011, is organised by SG Enable to recognise organisations and individuals who have committed to integrating people with disabilities in the workforce. Since then, more than 300 awards have been given out. In its fifth edition in 2019, the EEA presented 19 employer awards, 78 certificates of recognition to inclusive organisations, and 14 individual awards.

Angalamma was honoured as Exemplary Employee for making her mark through extraordinary performance in the workplace. This accolade means a lot to Angalamma, who was born with bilateral congenital club foot. She says the award motivates her to work even harder.

“I would like to encourage all persons with disabilities not to feel self-pity because of their disability,” she says. “If you fail at something, try again…The important thing is to put aside disappointment, build up confidence and not be worried about the perceptions of others.”

Angalamma’s upbeat view on life is buttressed by supportive supervisors and colleagues. When she is not attending to couples, she is at her workstation tabulating statistics and collating returns from marriage solemnisers. Her colleagues ensure the path is kept clear of obstacles so that she can physically move around with ease and peace of mind.

Colleagues have also arranged files and cupboards at a convenient height for Angalamma to access them. If she has errands to run, she can turn to her colleagues for help.

When asked what advice she would give to employers looking to be inclusive, she says, “Show encouragement. Be patient.”

Better ComCare Long-Term Assistance for the Vulnerable

Due to complications arising from diabetes, Mdm Habibah Binte Hamdi had to amputate her leg a few years ago. Despite her physical condition, the 64-year-old attends to her daily chores independently. She enjoys interacting with the children from the kindergarten located on the ground floor of her HDB block, where she lives with her brother and his family.

She is committed to taking care of herself and living a full life, even if she requires help every now and then. “I try to be as independent as I can,” she quips.

Mdm Habibah was placed on public assistance after she was certified permanently unfit for work in 2015. She receives monthly cash assistance through the ComCare Long-Term Assistance (LTA) scheme. This helps with her daily living expenses, including food, rental, utilities, Service & Conservancy Charges, clothing, transport and communications.

To better support families and individuals in need like Mdm Habibah, MSF increased the cash assistance for ComCare LTA in July 2019. The increase means that one-person LTA households will receive $600 per month, up from $500 previously.  For a household with two LTA beneficiaries, the rate will increase from $870 to $1,000. Larger household types will receive higher amounts.

Increasing the cash assistance rates is only a part of MSF’s efforts to provide more comprehensive, convenient, and coordinated support to low-income and vulnerable families.

MSF is also simplifying the financial assistance processes for clients so that they no longer have to be assessed separately for MediFund when they visit public health care institutions.

Whenever Mdm Habibah heads to Changi General Hospital for check-ups and medicine, she is relieved and thankful that she needs to only show her LTA card (also commonly known as the Public Assistance card) for free medical treatment.

This arrangement reduces the stress for individuals who may be faced with multiple needs. Samuel Chua, Mdm Habibah’s social assistance officer from Social Service Office @ Tampines, says this has positively impacted the lives of many ComCare clients. “They can focus on their health and well-being.”

Samuel says Mdm Habibah’s independent streak comes from being part of the Merdeka generation – those who grew up during the turbulent years from 1950 –  1959 and contributed to Singapore’s development.

In recognition of their efforts, the government announced the Merdeka Generation Package at the National Day Rally in 2018. Mdm Habibah will receive a $200 Medisave top-up every year, from 2019 to 2023, among other benefits of the package.

Besides helping with Mdm Habibah’s medical expenses and appointments, Samuel also works with community partners, such as mosques and the North East Community Development Council, to invite Hdm Habibah to their events to keep her active.

Since meeting Mdm Habibah two years ago, Samuel has bonded with her.

When asked what it was like working with Samuel, Mdm Habibah joked that he has become more handsome over time.  She also shared that Samuel would arrange to meet her when she makes her way to SSO for review of her assistance at the drop off point and assist her after each meeting.

“That’s the kind of person he is, always ready to help.”

 

KidSTART: Kickstarting better child development

KidSTART officer Lee Wei Qi finds joy in “being on the ground, and working directly with parents and young children”. As part of the Home Visitation Team of the Early Childhood Development Agency (ECDA)’s KidSTART programme, she makes her way to their homes, to equip and empower parents in caregiving.

Since the programme started in 2016, over 900 children have received KidSTART support, in the pilot regions of Kreta Ayer, Bukit Merah, Taman Jurong, Boon Lay and Geylang Serai.

One of KidSTART’s guiding principles, as Wei Qi puts it, is “Parents are the children’s first teachers.” It is therefore crucial to equip parents with the knowledge and skills to nurture their children effectively and independently.

One parent who has benefited from KidSTART support is Nurhidayah Binte Abdullah, a mother of three. Initially, she had allowed her children excessive screen time on the television and their electronic devices, thinking that games and videos would suffice as learning. Following Wei Qi’s visits and advice on the importance of outdoor activities, use of language to engage children and the harmful effects of excessive screen time, she now regularly brings her children to the playground, conversing with them as they develop psychomotor skills.

From being completely silent during Wei Qi’s initial visits, Nurhidayah’s three-year-old daughter is now chatty and vibrant. “When we go outdoors, they are running, climbing and observing things around them,” says Wei Qi, explaining the importance of developing a child’s different senses for learning.

KidSTART’s methodology in this area is guided by the Abecedarian Approach, which is evidence based and developed in 1972 by Dr Joseph Sparling and Dr Craig Remy. Its hallmarks include turning everyday experiences into opportunities for learning, conversing and adding educational content.

KidSTART officers, like Wei Qi, also teach parents songs and rhymes that can be incorporated into daily routines to enhance the quality of interaction for parent and child.

Wei Qi and her team are currently working on a guide with more tips for KidSTART parents to incorporate into their routines. One challenge is customising resource material to make it more accessible to parents, she says, joking that the English in some of the existing textbooks is “a bit cheem” (Singlish for profound).

With her fellow KidSTART colleagues, Wei Qi is also looking to incorporate infographics and localised examples as illustrations for learning. For example, instead of telling parents to bring their children to the backyard, as is common in Western countries, they would tell them to bring their children to the void deck or playground.

It has not always been smooth-sailing for the KidSTART home visitor. Wei Qi says that when she first started, some parents would challenge her, questioning her ability to teach about parenting given that she is not a parent herself.

However, over time, the former early childhood educator and preschool principal managed to build rapport with the parents and they began to see how Wei Qi was able to engage them and their children through her warm, intentional interactions and extensive knowledge of early childhood development. They saw for themselves how well their children responded to the techniques taught by Wei Qi and eventually “let their guard down” and trusted her.

Besides giving individual attention to parents, KidSTART also leverages on peer support through its Group Connect sessions. At these sessions, parents are invited to connect with one another and are happy to exchange telephone numbers. Knowing that they all have common concerns, such as tackling sibling rivalries and ensuring child nutrition, helps to bond the parents too, says Wei Qi. KidSTART also works closely with community partners and if families require additional support, they are referred to Family Service Centres (FSCs) and Social Service Offices (SSOs)

Parents who have completed the programme still keep in touch through a WhatsApp group they created. They share baby items with one another and set up play dates among themselves. They have built their own social support network and are independently keeping their networks going, something which KidSTART supports.

For Wei Qi, KidSTART is not a one-way process. “As much as we are sharing parenting strategies with them, I think we as officers also learn a lot from the families—they are very resilient…despite the stresses they face in their lives.

“Seeing their love and care for the children is really touching and inspiring.”

Community support – key to successful probationer rehabilitation

Toh Yue Sen, a 25-year-old Sports and Exercise Science student at Republic Polytechnic, hopes to get a degree after completing his diploma. A decade ago, pursuing an education was the farthest thing from his mind.

Back then, as a teenager, he had committed theft and robbery and was ordered to reside in Singapore Boys’ Home for two years. A few years later, he was remanded in prison for acting on behalf of an unlicensed moneylender.

During the prison remand, Yue Sen met Selina Yeo, his Investigating Probation Officer. Guided by Selina, he re-looked at where he was headed and took stock of his life prospects.

“I cried because I was touched when she talked about my family, my sisters,” he says. He realised how his incarceration would affect his loved ones and was relieved when he was placed on probation by the Court.

That was just the start of his rehabilitation. Supported by MSF’s Probation and Community Rehabilitation Service, Yue Sen started to make positive changes to his life.

He performed community service at a welfare home at Pelangi Village where he befriended elderly residents. He viewed his time there as “a gift” instead of a mere assignment, thanks to the friendly staff and residents. Yue Sen’s parents told Selina that he became more patient after serving at the home.

Yue Sen’s class advisor, Cass Lim, in ITE College East also played a crucial role in his rehabilitation. She recommended him for various courses and worked closely with Selina to guide him. With their support, Yue Sen became a role model in his fitness training course at ITE, where he was selected to be the class discipline master. He was also awarded the National Youth Achievement Award in 2018 for his leadership qualities and exemplary conduct in school.

This network of coordinated care across organisations is a key focus in MSF’s community rehabilitation efforts. To support probationers in their rehabilitative journey, MSF collaborates with many corporate and community partners to provide them and their families with diverse types of support. Strong community and family support were key factors that supported a high probation order completion rate of 84% in 2018.

Yue Sen shared that his parents played a big part in his rehabilitation. His father began taking an active interest in his boxing hobby, and supported him during a competition in July 2015. This helped to bond the family together.

Selina says Yue Sen’s parents acknowledged and supported his efforts to change himself, which improved their relationship. Yue Sen shared that he is now able to communicate openly with them without worrying that they may end up arguing or disagreeing with one another. He added that poor family communication could be the reason why some probationers struggle.

“Successful rehabilitation really starts with the family,” adds Selina. Recognising this, MSF is collaborating with Functional Family Therapy LLC to implement Functional Family Probation that focuses on the involvement of everyone in the family to strengthen support for the probationer.

Selina says some probationers do not succeed in rehabilitation because of the lack of family support and unconstructive engagement. “If the probationers are able to focus on developing better relationships with their family and commit to being constructively engaged in their studies or at work, it will encourage them to make amends and be more responsible.”

Yue Sen is committed to staying on the right path. He says he leads a “normal” life, going to school and working part time in the Food and Beverages industry.

His teenage follies and time on probation have taught him about the consequences of wrong decisions, and he is determined to stay out of trouble.

“It’s not worth my time.”

ECDA Fellows Talk Series

Do you know how to turn ordinary life moments to authentic learning experiences for our children? Build our children’s confidence and resilience to prepare them for transition from preschool to primary school. Use the V.A.L.U.E. model to communicate with teachers effectively to support children’s holistic development. These are some tips and advice shared by eight of our ECDA Fellows in the 2nd ECDA Fellows Talk Series.

The ECDA Fellows Talk Series is a collection of short videos on various topics related to early childhood, such as Mother Tongue Teaching and Learning, Pedagogical Practices, Partnerships and Support and Staff Development.

The EC​DA Fellows programme is one of ECDA’s key initiatives to recognise pinnacle leaders in the early childhood profession. It also expands opportunities for these leaders to further develop their careers to fulfil their aspirations. The ECDA Fellows work closely with ECDA to drive quality improvements in the sector, as well as inspire and contribute to the professional growth of the current and next generation of early childhood leaders.

The World is Your Classroom

It may just be a convenience store, bakery, and a recycling bin to you. But, ECDA Fellow Ong Siew Teng sees them as learning opportunities for the children in her centres. The entire neighbourhood can be a classroom for the little inquisitive minds to have “Authentic Learning Experiences”.

Strengthening Roots

ECDA Fellow Suhana Binte Salleh is excited about the government’s initiatives to expand the provision of mother tongue languages in preschools. She believes in teaching beyond the Malay language. With a creative touch, she helps children understand their heritage and culture to find their own identity.

School Starter

Making the leap from preschool to Primary One can be a daunting experience for some children, but preschools can smoothen the adjustment with different strategies. Learn how ECDA Fellow Seri Rahayu Binte Ariff helps prepare children in her centres for this transition with the “P1 Starter Kit”.

Nurturing Place for All

Novice early childhood educators often face challenges that cause them to burn out and leave the industry. ECDA Fellow Sylvia Yeo has designed an induction programme to help new teachers ease into the new preschool environment and their new roles, with guidance from their mentors. She believes in creating a “Nurturing Place for All”.

The Trusty Teacher’s Assistant

From the moment children step into a preschool, their learning begins. The environment is the third teacher, which opens up educational possibilities for children to express themselves, engage with their peers, and respond with thoughtful decisions. See how ECDA Fellow Melissa Goh jazzes up an environment and grooms it to become a child’s third teacher.

Learning Together

Learning Mandarin may be difficult for children with parents who “grew up in an English speaking environment”. ECDA Fellow Chua Lay Mui believes that parents play a huge role in “cultivating a child’s love for the language”. Learn how she designed activities for parents and children to learn their mother tongue together.

Journey Together

Ms Zaiton, a pinnacle leader and a mother, understands the struggle that many parents go through to balance work and childcare commitments. Watch how preschools can “Journey Together” with parents using strategies (such as the VALUE model) to build positive relationships and enhance children’s learning.

Sparking Change

While many centres understand the importance of raising the standards of early childhood education, the hassle that comes along with SPARK certification drives many away. ECDA Fellow Hephzi Tee spent six months convincing her staff and teachers to embark on the SPARK-certified journey. Today, her centre is happily SPARK-certified with commendation!

Marriage, according to our young Millennials

Asked about her plans for marriage, 19-year-old Tang Wen Yu imagines herself tying the knot in her late 20s or early 30s, once she has completed higher studies and her “finances are secure”.

On the other hand, 23-year-old Fong Yu Yang is already engaged. “Some of my friends don’t really put marriage as their first priority because they have other personal achievements that they want to accomplish first, like a good career or to travel around the world,” he says. But, having been with his girlfriend for seven years, they find that their relationship has not held them back from pursuing their goals.

Wen Yu and Yu Yang are among 30 students who are partnering MSF to redesign our iconic ROM and ROMM Building. It is part of our ongoing collaboration with Institutes of Higher Learning – including Singapore University of Technology and Design (SUTD), Ngee Ann Polytechnic(NP) and Temasek Polytechnic.

Wen Yu recalls being slightly “shocked” when fellow participants shared their dreams of marrying early. Although marriage is not yet on the cards for her, she says that the involvement to redesign ROM and ROMM project is special because it gives her a chance to make an impact “on the real world”. “It’s cool to know that we might be married in the very same building that we [helped to] design,” she says.

Currently studying Sustainable Urban Design and Engineering at NP, she says one possible idea for the revamp is replacing the prosaic seats at the waiting area with a comfortable lounge. Perhaps inspired by the coffee culture of her generation, she suggests setting up a café to serve couples waiting for their turn for solemnisation.

As for Yu Yang, he imagines a special area for love locks which couples can attach to bridges, fences and other public fixtures to symbolise their love. If there is insufficient space for this, this feature could be digitalised. Taking inspiration from Changi Airport’s Social Tree, he also suggests creating a similar installation at ROM and ROMM for people to upload and share photographs. Yu Yang is currently studying Engineering Systems and Design at SUTD.

On Valentine’s Day earlier this year, MSF collaborated with the Singapore Memory Project to launch “MyROMStory”, a portal for couples to share such photographs and their memories. MyROMStory encourages couples to remember their special day and inspire those who have said “I do” to re-commit to each other and say “I still do”.

As a designer herself, Wen Yu would like her own wedding to be “decorative, but still very intimate”, with only her close family and friends in attendance. Wen Yu has been with her boyfriend for four years. When he found out about her participation in this project, he was excited like her, she says.

Yu Yang’s girlfriend was also delighted to learn of his participation in the project. They had not previously thought of having their solemnisation in the ROM building, but are now considering it. His participation in the refurbishment project is “going to be a special reason why we should get solemnised and married in the ROM building itself”.