*Has been changed for easy identification

Mr. Lee A.C. aged 64, is married with 2 children. He is currently living with his wife, Mrs. Lee aged 53, his daughter, *Alena aged 34, and his son, *Howell aged 31, in a 3-room HDB flat.

At this golden age, Mr. Lee should have been happily retired and enjoying his ageing years, however what Mr. Lee and his family are facing is not something which most people can imagine.

Mr. Lee himself is suffering from multiple medical conditions which require constant long term consumption of medications. 3 of Mr. Lee’s health conditions, Hyperlipidemia, Hypertension, and Ischemic Heart Disease are life threatening, possibly resulting in severe health situations, particularly to the heart, or even death if the conditions are left untreated. Parkinson disease which is a disorder in the production of brain cells, has also taken a toll on Mr. Lee’s physical well-being, by slowing his movements, affecting his memory, and making him lose his balance and coordination. These resulted in the lost of his ability to work. Problems with urination and inability to sleep at night further added on to the list of health issues for Mr. Lee. But the most worrying condition which have brought Mr. Lee and his family into prolonged extreme sadness is Depression.

The onset of these conditions have deteriorated Mr. Lee’s physical wellness and health, making him feel useless that he is no longer able to work and support his family who are all suffering from a varying degree of mental conditions. His wife is suffering from Schizophrenia and his son, *Howell is suffering from depression and epilepsy, leaving his daughter *Alena to be the only family caregiver despite her own condition of schizophrenia, depression and physical health issues.

Due to Mrs. Lee and *Alena’s incurable Schizophrenia condition, it have prevented the both of them to engage themselves for employment. In addition to the family’s financial burden was also the costly long term medication that is needed to keep their condition under control.

Even though Mrs. Lee is in poor condition for employment, but she does her best to take care of the household chores and meals while managing her own medications without further burdening *Alena, who handles the rest of the care-giving duties at home.
 
*Howell is fit enough to work on a production line currently to help support his family with his nominal pay, but he is facing an extensive amount of stress from the constant bullying and teasing from his colleagues due to his mental condition. The medical conditions of his family members and worries for his family’s ability to take care of themselves have also taken its toll, all causing *Howell to be very temperamental,  and  he throws his temper whenever he is unhappy. These high stresses have also frequently induced suicidal thoughts in him.

Apart from *Howell, there is also *Alena who faces the same worries that her brother has for the family’s survival, but she is unable to do anything about it other than caring for them. She too faces very high stress level not only about the family’s survival concerns, but also from handling the multiple and different medications that her father and brother have to administer daily with varying dosages and frequencies. She also has to cope with her brother’s mental condition while managing her own depression and health issues. The high stress level at home had driven the main home caregiver for the family, *Alena to attempt suicide at some point of time during the darkest time of her life.

Further complicating matters, their house was in a really bad state. The lack of motivation in life from the family members has deprived the house of any proper maintenance or care, and the house was infested with bed bugs. All these accumulated problems at home lead to Mr. and Mrs. Lee’s frequent heated arguments, causing a further strain in the family relationships with each other. Facing all these conditions and depleted financial ability, Mr. Lee’s depression eventually evolved into having little motivation to continue living.

At this crucial point of time, THK ACE which provides services to assess the clients needs and align them with existing resources which are appropriate while managing it on their behalf, quickly stepped in to assist Mr. Lee after he was referred to us by CEL (Centre for Enabled Living). The Case Manager (CM) made necessary referrals and linked Mr. Lee to various services without charging him while further extending additional help to his family members. These arrangements greatly reduced the emotional worries for Mr. Lee as the unpredictable and dark future seemed to have a beam of light shining through now for him and  his family without any additional financial burden.

With referral from THK ACE, Mr. Lee and *Alena under-went Counseling, where the sessions have proven effective to help reduce their emotional stresses and improve their psychological wellness. Besides that, *Alena who has high caregiver stress was also taught caregiver strategies to relieve her stress to prevent relapses of her mental conditions by the Caregiver Support Services. Some strategies recommended for *Alena were to keep a journal, having time off for herself, and to go for walks which acts as a breather for her from the stress she faces from taking care of her family.  *Howell was also referred to our Bukit Panjang Family Service Centre’s social worker for help regarding his suicidal thoughts, bully related issues, mental condition and temperamental control which greatly reduced *Alena’s stress and worries.

CM also provided Mr. Lee and *Alena with advices and explanations regarding Mr. Lee’s medications and medical conditions as Mr. Lee had no proper understanding about his health conditions and medications, resulting in him refusing to take his medications and not putting efforts into taking proper care of his own health. These advices and explanations better assisted Mr. Lee and *Alena in coping with Mr. Lee’s medical conditions, such as understanding the progression of the various medical conditions and some of the side effects of the medications.

However, due to Mr. Lee’s multiple medical conditions, Mr. Lee and *Alena were overwhelmed with the numerous medications and often had problem administering Mr. Lee’s medications. Apart from that, *Howell’s medications added on to *Alena’s confusion and stress in handling them. So in order to ensure that both Mr. Lee and *Howell are competent in taking their medication and to reduce *Alena’s stress, Mr. Lee and his son were referred for the Blister Packing service at no charge. The service allows 1-month’s worth of various medications to be packaged accordingly by dosage intake and frequency at the Khoo Teck Puat Hospital, a partnership project with Thye Hua Kwan Moral Society (THK), allowing Mr. Lee and *Howell to consume just 1 blister each time instead of the multiple medications. These blister packs assisted *Alena with administering the medications to her father and brother, hence increasing their medication compliance rate by not forgetting or over-consuming their medications.

Caregiver Training was also be provided to assist *Alena to better cope with the care of Mr. Lee, where nursing trained staff and physiotherapist imparted knowledge and skills to *Alena on better managing the challenges of care giving for Mr. Lee at home.

Life for Mr. Lee has since improved! The services provided not only have helped *Alena to reduce her stress level, it has also taught her how to better manage her emotions. Apart from that, Mr. Lee is more cheerful these days and there is less quarrels within the family. Their house has also been cleaned and is now free of bed bugs, thus providing a more conducive environment for them to live in.

Please stay tuned for more updates on Mr. Lee and his family in 6 months’ time.