What does the nursing home aim to provide? Besides traditional provision of medical care, there are other important objectives —providing a safe and supportive environment for the chronically ill and dependent, restoring and maintaining the highest possible level of function, preserving individual autonomy,, maximizing quality of life and life satisfaction, and providing comfort and dignity for patients — and their loved ones — at the end of their lives.
A story from “Being Human— Stories from Family Medicine”
By Sun and candlelight
On love that never dies, that forever endures whatever, wherever, and transcends our physical existence. A husband in his seventies, himself saddled with several chronic conditions and residing in a sheltered home, comes regularly to visit his frail wife in the nursing home. He does this thrice a week, enduring the long bus rides to and fro. He and his wife sit in a quiet corner of the balcony, where he peels grapes and plays fifties-era Chinese jazz for her on the radio. The wife’s brain has been ravaged by radiotherapy for a brain tumor, followed by a stroke a few years later. She can hardly talk, but to her husband, this does not matter. I joke with them that they are on a paktor — Hokkien for boy-girl date — and he smiles at me sheepishly.
Enduring Grace
A son in his seventies came daily to the nursing home for months, to dress the malodorous, gangrenous foot of his centenarian mother, till she passed away. He considered dressing her foot as his filial duty, and would not allow staff to do it.
Gladness
In the drawing, a member of the staff greets an elderly resident cheerfully, and the resident reciprocates with a heartfelt smile. It is important to highlight that the medical student was struck by this act of kindness and chose to record it for posterity.
This drawing is an apt tribute to nursing home staff. The staff comprise a handful of locals and majority of foreigners from nearby Asian countries, who undertake demanding work in a taxing environment for a modest wage. Many are there for years, dedicating their working lives to caring for the frailest, and getting to know their charges thoroughly, like a true family.
Apart from good environmental and activity design, it is fair to say that in nursing homes, the staff are the quality of life.
What happens when a resident dies? We try to have a joyous celebration of his or her life. At our mortality and morbidity meetings^, staff who have cared for a deceased patient give a eulogy, to celebrate the person and his life. Quirky behaviors, funny incidents, how the patient had been during his heyday, and stories of their families, are shared, to laughter, smiles and the occasional tear amongst those present.
The best gift we can give our residents who have left us, is to remember them in our hearts. This too, is the essence of being family.
—-Dr Marie Stella P. Cruz
^Mortality and morbidity meetings are regular meetings during which patient deaths (and other serious outcomes) are reviewed to ensure that the best care has been rendered.
Marie Stella P. Cruz believes that bringing cheer to patients, and supporting, affirming the love and sacrifice made by caregivers, are equally important tasks as optimizing the health of her nursing home residents and home bound patients. She is actively involved in teaching undergraduates and postgraduates, and is also in assessment. She is a mother of four who brisk walks almost daily, and enjoys reading novels, cycling along park connectors and playing Scrabble with friends.
The above write up has been reproduced with permission from the book ‘Being Human, Stories from Family Medicine’ edited by Cheong Pak Yean and Ong Chooi Peng and published in 2021 by the College of Family Physicians Singapore,
Pictures of illness experiences were drawn by NUS medical students in workshops conducted from 2012-2017 by Cheong Pak Yean. Senior family physicians subsequently shared vignettes and commentaries based on the pictures.
