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.”

 

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”.

A youth caseworker’s reflections

The rehabilitation of youth offenders may begin in the Singapore Boys’ and Girls’ Homes, but it should not and does not stop there. Once they are discharged from the Homes, the youths face the sometimes daunting task of reintegrating into their schools and families.

Guiding them in this transition is key to keeping them on track in their rehabilitation journey. This is where caseworkers like Ms Lim Li Min play a pivotal role. Having served as a caseworker for seven and a half years in MSF, Li Min’s job entails conducting individual and family counselling, helping youths gain new skills, and linking them up with opportunities in the community, to address the risks and needs of those under her charge.

Ranging from displays of anti-social behaviour and violent tendencies to estrangement from family members, the challenges the youths face are increasingly complex. “Caseworkers need to be agile and resourceful to support them in personalised ways so they can have a good re-start in our community,” says Li Min.

Currently, youths are given post-care support for two months after they are discharged from the Singapore Boys’ and Girls’ Homes. After assessing that some of them continued to feel lost after the two-month period and unable to approach someone they could trust for advice, MSF will extend post-care support to one year. The pilot with about 15 to 20 selected youth will commence this year and will be progressively expanded in 2020 to include every youth discharged from the two Homes.

Under the initiative, MSF will work with appointed Voluntary Welfare Organisation partners to assign post-care workers to journey alongside the youths in the community. The post-care officers will engage the youths at least six months before they are discharged from the Singapore Boys’ and Girls’ Homes. Caseworkers like Li Min will then have a longer time to partner with these post-care officers to work out discharge plans and facilitate relationship building between the youth and their post-care officers. This will ensure a smooth reintegration and sustained rehabilitation.

Jervin Tay, now 19, is one of the youths counselled by Li Min. In 2017, after a rioting case, he was ordered by the Youth Court to reside in the Singapore Boys’ Home for 12 months. With the help of his parents and Li Min, Jervin turned his life around and even completed a barista programme.

Li Min helped Jervin to better communicate with his parents. Since his discharge in July 2018, Jervin has committed himself to making the best out of his life. He is currently in National Service and hopes to complete his ‘O’ Levels and get a diploma in the F&B industry.

Rehabilitation is not always smooth sailing, and Li Min says schools, employers and families should be prepared that these youths may “require a lot more support in the community” than in Homes.

“Building rapport and a relationship is key to being able to support a youth effectively”, she says. Only then will caseworkers be seen as “trusted adults” by the youths. “This gives them some motivation to change and move forward with their aspirations in life, knowing that they are safely anchored in someone who believes in them and whom they can fall back on.”

And relationship-building will continue to play a key role as caseworkers, and in the near future post-care officers, work hand in hand to support our youths.

 

 

From preschool to home: supporting a child with learning needs

Ethan Wong, like any other preschooler, enjoys playing with toy cars and Lego blocks. The bubbly five-year-old attends NTUC First Campus’ My First Skool @ Punggol Place. According to his mother Mrs Wong however, he used to have some difficulty following instructions and would be easily distracted in class.

After a screening assessment by his preschool, which identified him as eligible for early intervention services, his parents enrolled him in the Learning Support (LS) programme in September 2018. Under this programme, children with learning needs receive support in their preschools from Learning Support Educators, in areas such as handwriting, social communication, language development and literacy.

In addition to supporting Ethan once a week at his preschool, the Learning Support Educators also taught Mrs Wong how to better support her son at home. She conscientiously incorporates the toys that her son likes into step-by-step instructional games to increase his attention span for example.

Today, after eight months of early intervention support, Ethan is able to stay attentive in class and follow two- to three-step verbal instructions. Mrs Wong says such improvements take time and require support both within and outside of the classroom. “I believe parents need to take part. Parents need to go back and practise more with their kid at home,” she says.

It helps that the LS programme is conducted within the preschool. Mrs Wong does not need to seek external sources of help and can spend more time supporting her child’s development. She also finds it a useful resource for parents who may not be familiar with such programmes, and is a “good start” for children with mild learning needs.

In preschool, Ethan was supported by Ms Veronica Tang, a Learning Support Educator from NTUC First Campus. Ms Tang – or “Teacher Veron”, as students affectionately call her – gives extra guidance to children from My First Skool with developmental needs. Over the course of three months, she conducted 10 early intervention sessions with Ethan. These sessions were customised to Ethan’s specific learning needs, targeted at focusing on tasks at hand and following step-by-step instructions through the use of play and daily routines. Ms Tang provided a progress report to Mrs Wong after each session.

Ms Tang says early intervention services give “peace of mind to parents” because they know they have “additional support” at their children’s preschools.

Recognising the importance of such support, MSF announced in January 2019 that spending on early intervention programmes would be raised to around $60 million per year, up from $45 million previously.

The Ministry further announced in April 2019 the setting up of a cross-sectoral inclusive preschool workgroup to study and develop recommendations to further support children with moderate to severe developmental needs within preschools. The workgroup is co-chaired by Senior Parliamentary Secretary for Social and Family Development Associate Professor Muhammad Faishal Ibrahim and National Institute of Education Associate Dean (Education Research) Kenneth Poon.

And progressively from July 2019 till end 2020, the Early Childhood Development Agency (ECDA) will oversee both early intervention services and preschool services.

These initiatives will ensure better coordination and delivery of the various services for children with developmental needs.

Ms Deniece Bidhiya, Senior Manager (Learning & Developmental Support) at NTUC First Campus’ Child Support Services, says more parents have been enrolling their children in such programmes since the school started offering them in 2012.

Initially, she shares, some parents were apprehensive. A common concern was that their children might feel singled out through such intervention lessons, or be viewed differently by their friends.

“I always assure parents that the Learning Support Educators are professionals and know how to build a relationship with not just the child, but also their peers.”  She adds that the children find Ms Tang’s activities so fun, they sometimes cannot wait for their turns with her.

As Ms Tang describes her approach to education, “Learning cannot be just: ‘Sit at the table, read a book and then write, write, write’. It needs to be engaging.”

Judging by the scene when she walks around the preschool, the students are certainly engaged. They crowd around her, eager to chat and share their latest drawings with her.