Most caregivers are elderly spouses

Many have little education and health problems of their own: Study

By Poon Chian Hui, The Straits Times, 3 Aug 2012

MANY old folk who return home from hospital are cared for by spouses who could be as old and frail as them.

The majority of these caregivers have little education and many also have health problems as more than half are above 65 years old, a study here has found.

The study by an Aged Care Transition (ACTION) team, under regional health-care group Eastern Health Alliance, interviewed 3,086 patients and caregivers from 2008 to 2010.

ACTION was set up in 2008 by Changi General Hospital and the Agency for Integrated Care to help the elderly ease back into life at home after hospitalisation.

The aim of the study is to better understand the needs of caregivers and come up with ways to help them.

At 28 per cent, spouses form the largest group of main caregivers of the elderly sick at home.

They are followed by maids and children at 23 per cent and 21 per cent respectively, while the remainder either take care of themselves or are looked after by friends.

Of great concern is the spouse's education level, said Action assistant manager Zahara Mahmood.

A staggering 81 per cent have had no formal education. This can affect their ability to, say, spot side-effects of drugs and read dosage instructions.

The biggest problem is the physical stress, with one in three spouses saying the caregiving work is far too exhausting.

For Madam Tay Siew Suan, 64, looking after her husband can get so tiring that she suffers chest pains from time to time.

Her 78-year-old husband Lee Kah Seng has heart disease and dementia, and was also recently diagnosed with Parkinson's disease.

"It takes a lot of strength," she said of the times she had to help move him around the house since he fell sick about six years ago.

It does not help that she has arthritis, which causes knee pain.

The couple live in a one-room rental flat, apart from their two grown-up children.

Another major issue is the lack of social support faced by 21 per cent of the spousal caregivers. For example, their children are too busy with work to help them.

The ACTION team found that caregivers coped better when the team got involved, such as making home visits to the sick.

On average, each caregiver managed to tap an average of two services after the team stepped in.

An example is Madam Margaret Hoh, 75, who sought help for administrative matters like applying for Medifund assistance.

She and her 78-year-old husband, who suffers from diabetes and Parkinson's disease, also started going to a day rehabilitation centre.

Regular exercise there helps her to maintain her strength, especially since she fell and hurt her back last year.

Such interventions also keep the patients out of hospital.

Incidents of them requiring hospitalisation dropped from 25 per cent to less than 5 per cent over the two-year period of the study.

Ms Zahara said the team hopes to better customise care for the elderly spousal caregivers.

"Many are socially isolated as well as physically and emotionally overwhelmed," she added.

Who looks after old folk on return from hospital?

28% - Spouses

23% - Maid

21% - Children

The rest look after themselves, or have friends who take care of them.