Taking care of the caregiver


IT IS inevitable that as people age, they lose more and more control over their lives. The ageing process may bring about anger, as seniors vent frustration about getting old, having memory issues and chronic pain, losing friends, being incontinent and being on a wheelchair – all of the undignified things that can happen to them as they age.

As parents age, many family members are actively involved in making sure that the basic needs of their parents are taken care of so that their parents can lead a normal life. Daily living assistance provided by family members could range from giving their parents their daily medication to bathing, feeding, toileting them, including changing their adult diapers and transferring them from bed to wheelchair and vice versa.

These chores may seem small but the sacrifices can be huge involving 24/7 care over an extended period of time and will get even more enormous as the gravity of the illness or incapacities increase.

However, 63-year-old Selvaraj Nadarajah and brother Danaraj (61) – sons of 99-year-old Nadarajah Govindasamy – don’t regard these essential caregiving needs as a big deal.

They feel that they are just doing what comes naturally to them: taking care of someone they dearly love and cherish. They shower their dad with unrequited love and dedicated care to enable him to continue to “enjoy” the remaining limited years of his life on this Earth. I must say that Nadarajah is one lucky man.

Malaysian men have an average lifespan of 72.2 years while the women live seven years longer. While most of Nadarajah’s contemporaries have left this world a long time ago, this former Civil Aviation Department officer who retired 44 years ago is still able to continue living an ordinary life; he has lived 27 years longer than the average male in the country. In terms of his other half, this hale and hearty senior has outlived her – she passed away three years ago.

Nadarajah giving the thumbs-up sign. With him are his son Selva and wife, and two grandchildren.
Nadarajah giving the thumbs-up sign. With him are his son Selva and wife, and two grandchildren.

I recently attended Nadarajah’s 99th birthday bash and I was indeed impressed with what I saw. I kept wondering what were his “secrets” for continuing to live life with full enthusiasm at such a ripe age. I was amazed that for a man of his age, he displayed strong staying power. There seemed to be a lot of life left in him. He even joked that he was ready to marry again.

The more I talked to him, the more answers I got. For starters, Nadarajah is an easy-going person. There is no personal charm as great as the charm of a man’s jovial temperament; Nadarajah is one such cheerful and happy man as opposed to many seniors I have come across who are persistently depressed. Seeing this man live his life at this “ripe” age was a breath of fresh air. He appeared contented, joyful and grateful and was somewhat confused with all the attention showered on him.

I can only conclude that one of the important contributory factors for his longevity is his positive outlook to life and with a disciplined approach to taking less sugar for his 50-year-old diabetic condition.

Secondly, he is dearly looked after by his two sons and their spouses with tender and loving care.

The brothers have engaged a full-time caregiver and a part-time physiotherapist who makes house calls.

Although their dad is not demanding at all, nor does he have temper tantrums, the daily demands do take a physical, financial and emotional toll, but they take it in their stride. They have accepted that things have changed now that their dad is totally dependent on them but they have mentally prepared themselves for this radically new paradigm in taking good care of their dad. It is gratifying to see that their dad, a grandpa of eight adult children and two great grandchildren, is happy and blissful despite his age.

Aside from taking care of his dad’s health needs such as medication monitoring and management, physician’s appointments and physical therapy, Selva reminds me that there is also the emotional care aspect such as companionship, meaningful activities and conversation that are equally important.

Although in a wheelchair after a fall recently, Nadarajah is mobile and not confined to his bed all day long. As a safety measure, bars have been erected on his bed to prevent him from falling. He eats the same food as the rest of the family. There is no need to prepare special food for him. He loves hawker food and his favourite is baked curry puffs for his afternoon tea.

With strong genes, he has minimal dementia, no Parkinson’s Disease, but he has diabetes. He eats and sleeps well, reads the papers daily (although it takes him at least two hours reading page by page) and enjoys watching TV.

My wife marvelled at his strong teeth. At a recent Deepavali do at his house, we saw him happily munching muruku – my other half cried “my gosh; my dentist would never allow me to do so”.

Until recently he was an avid Arsenal Football Club fan. He never missed any of Arsenal’s games. In fact he used to watch regularly all English Premier League matches. When Arsenal came to Malaysia two years ago to play at the Bukit Jalil National Stadium, Dana managed to get a VIP seat for his dad which was located next to the royal box. It really made his day! He cherishes that match till today.

Yes, caregiving does have its rewards. Selva and Dana tell me that taking care of their father has actually improved their relationship with him, created positive memories and fostered peace of mind; they have bonded with dad in a new and deeper way.

Also, along with the everyday responsibilities and challenges comes the unanticipated gift of caregiving, namely compassion, learning to be extra patient and forgiving, and the courage that can weave hope and healing into hardship.

What are some of the insights that Selva and Dana have gained taking care of their “super” dad? The first challenge they say is to maintain balance and not lose track of their own needs.

Selva says, “It’s so easy to surrender to taking full care of my ageing dad”. But he knows that it will not serve him nor his dad well if he fails to take care of his own health. His life still needs to be about him. Selva is aware that he might be at risk of experiencing “caregiver burnout” – a state of mental and physical exhaustion brought on by the physical, mental and emotional stresses of providing ongoing care, usually over a long period of time.

So Selva has also to have time for himself and take care of his own needs; just like the mother on a plane who has to put on the oxygen mask first before she does it for her child.

Recreation is not a luxury; it is a necessity to “re-create” and renew himself. So, at least once a week for a few hours at a time, he reserves time just for himself – to read a book, go out for lunch with a friend, or go for a swim.

Another insight gained is that he also has to take good care of all the healthcare providers such as the maids (he calls them house managers or “pengurus rumah”), the physiotherapist, other family members, and the nurses and doctors. Selva says he treats each and every one very well.

He would like these caregivers to have positive thoughts when they think of his dad. He says that steady kindness, encouraging words and little gifts can go a long way toward ensuring the caregivers have positive vibes when it comes to taking care of his dad.

Update: This article was written before Christmas. Sadly, I learnt Nadarajah had a stroke before Christmas and passed away a week later.

Nadarajah and family many years ago. His sons Selva and Dana (right) are at the back.
Nadarajah and family many years ago. His sons Selva and Dana (right) are at the back.
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