Contributed by: Winie Trazona
Winie is the resident caregiver at Ninkatec. She worked as a Healthcare Assistant at the NUH for 4 years after she obtained Higher Certificate in Healthcare Support. She also had 6 years of experience with the Operations Team providing administrative support at the NUH. She lived in the United States for 4 years and worked as a caregiver in both private home care and assisted living facilities. She has experience in home care, including helping patients with dementia, cancer, terminal illness, and quadriplegia. She assists with their activities of daily living such as oral and tube feeding, medication, and personal care. She is hardworking, motivated, and enthusiastic.
A caregiver is someone responsible for helping and providing aid and companionship to a patient. Caregivers include not only certified health professionals, but also a partner, family member, friend, or a loved one taking on this important and challenging role. Being a caregiver means taking responsibility for the well-being of another person, which can be emotionally and physically demanding. However, there are a variety of measures and approaches you can apply to improve the living standards for you and your patient or loved one.
In Singapore, an estimated 6%-8% of the population aged between 18 and 69 are performing informal caregiver roles on a regular basis. This works out to over 200,000 informal caregivers, in addition to the 8,300 professional caregivers (as of 2017) working at care facilities across the island. The importance and number of caregivers is bound to increase as the nation ages. In this article, we share the caregiving journey of a professional caregiver, and her tips and advice to all the informal caregivers out there.
What are the Caregivers?
“The job may sound very easy but, to be honest, it’s never been easy, professionally or otherwise,” said Winie Trazona, a certified caregiver (WSQ) from the Philippines, currently working on her diploma in Healthcare Services Management in Singapore. It is the caregiver’s job to provide living assistance by helping to carry out daily activities, such as feeding, dressing, bathing and transportation. “By doing day-to-day tasks, such as meals, cleaning, and driving, or arranging transportation, you become an important part of the patient’s care team. You don’t just work by yourself,” she added.
When you become a caregiver, formally or informally, you also become a crucial and influential part of the care team and the patient’s life. There will be good and bad days, both of which must be faced as a natural part of the process, without feelings of guilt or the sense that somehow the progress or evolution of the patient’s condition directly translates into evidence or proof of the caregiver’s skills.
One of the challenges for professional caregivers is that they not only need to meet the needs of the patient, but also the needs of their family members. Providing care can be both fulfilling and overwhelming at times. Although caregivers are helping someone else improve their quality of life, sometimes it can be difficult to focus on the emotional rewards of caregiving when the distress inherent to this career has taken a toll on their own mental and physical health.
The Journey to Becoming a Caregiver
When asked about the reason for caregiving as a career choice, professional caregivers often say that they enjoy helping and taking care of others, especially elderlies. For Winie, “the passion to care for old people, and the satisfaction from little things like when a patient who can’t talk tries to respond with facial expressions” keeps her going. This is an essential quality for someone in a position where there is the responsibility to care for another individual while assuring that the patient maintains his or her dignity in difficult situations. Professional caregiver training often involves going through thorough physical and psychological training, to ensure passion is strengthened with the right skills.
Caregiving service nowadays is needed in a variety of settings such as the patient’s home, nursing home, care centres, hospitals, or any other health care setting. Aside from the passion for helping those in need, when becoming a certified caregiver, it is important to have strong verbal and non-verbal communication skills to be able to nurture a relationship based on honesty, trust and respect, with both the patient and his or her family. A caregiver should also be able to effectively manage stress, as well as flexibility to work in different settings, locations, and schedules.
Becoming a caregiver however isn’t always a professional choice. In fact, in Singapore, for every professional caregiver, there are multiple times as many informal caregivers. A survey by the Ministry of Manpower in 2017 revealed that about 6% of the 200,000 Singapore residents left their jobs to provide caregiving to families or relatives. The statistics show the responsibility on the shoulders of family members to provide caregiver roles. Being an informal caregiver is probably a family necessity or responsibility at a certain stage of illness of a family member.
Even when there is a family relationship between the caregiver and the care recipient, the job is no less challenging. Most caregivers will soon learn that though informal, caregiving to a family member can be equally exhausting and challenging. In addition, many of the informal caregivers assume the role without professional training or the professional network for them to turn to when they have questions or concerns. In such cases, caregivers are encouraged to join caregiver support groups, or turn to professionals for advice and guidance.
Building a Positive Relationship Between Caregiver and the Patient’s Family
With or without an informal caregiver at home, when the amount of responsibility is overwhelming, families often find it necessary to turn to a licensed health professional for help. The relationship between the professional caregiver and the patient’s family should be based on honesty, trust and respect. “Caregivers lighten the burden of both patients and family and give them the quality of life they deserve,” Winie said, adding, “But it should be a shared role. The presence and involvement of the family of the patients are very important. Family support helps to make the patient’s life as normal as it can be. Showing familial care and love makes a difference to people who are suffering from illness.”
In any case, the caregiving role shouldn’t be left entirely to the professional caregiver. It is best that the family is there and involved in the whole process and informed every step of the way, especially when it comes to making medical decisions. In Winie’s experience, it helps when the family “know and understand more about disease, the treatments, and where to turn to for help and learn to accept and train themselves on how to support their loved ones during this hard time.”
Fighting Diseases Together
Facing diseases that require a long-term caregiver such as cancer, stroke or dementia is a long, strenuous and arduous process, with many different stages and often unpredictable outcomes. The professional caregiver becomes a part of the journey, going through the experience with both the patient and their family, witnessing the anxiety of not having any guarantees nor knowing what’s going to happen next, if the treatment will be successful, or whether there will be any adverse effects or complications.
Caregivers should be prepared to experience episodes of intense emotions from the patient, such as anger, sadness, anxiety, disengagement and fear. It is of extreme importance to make sure the patient feels his or her emotions validated and wishes fulfilled. Informal caregivers who have not undergone professional training are advised to make an effort to meet the patient’s necessities, particularly when it comes to help with daily activities that the patient is not able to perform normally.
Uncertainty in treatment outcome may also require flexibility on the part of the caregiver. For example, in the case of a cancer patient, many factors may influence the patient’s state of health such as type of cancer, stage of cancer, type of treatment (radiotherapy, chemotherapy, surgery), duration of treatment, location (the patient may need assistance and transportation to a hospital or other health facility, or any other kind of additional care at home).
Depending on his physical and mental condition, the patient may eventually express the wish to return to his or her regular daily activities and routine. The caregiver should patiently help him or her through the whole process of adaptation, especially considering that he might have to deal with some complications or permanent changes as the result of life-saving treatment.
Managing Patient’s Discomfort
As a caregiver, you might have to witness a lot of pain and discomfort. Whether in acute or chronic medical conditions, pain is a symptom predominantly present in the daily lives of patients who need long term caregiving. Pain control comprises not only mitigating the physical pain, but also healing the state of mind of the patient, particularly the expression of emotional pain.
An effective pain control often aims to ensure stress management and compliance with therapy. Winie shared that in her experience caring for cancer patients, “the pain can be extreme. As a caregiver, our role is to lessen the pain and give them the medication doctors prescribe. But aside from that, it’s no less important to listen to the patients, make them feel that you share their pain, encourage them, and let them feel you are there for them. Cheering them up and showing them physical affection like holding their hands helps as well.”
Take Care of Yourself as Caregivers
It is the caregiver’s job to focus on someone else’s comfort and well-being. However, the stress, the unexpected changes, and the difficult decision-making for caregivers who are also family members can take a toll on the caregiver. When caring for someone in a more distressed situation, caregivers often dismiss their own physical and mental health. Sometimes, taking a break can be hard or cause feelings of guilt.
Caregivers need to remember that if they are not well, they will not be able to give the best care to someone else. They should not put their own well-being on the back burner because caregiving can be a long journey, and no one has the ability to work 24 hours a day without any consequences on their overall health. Taking just a short walk, having social interactions or any other activities that allow the caregivers to get out of the house can improve greatly your quality of life, while also improving the quality of the assistance and support you provide.
For that reason, it is important for caregivers to take responsibility for their own well-being, acknowledging and making sure their needs are met, and avoid caregiver burnout. How one adjusts and copes with feelings or situations of distress has a direct impact on how one responds to a stressful, demanding event, hence it is necessary to ensure one’s own comfort and welfare, in order to provide the best care to the patient. “Be strong and know your limit too. Take care of yourself while taking care of the patient. Be an encouragement to others. Be kind. Being a caregiver is rewarding”, recommended Winie.