Commentary: Opening earlier and more - some senior care centres in Taiwan take service to new levels
New innovative concepts in Taiwan promote dignity and compassion in old age and senior care, says SUSS’s Sng Hock Lin.
SINGAPORE: At an organisation for senior citizens in Taipei, about 1,600 volunteers provide support to its 300 staff to serve a total of 4,200 elderly folk.
This high level of volunteerism — one volunteer to three seniors — at HonDao Senior Citizens Welfare Foundation — can be attributed to its successful unique programme, known as the Time Dollar-Mutual Support, implemented since 2006.
The programme applies the concept of paying forward to offer one’s time in volunteer work, which entitles the volunteer to receive assistance back from the organisation later in the future, when he or she needs it.
For example, student volunteers can use the “time dollars” accumulated to ask for help in fixing computers and getting someone to give them a wake-up call.
Older volunteers can use their “time dollars” to learn how to make quilts or take part in “soul restorations”, which are traditional rituals aimed at helping those who have received a shock or encountered other disturbing situations to overcome their trauma.
This concept is slowly being introduced in more senior care centres in Taiwan.
This innovative initiative — something certainly worth exploring in Singapore — is just one of several admirable aspects of the senior-care model that a Singapore University of Social Sciences’ (SUSS) team came across during a study trip in Taiwan.
YOUTHS IN THE SENIOR CARE SECTOR
Another noticeable feature is the strong presence of young people serving in the nursing homes and dementia centres that the team visited, both as full-time staff and volunteers. At HonDao Senior Citizen Welfare Foundation, for example, the average age of a volunteer is 30.
The way education in senior care, gerontology and career pathways have been structured to groom and attract Taiwanese youth to serve in this sector explains much of this youthful presence in a senior care setting.
The universities provide gerontology degree courses to prepare students for work in the long-term care sector. The Ministries of Health and Education are also working towards introducing long-term care course in vocational schools.
Progression pathway are porous, allowing for one to start as a care worker to eventually become supervisors and leaders through experience, continuous learning and performance.
The youth element aside, some medical institutions such as Tzu Chi Hualien General Hospital are taking the concept of patient-centric care to a whole new level.
Knowing that seniors tend to wake up very early in the morning, the clinics at Tzu Chi start operating from 5am daily to serve their elderly patients. The lack of hospitals in Hualien also gives it more reason to operate early, and provide acute care for seniors at the time when they need it.
These early operating hours relieve the seniors from having to queue for a long time, since there are fewer other patients, and allow their caregivers to accompany them to the clinic, and then report for work with minimum disruption to their work routine.
Who would have thought that such a small tweak in the service hours could make a significant impact on the physical, social and even financial well-being of the seniors and their caregivers?
The staff’s willingness to go the extra mile for their patients may be linked to the fact that Tzu Chi trains its medical doctors and professional staff in the hospital university.
GETTING TO KNOW THE DEPARTED
The university focuses not only on medical knowledge but also places much emphasis on moral values and the spirit to serve.
It has a strong curriculum to inculcate this service spirit through compulsory volunteer work, which includes overseas missions and integration with the community in the training of the medical doctors.
For example, trainee doctors will sometimes use donated bodies from the community for their training. Before operating on the cadaver, the trainees must first be familiarised with the dead person’s life story through interviews with his or her family members and friends.
After doctors have completed their training, a cremation ritual will be held for the departed. This extra ritual performed by the university lets trainee doctors show their appreciation for the deceased and his or her family.
Trainees will then share what they have learnt with family members, who will in turn give their feedback, encouraging these doctors to serve the community.
The whole process allows the community to be involved in this process, socially and emotionally, which in turn, helps trainee doctors grow compassion.
CARING FOR DEMENTIA PATIENTS’ CAREGIVERS
Another senior care centre Chung Gung Dementia Centre ensures the well-being of caregivers is not forgotten.
After all, being “caregiver-centric” is the centre’s philosophy, said its director, Dr Hsu Wen-Chuin. He pointed out that because dementia patients will not recover, “caregivers cannot fail”.
The centre’s programme involves interactions between dementia patients and caregivers, and educating caregivers on the progress of the disease to help them progressively accept and adapt to the dementia patient’s deterioration in health and behaviours.
The centre, which currently operates as a day-care centre, aims to engage dementia patients through art, music, reminiscence and light therapy.
Their therapy uses a special lamp that is brighter, is meant to stimulate natural light and does not have damaging ultraviolet rays, to help patients keep awake during the day so that they will sleep well at night. If the dementia patient sleeps well, then caregivers can also get a good night’s rest.
Chung Gung also pays attention to caregivers’ work schedules in the planning and coordination of the transportation of dementia patients to and from their homes. This attention to detail speaks volumes of the centre’s strong service orientation.
The various approaches and services offered by the institutions visited by the SUSS team point to one thing: The vital importance of software and “heartware” in any senior-care model, even as the hardware is undoubtedly important.
While Singapore and Taiwan are two very different societies, some aspects of the latter’s care models are certainly worth exploring to see if they can be adapted in the Singapore context.
There is also much more that Singapore can do to encourage interest in gerontology, a multi-disciplinary study on ageing, and develop educational pathways and career paths for gerontologists — which, in turn, may attract young people to join the senior-care sector to support the fast-ageing population.
Sng Hock Lin is a Gerontology PhD student at the Singapore University of Social Sciences (SUSS). With a Master of Gerontology from the university, he is also SUSS Gerontology Alumni Chairman.