SINGAPORE: It’s been about 80 days since Mr Heron Khalid Goh’s father died, but his mother still thinks at times that her husband is around.
About two weeks after his father’s funeral, Mr Goh’s mother asked him where her lifelong partner was. She was looking out the window, trying to catch a glimpse of him.
“I answered ... ‘Daddy, no more already. Daddy passed away'," recalled Mr Goh.
Mr Goh’s mother was diagnosed with dementia in 2023. He had expected to rely on his father for help to care for her. But the following year, his father was diagnosed with dementia as well.
“When my mum was diagnosed, it was like ‘Okay, I can manage’,” said Mr Goh. “But after I was told that my father had Alzheimer’s, I broke. I literally broke.”
Caring for someone with dementia involves duties like toilet visits, eating, housekeeping and supervision. For Mr Goh, that load was doubled.
According to a study commissioned by Dementia Singapore, caregivers spend about 217 hours a month on average – that’s more than nine full days – taking care of their loved ones.
Those hours go up to 292 if the person has severe dementia.
The survey’s findings, released on Oct 14, also show that caregivers sleep on average 6.1 hours a day.
Besides the physical toll, caring for someone with dementia costs a median of S$2,020 (US$1,560) monthly after subsidies. That comes up to about S$24,000 a year.
For Mr Goh, 57, life caring for his parents involved nights with less than five hours of sleep and an end to the overseas trips he loved.
As he juggled care responsibilities with working from home, his income took a hit. “The cost is not just financial, it is emotional,” he said.
Mr Heron Khalid Goh's parents. (File photo: Mr Heron Khalid Goh)
Before he became his parents’ sole caretaker, Mr Goh loved to spend his weekends in Japan.
His usual routine: catch a red-eye flight to Tokyo, land on Friday morning, spend the next three days doing whatever he wanted and be back in Singapore at 1am on Monday.
“That was how I was having a good time every other weekend,” he said, before clarifying with a chuckle that this was an exaggeration - but it was still quite a lot of weekends.
When he began caring for his parents, those trips came to an end.
Working from home as a partner in a consulting firm, Mr Goh’s daily routine involved staying up until 1am or 2am, and rising around 5.30am.
The earliest hours were spent preparing for the day ahead: cleaning, doing laundry and preparing medication.
Whatever time he had before his parents woke up was used to cook and squeeze in as much work as he could.
“Then don’t forget, you still need to run to go to the market. So all these little things you juggle in between time,” said Mr Goh.
Managing to get his parents into care centres that provided dementia assistance brought a huge relief to him, as it freed up three or four hours in his day.
It might not have given him the time to fly to Japan for a weekend, but it gave him some respite – to “have a roti prata and not worry”.
“It was heaven. It’s even better than going to Japan,” he said.
Mr Heron Khalid Goh with his parents. (File photo: Mr Heron Khalid Goh)
Parts of Mr Goh’s experience mirror that of Mr Mark Chin, who has also cared for two people with dementia at the same time.
He took more than a year to overcome the physical and mental struggles of being a caregiver.
In 2020, he became the sole caregiver to his father-in-law, who was diagnosed with Alzheimer’s disease. Two years later, his mother-in-law was told she had vascular dementia.
“This overlapping between my father-in-law and my mother-in-law, that was the most difficult period, and was very, very different in terms of a learning curve,” he said, as his in-laws had different forms of dementia alongside other medical conditions.
For him, one of the biggest struggles transitioning from work life to caregiving was learning to change diapers.
“They poop and they don’t know what to do with their poop,” he said. “They’ve forgotten what to do with their poop. So the poop goes everywhere.
“If you’re not trained, if you are averse to all these things … you’re in big trouble as a caregiver.”
The elderly couple could no longer get along in their states of dementia, and his father-in-law had to move into a nursing home shortly after.
Dementia can also cause behavioural changes as it progresses and may make someone act out of character.
Mr Chin’s mother-in-law sometimes experiences these changes in the late afternoon and into the evening - something known as “sundowning”.
Sometimes, her whole mood and state of mind change, he said. She would fight back against everything he says and could be violent at times.
“At the onset, before she started her medication … it was quite bad,” he said. “It was like an ongoing war every evening.”
His mother-in-law also became argumentative and would sometimes accuse people of taking her things. “It goes on and on, and they’ll just keep repeating themselves,” he said.
“If you’re a first-time caregiver, you find this very frustrating, trying to explain to them.”
Mr Mark Chin is the sole caregiver for his mother-in-law. (File photo: Mr Mark Chin)
Mr Goh’s father would occasionally have outbursts in public, and had called him a “good-for-nothing son” in front of strangers.
“It’s very embarrassing … I sit down, I keep quiet,” said Mr Goh.
Once, after an outburst, he went up to the cashier and said: “How much do I need to pay? The good-for-nothing son is here to pay the bill.”
These comments hurt before Mr Goh knew that his father had Alzheimer’s disease, but he came to see the older man differently after the diagnosis.
“Every time he scolds me, I will tell him, ‘It’s okay’,” said Mr Goh. After he attended training by caregivers' support group Mindfull, he found things easier.
“It’s not about managing them (those being cared for). Caregivers must learn how to manage themselves, because if you don’t manage yourself as a caregiver – you have lost the plot,” he said.
“Because how can you take care of others if you can’t take care of yourself?”
Mr Goh spent about S$3,000 a month caring for both of his parents.
But alongside the increased spending was a drastic loss of income – he saw an 85 per cent drop since he was unable to work as much as he used to.
One key source of income – giving talks to lawyers – was no longer possible.
The study commissioned by Dementia Singapore found that care costs increased “sharply” with dementia severity – rising by around 33 per cent from the mild to moderate stage.
Caregivers of those with severe dementia face the highest costs before subsidies, a median of S$4,081.30 per month, due to increased dependency and care demands.
Mr Chin pays about S$1,000 a month to care for his mother-in-law. Day-to-day expenses include transport, diapers, food, utilities and laundry.
Outside of the daily costs, there is also her medication and medical care to account for, although these are subsidised.
The 66-year-old has sold his architecture firm and stopped working, forgoing an annual salary of more than S$100,000. His wife, who is younger, still works.
Caregiving without receiving any salary is something that he struggles with.
He said there is a “complexity of giving out a stipend” to caregivers.
“I don’t use the word salary, I used the word stipend. Because we are keeping these people out of nursing homes to some degree, as far as possible,” he added.
“We’re actually giving that system some support, behind the scenes, without the salary. So how do you account for this?”
He pointed out that other younger caregivers may lose a lot more than just salary – most times, they lose their social and family life.
These are losses that Mr Goh can identify with.
“I had the time, I had the space,” he said. “I could go for black-ties that I don’t go for anymore – not because I don’t want to, but because of restrictions on my capacity to leave the home.”
The requirements of caregiving can strain other relationships. He said: “You have now put on baggage that is beyond anybody’s imagination.”
When he became a caregiver, he did not think of the things that he would be giving up.
“You just do what is necessary. You don’t think, ‘oh, I have to give this up’. Then along the way … it creeps into you.”
When Mr Goh’s 88-year-old mother started looking for his father after his death, a friend who was with them during the exchange cried. Bewildered by her reaction, he asked her what was going on.
“How do you manage grief when you’re trying to manage your mother’s grief?” she had asked. He realised he had never thought about that.
For Mr Goh, the grief from his father’s death was the worst feeling he experienced as an adult.
“Caregiving is endless, and after the endless period, the grieving period is more than endless. It will be forever,” he said.
“Now, I have to deal with my own grief while I take care of my mother.”
Despite its challenges, Mr Goh said he is grateful for the experience. “It has given me the opportunity to get to know them, for which otherwise I would have taken for granted,” he said.
Mr Goh said caregiving would humble you and teach you things you would otherwise never see.
For all its difficulties, caregiving is something you need to embrace and not just “accept”, said Mr Chin.
"Once you embrace it, you will know that everything you do is for the good of that person," he added.
"If I can see that the person who is in that state of dementia accepts it and is happy, I would be happy too.
"It’s very difficult, extremely difficult. It took me four and a half years … to get to this point."
The overall number of adults aged 60 and above with dementia rose from 51,934 in 2013 to 73,918 in 2023, according to a study by the Institute of Mental Health.
The total number is projected to increase to about 152,000 by 2030, according to the Ministry of Health.
Nearly nine in 10 caregivers who were polled in the Dementia SG survey said they believed more can be done to support them.
Mr Chin said one way is to help new caregivers understand what support is available to them.
“For the new caregivers, it's a real maze,” he said. “So there needs to be an easier system for them to navigate all these subsidies, advice and so on.”
To Mr Goh, support groups like Mindfull play an important role. It offers peer-led support groups, education programmes and outreach sessions to caregivers and care recipients.
That community has provided much-needed guidance for Mr Goh since he started caring for his parents.
“If not for Mindfull, I would have been completely lost. And even until today, I wouldn’t know where I would be,” he said.
He added that the next step after public understanding of caregivers must be “structural”.
“Caregiving should not rely on quiet heroism. It requires co-ordinated systems, clear pathways, public recognition - not just of labour, but the lives shaped by it.”
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About two weeks after his father’s funeral, Mr Goh’s mother asked him where her lifelong partner was. She was looking out the window, trying to catch a glimpse of him.
“I answered ... ‘Daddy, no more already. Daddy passed away'," recalled Mr Goh.
Mr Goh’s mother was diagnosed with dementia in 2023. He had expected to rely on his father for help to care for her. But the following year, his father was diagnosed with dementia as well.
“When my mum was diagnosed, it was like ‘Okay, I can manage’,” said Mr Goh. “But after I was told that my father had Alzheimer’s, I broke. I literally broke.”
Caring for someone with dementia involves duties like toilet visits, eating, housekeeping and supervision. For Mr Goh, that load was doubled.
According to a study commissioned by Dementia Singapore, caregivers spend about 217 hours a month on average – that’s more than nine full days – taking care of their loved ones.
Those hours go up to 292 if the person has severe dementia.
The survey’s findings, released on Oct 14, also show that caregivers sleep on average 6.1 hours a day.
Besides the physical toll, caring for someone with dementia costs a median of S$2,020 (US$1,560) monthly after subsidies. That comes up to about S$24,000 a year.
For Mr Goh, 57, life caring for his parents involved nights with less than five hours of sleep and an end to the overseas trips he loved.
As he juggled care responsibilities with working from home, his income took a hit. “The cost is not just financial, it is emotional,” he said.
Mr Heron Khalid Goh's parents. (File photo: Mr Heron Khalid Goh)
OUR LIVES CHANGED
Before he became his parents’ sole caretaker, Mr Goh loved to spend his weekends in Japan.
His usual routine: catch a red-eye flight to Tokyo, land on Friday morning, spend the next three days doing whatever he wanted and be back in Singapore at 1am on Monday.
“That was how I was having a good time every other weekend,” he said, before clarifying with a chuckle that this was an exaggeration - but it was still quite a lot of weekends.
When he began caring for his parents, those trips came to an end.
Working from home as a partner in a consulting firm, Mr Goh’s daily routine involved staying up until 1am or 2am, and rising around 5.30am.
The earliest hours were spent preparing for the day ahead: cleaning, doing laundry and preparing medication.
Whatever time he had before his parents woke up was used to cook and squeeze in as much work as he could.
“Then don’t forget, you still need to run to go to the market. So all these little things you juggle in between time,” said Mr Goh.
Managing to get his parents into care centres that provided dementia assistance brought a huge relief to him, as it freed up three or four hours in his day.
It might not have given him the time to fly to Japan for a weekend, but it gave him some respite – to “have a roti prata and not worry”.
“It was heaven. It’s even better than going to Japan,” he said.
Mr Heron Khalid Goh with his parents. (File photo: Mr Heron Khalid Goh)
Parts of Mr Goh’s experience mirror that of Mr Mark Chin, who has also cared for two people with dementia at the same time.
He took more than a year to overcome the physical and mental struggles of being a caregiver.
In 2020, he became the sole caregiver to his father-in-law, who was diagnosed with Alzheimer’s disease. Two years later, his mother-in-law was told she had vascular dementia.
“This overlapping between my father-in-law and my mother-in-law, that was the most difficult period, and was very, very different in terms of a learning curve,” he said, as his in-laws had different forms of dementia alongside other medical conditions.
For him, one of the biggest struggles transitioning from work life to caregiving was learning to change diapers.
“They poop and they don’t know what to do with their poop,” he said. “They’ve forgotten what to do with their poop. So the poop goes everywhere.
“If you’re not trained, if you are averse to all these things … you’re in big trouble as a caregiver.”
The elderly couple could no longer get along in their states of dementia, and his father-in-law had to move into a nursing home shortly after.
BEHAVIOURAL CHANGES AND THE HURTS
Dementia can also cause behavioural changes as it progresses and may make someone act out of character.
Mr Chin’s mother-in-law sometimes experiences these changes in the late afternoon and into the evening - something known as “sundowning”.
Sometimes, her whole mood and state of mind change, he said. She would fight back against everything he says and could be violent at times.
“At the onset, before she started her medication … it was quite bad,” he said. “It was like an ongoing war every evening.”
His mother-in-law also became argumentative and would sometimes accuse people of taking her things. “It goes on and on, and they’ll just keep repeating themselves,” he said.
“If you’re a first-time caregiver, you find this very frustrating, trying to explain to them.”
Mr Mark Chin is the sole caregiver for his mother-in-law. (File photo: Mr Mark Chin)
Mr Goh’s father would occasionally have outbursts in public, and had called him a “good-for-nothing son” in front of strangers.
“It’s very embarrassing … I sit down, I keep quiet,” said Mr Goh.
Once, after an outburst, he went up to the cashier and said: “How much do I need to pay? The good-for-nothing son is here to pay the bill.”
These comments hurt before Mr Goh knew that his father had Alzheimer’s disease, but he came to see the older man differently after the diagnosis.
“Every time he scolds me, I will tell him, ‘It’s okay’,” said Mr Goh. After he attended training by caregivers' support group Mindfull, he found things easier.
“It’s not about managing them (those being cared for). Caregivers must learn how to manage themselves, because if you don’t manage yourself as a caregiver – you have lost the plot,” he said.
“Because how can you take care of others if you can’t take care of yourself?”
LOSS OF INCOME, INCREASED SPENDING
Mr Goh spent about S$3,000 a month caring for both of his parents.
But alongside the increased spending was a drastic loss of income – he saw an 85 per cent drop since he was unable to work as much as he used to.
One key source of income – giving talks to lawyers – was no longer possible.
The study commissioned by Dementia Singapore found that care costs increased “sharply” with dementia severity – rising by around 33 per cent from the mild to moderate stage.
Caregivers of those with severe dementia face the highest costs before subsidies, a median of S$4,081.30 per month, due to increased dependency and care demands.
Mr Chin pays about S$1,000 a month to care for his mother-in-law. Day-to-day expenses include transport, diapers, food, utilities and laundry.
Outside of the daily costs, there is also her medication and medical care to account for, although these are subsidised.
The 66-year-old has sold his architecture firm and stopped working, forgoing an annual salary of more than S$100,000. His wife, who is younger, still works.
Caregiving without receiving any salary is something that he struggles with.
He said there is a “complexity of giving out a stipend” to caregivers.
“I don’t use the word salary, I used the word stipend. Because we are keeping these people out of nursing homes to some degree, as far as possible,” he added.
“We’re actually giving that system some support, behind the scenes, without the salary. So how do you account for this?”
He pointed out that other younger caregivers may lose a lot more than just salary – most times, they lose their social and family life.
These are losses that Mr Goh can identify with.
“I had the time, I had the space,” he said. “I could go for black-ties that I don’t go for anymore – not because I don’t want to, but because of restrictions on my capacity to leave the home.”
The requirements of caregiving can strain other relationships. He said: “You have now put on baggage that is beyond anybody’s imagination.”
When he became a caregiver, he did not think of the things that he would be giving up.
“You just do what is necessary. You don’t think, ‘oh, I have to give this up’. Then along the way … it creeps into you.”
EMBRACE, NOT JUST “ACCEPT”
When Mr Goh’s 88-year-old mother started looking for his father after his death, a friend who was with them during the exchange cried. Bewildered by her reaction, he asked her what was going on.
“How do you manage grief when you’re trying to manage your mother’s grief?” she had asked. He realised he had never thought about that.
For Mr Goh, the grief from his father’s death was the worst feeling he experienced as an adult.
“Caregiving is endless, and after the endless period, the grieving period is more than endless. It will be forever,” he said.
“Now, I have to deal with my own grief while I take care of my mother.”
Despite its challenges, Mr Goh said he is grateful for the experience. “It has given me the opportunity to get to know them, for which otherwise I would have taken for granted,” he said.
Mr Goh said caregiving would humble you and teach you things you would otherwise never see.
For all its difficulties, caregiving is something you need to embrace and not just “accept”, said Mr Chin.
"Once you embrace it, you will know that everything you do is for the good of that person," he added.
"If I can see that the person who is in that state of dementia accepts it and is happy, I would be happy too.
"It’s very difficult, extremely difficult. It took me four and a half years … to get to this point."
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SUPPORT
The overall number of adults aged 60 and above with dementia rose from 51,934 in 2013 to 73,918 in 2023, according to a study by the Institute of Mental Health.
The total number is projected to increase to about 152,000 by 2030, according to the Ministry of Health.
Nearly nine in 10 caregivers who were polled in the Dementia SG survey said they believed more can be done to support them.
Mr Chin said one way is to help new caregivers understand what support is available to them.
“For the new caregivers, it's a real maze,” he said. “So there needs to be an easier system for them to navigate all these subsidies, advice and so on.”
To Mr Goh, support groups like Mindfull play an important role. It offers peer-led support groups, education programmes and outreach sessions to caregivers and care recipients.
That community has provided much-needed guidance for Mr Goh since he started caring for his parents.
“If not for Mindfull, I would have been completely lost. And even until today, I wouldn’t know where I would be,” he said.
He added that the next step after public understanding of caregivers must be “structural”.
“Caregiving should not rely on quiet heroism. It requires co-ordinated systems, clear pathways, public recognition - not just of labour, but the lives shaped by it.”
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