Friday, Jul 21st

Last updateWed, 11 Nov 2015 11am

Sunday, 04 June 2017 00:00

To Heal and Comfort through Home Visits

Written by  Julie Yen Yu Chu, Malacca / Translated by Goh Hwe Yong

Valathamonie (2nd left) smiled broadly and was happy to show Dr Ng Guat Kiat (3rd right) and all present the result of her efforts in rehabilitation. [Photograph by Julie Yen Yu Chu]

It is not uncommon to hear doctors blaming their patients for not adhering to what they are told to do, like carrying out rehab routines, and taking medication regularly at the correct doses. However, the reason for patients not doing what they are told to do is often unheard. In order to maintain a closer doctor-patient relationship and provide the assistance needed, medical doctors must take the initiative to find out the patients’ difficulties.


Since March 2017, medical personnel of TIMA Malacca have started to join volunteers on their visits to Tzu Chi’s care recipients at their homes. The emphasis is on those who, as a result of illnesses, are faced with family problems, or are suffering from mental stress. Such visits are initiated in order to give timely professional aid and counselling to the needy, while at the same time, allow the professional carers to fully appreciate the plight of the suffering ones, and thus are motivated to take necessary actions professionally.

“To pay home visits to deliver medical care is different from seeing patients in hospitals and clinics, in that a more empathetic and caring attitude accompanies consultations; and there is also a sense of realization upon witnessing the situation. It is through such home visits that I come to learn of the difficult family situations that arise due to illnesses and poverty,” said Dr Ng Guat Kiat thoughtfully. She hoped to gather more medical workers to join her in this mission to make it a long term and sustainable project of medical care.

Respect and protection as the principles

“Masa (anonym) contracted HIV due to drug abuse. As the treatment cost was too heavy for his family to bear, Tzu Chi has been providing them with financial aid and humanitarian care. With the disease being a sensitive issue, volunteers found the family rather cautious and cold initially. The wife preferred to keep to herself, though the patient was friendlier. It took volunteers six long years before the wife was ready to open her heart, despite the worries hanging heavily on her mind. Though Masa is more jovial, his children are rather quiet and lacking in self-confidence.”

Before they started on their journey on June 3, volunteer Teng Swee Lieng briefed the medical personnel on the family background of the patient they were going to visit. Volunteer Tan Siew Fong, who has been giving care to the family, told of her initial experience of being puzzled by the family’s cold attitude despite the volunteers’ attempts to offer help. Finally, she realized that none of them ever wanted to disclose Masa’s illness to any outsiders, and it was especially a taboo where the wife is concerned.

Dr Siti Zunairah commented that the couple, and especially the wife, must have been feeling greatly stressed in that situation. Swee Lieng concurred and added that the volunteers have not been able to better care for the subjects in question due to their lack of professional knowledge in the disease. Dr Ng replied that the doctors would handle the case appropriately for better communication, and that Dr Siti Zunairah would counsel the children.

Dr Siti Zunairah reminded the volunteers to take precautions not to get too close to the patient when he coughed, nor should they touch any open wound found on the patient.

To care with wholehearted love

The volunteers and medical personnel arrived at Masa’s house with a gift for Aidifiltri, since the visit was made in the Muslims’ fasting month. Masa was taken by surprise to see doctors and nurses coming with the volunteers.

The home visit started in a very jovial manner; all were engaged in light conversations, and even the children were engaged too. When Dr Siti Zunairah came to know that Masa was smoking two packets of cigarettes daily, she advised him on the risks, and told him where to get help to quit the habit. Masa revealed that he started smoking at the tender age of ten, and so it was difficult to quit. The volunteers suggested that he takes part in recycling work, or engage in sports to de-stress, hence quit smoking. Masa did not make any promise. It was hoped that he would give the advice a second thought.

When it was time for the subject proper of the visit, as an expression of respect for privacy, only Siew Fong stayed on with the medical doctors to talk to the family. The doctors gave clear instructions to the family members on precautionary medical measures against the disease. The children said that they understood the need to protect themselves. The visit succeeded in easing the cautious attitude of the wife, although further counselling has yet to be carried out. The wife looked much happier than before, and credit should go to the professionalism of the medical personnel.

Confidence re-established after illness struck

The group of volunteers and medical personnel then made the next home visit to Valathamonie a/p Chinniag. Valathamonie was happy to see them, and made an effort to sit up as a gesture of welcome.

At the first visit four months ago, volunteers found her in great despair as her right leg was amputated in November last year, due to diabetes. Thus, she felt very insecure and did not even dare to try to stand up. She was given subsidy for her use of diapers, and Tzu Chi volunteers had been paying her home visits.

Since then, she had became very much dependent on her daughter in everyday life, and this had led to a certain degree of friction between the two parties. Over the months, despite encouraging words and actions for her to overcome her psychological fear of falling, Valathamonie never stopped crying and complaining about her pain. Swee Lieng concluded that her complaint was real, but she had to overcome it to enable a breakthrough.

Thus, a home visit by the medical doctors was arranged and carried out last month to give her professional support. Over a period of one month, Valathamonie was transformed. No more tears but broad smiles on her face, and she was keen to show the result of her efforts in rehabilitation. As she shifted herself onto the wheelchair from her bed, she won a loud applause from the visitors. The happiest was Dr Ng, who was the doctor that visited her a month ago to give her professional advice and moral support.

Full team support

Amidst conversation, Goh Litt Chin, a nurse by profession, tested Valathamonie for the strength of her upper limbs, since a pair of strong arms was crucial for her movements. She taught her how to exercise her arms, legs, head and lower back to strengthen the muscles, and demonstrated the proper way to help her to stand up, so that the burden on Prinya, the daughter, could be lightened, while at the same time, injury for both mother and daughter could be avoided.

The practice session went on, but not without some difficulty, as Valathamonie was too heavy to lift herself up, while Prinya was too weak to lift the former. But all were happy because the patient was making the effort – a factor important for her return to normal life. Dr Ng explained that it would take practice to make perfect, while Litt Chin agreed, and pointed out that Valathamonie’s case was relatively not as serious, and she could make good progress if she really practised.

The routine of Valathamonie’s family life was disrupted due to her illness. Prinya has to stay at home to care for her mother, while her father works outstation. Moreover, Valathamonie has been rather dependent on Prinya, who felt the heavy burden on her shoulders. In fact, Valathamonie could be more independent if she regained her confidence. Hence, professional support, whether rehab or psychological, would help a lot in this respect.

“At every follow-up visit, the doctor in attendance would always ask: ‘Why is your mother still unable to stand up?’ I cannot do anything. She cannot overcome her fear. I am so grateful that the doctors and nurses pay us home visits to give assistance and to show us the proper ways of handling. This eases her mind. My mother is really happy for your visit,” said Prinya thankfully.

Learning the skill of professional care

Later, Litt Chin took Valathamonie outdoor on the wheelchair. The latter was happy, for she had not gone out of the house for the past six months.

The breeze outside was refreshing. Volunteer Fon Ay Jiun seized the opportunity of a relaxing atmosphere to request Valathamonie to practise the exercises she had just learnt. Valathamonie gladly obliged. Swee Lieng was glad to see the progress achieved by the patient. She was using the wheelchair for the first time in four months, and she had on her own shifted from her bed to the wheelchair. She regained confidence under the guidance of the doctors and nurses, and had made the efforts on her part to progress.

Prinya was surprised that she had pushed her mother on her wheelchair in the wrong way all the while. That day, she learnt the proper way.

Swee Lieng was also making notes all the time, for a detailed report on the home visit. He explained that the details are necessary for the benefit of the volunteers, who would then have a clear idea of the case.

He favoured the idea of the medical workers making such home visits because ordinary volunteers could then learn from them the ways of taking good care of sick care recipients.

Dr Siti Zunairah said that she could feel the great support for patients through home visits by volunteers and medical personnel from Tzu Chi. Home visits to patients would enable doctors to understand the real problem behind, hence a more holistic care could ensue for better recovery physically and mentally.

To Dr Ng, who has practised medicine for 30 years, home visits made it possible to see deeper and further. It was an experience totally different from seeing patients in the clinics. She hopes that more medical personnel would take part, for helping a patient to recover is as good as lifting a family out from the vicious circle brought into being by illness.

 

 

Volunteers presented a gift for Aidifiltri to Masa’s family during the home visit. [Photograph by Julie Yen Yu Chu]   Volunteer Tan Siew Fong (1st left) and Dr Siti Zunairah (right) in a private conversation with the patient and his family. [Photograph by Julie Yen Yu Chu]

Volunteers presented a gift for Aidifiltri to Masa’s family during the home visit. [Photograph by Julie Yen Yu Chu]
 
Volunteer Tan Siew Fong (1st left) and Dr Siti Zunairah (right) in a private conversation with the patient and his family. [Photograph by Julie Yen Yu Chu]
 
Nurse Goh Litt Chine demonstrated to Prinya (left) the proper way to help a patient to stand up, so that both the helper and the patient would be safe. [Photograph by Julie Yen Yu Chu]   Volunteer Teng Swee Lieng made detail notes on the home visits and included medical information on the disease and proper way of looking after the patient. [Photograph by Julie Yen Yu Chu]

Nurse Goh Litt Chine demonstrated to Prinya (left) the proper way to help a patient to stand up, so that both the helper and the patient would be safe. [Photograph by Julie Yen Yu Chu]
 
 
Volunteer Teng Swee Lieng made detail notes on the home visits and included medical information on the disease and proper way of looking after the patient. [Photograph by Julie Yen Yu Chu]
 
Valathamonie practised rehab exercise that she had just learnt. [Photograph by Julie Yen Yu Chu]  

Valathamonie practised rehab exercise that she had just learnt. [Photograph by Julie Yen Yu Chu]