Is It Ethical To Send Your Parent To A Nursing Home?

And so today I took the time to head down to the Institute of Mental Health with my mother to visit her mother, which is my grandmother. As we were making our way there, my mom told me she felt so guilty for not being able to visit her mother when she got admitted into IMH (She got transferred there from the nursing home because the nursing home couldn’t handle her fuss – she’s suffering from depression, please don’t judge). I wanted to comfort her but couldn’t find the right words to do so.

Over there, I once again witness my grandmother’s hands strapped to the bed she was lying on as was the case at the nursing home. This was so because she would frequently pull out those tubes that were placed on her if left untied. The brief time that we had, I watched my mom’s mom in tears. I witnessed my mom tearing before on several times too. My mom was clearly gutted that her mom had to be tied down but there was nothing she could do about it because that was what’s best for her. Even a blind person could see the love my mom had for her mom and vice versa, even though my grandmother had senile dementia and thought that I was her son. My mom may not be very educated, but she taught me the importance of filial piety and being respectful among many other life lessons.

So the big question is, is it ethical to send one’s parent[s] to a nursing home?

Well, the PhD answer would be, “It depends”.

Because it really depends on what grounds the son or daughter wants to do so. In 1994, the Government put into legislation the Maintenance of Parent Act, thus regulating that the son and daughter is responsible for caring for the parent. Assuming the worst, it could be because there is an increasing trend of children abandoning their parents when they are of no further use (sucked dry of their wealth), terminally ill (thus incurring high medical bills), are a liability (extra mouth to feed, extra bills to foot), can no longer ‘contribute’ (finances, etc), or are no longer easy to manage (being old does causes some to become emotionally and mentally less stable or worse, contract senile dementia). Just google and you find all these not-so-nice news about infighting for inheritance. Even news giant like Yahoo published a guide to Picking The Right Nursing Home For Your Parents; you know our country is headed towards a certain direction which could be either good (that people are just too busy to provide the proper care for their parents) or bad (they don’t give a sh*t about their parents). There is no need to look at the issue of the Government pushing the responsibility to citizens because it is not necessary over here.

As Singaporean Chinese, we still appreciate the values [or four virtues] that entails Confucianism such as filial piety, righteousness , loyalty and contingency along with other virtues like honesty, kindness, forgiveness, sense of right and wrong, modesty, respectfulness and so on. Humanism is the core of Confucianism. Be it Buddhist, Christian, Taoist, Atheist or Free-thinker, one doesn’t need to forsake his or her own values and beliefs to practice Confucianism. We practice Confucianism not because we have to as Chinese. We practice Confucianism not because it would be wrong not to do so, but because it is simply the right thing to do as a red-blooded human being.  These values do not define us as a human being but it certainly give us a context and a frame to navigating the world that we live in. And it is the root of which made us Chinese, well, a Chinese.

It is downright unethical to send one’s parents to a nursing home or in more morbid terms; an Old Folk’s Home when they are deemed unable to contribute, or are labeled a ‘liability’ to the household. This doesn’t just go against Confucianism; the thing that made us Chinese Chinese, this totally goes against our humanity (morality). Without any sugar-coated words, it is just downright inhumane and morally disgusting. There is no leeway to this.

The next question is, “I can’t afford to hire a private or home-stay nurse to take care of my parent(s) much as I want to, and I don’t want to send my parent(s) to a Nursing Home because it just doesn’t feel right, what should I do?”

Based on what I know, a private nurse (visit few hours a day, few days a week, etc) charges above $2,500 for her duties. Nothing wrong with that, I respect that because caring for the elderly is no easy feat when you weigh in the problems that she face in caring for the elderly – making sure medication is taken, ensure proper diet, bring them out for exercise, helping them to clear their bowels, carrying them on and off the bed or wheelchair, dealing with their tantrums especially, etc. And then there is the mental health issue to factor in. It is a highly stressful job in the first place and one has to really have the passion in order to stay long in this line of business [in which there aren’t many around]. Elderly with more complex problems that require the care of professionals with very specific skill-sets also increases the remuneration package of the private nurse in question. If that isn’t expensive enough, the services of a home-stay nurse will set you back at beyond the $3,000 mark. That’s like an entire month’s salary [and more] for some folks.

However, we can’t just leave an elderly at home unattended, because accidents do happen and we don’t want that [because they are our family and not because it is burdensome to clear up the mess!!!]. We are living in this fast-paced society whereby we have no time to stay at home and render the care that our parents need. Yet at the same time, there’s no way one can afford that kind of cutthroat price of hiring a private or home-stay nurse in this day and age whereby as middle income households, one’s hard-earned salary and its increments can hardly beat the bills and inflation as a matter of factly. You have to be in the high income earners in order to be able to acquire the services of these nurses. Either that or you have ten siblings who can contribute.

So that rules the option of private nurses and them staying at home alone, out. That leaves us with one rather awkward option; the nursing home. Even still, it isn’t cheap. A website managed by the SingHealth group puts the figures of securing a place at private nursing homes between $1,000 to $5,000 depending on the quality of care and stay. Although there are subsidy schemes which the Government offer for nursing homes under their subsidy, there are loopholes as well (like how subsidy is inversely based on household income but not taking in other factors and variables – correct me if I am wrong), and there are many households who fall into that category.

The average rate people are forking out for nursing homes is believed to be around $1,600 range. My grandmother is/was staying at a nursing home which cost $XXXX (slightly below $2,000 range) and the facilities aren’t fantastic. But still, there’s a comfortable bed to lie on, television to watch, interaction and companionship with other senior citizens, all-in laundry services provided, three meals a day plus snacks as and when required, someone to bring one one’s medication, and so on. Most importantly, there are trained professionals (nurses albeit many being foreign labor), doctors, dietitian (depends on the nursing home you have selected and paid) and physiologist to give proper care to the grey-haired individuals we so dearly love. It is not the best measure to take but it is now a viable option.

So is it right to send one’s parents to a nursing home on grounds of being financially tied?

Yes…. And no. You can’t just dismiss it totally like white and black. Is it the best practice to send one’s parent(s) to a nursing home? Certainly not, BUT if one can’t afford the pricey tag of hiring a private nurse and, the same if not similar levels of care is provided from that of nursing homes, I believe it is okay to do so. Only then should [nursing home] be a viable option. That is also provided one frequently visit his/her parent(s) at the home la, I mean they took care of you from tod to adulthood. That way, you could keep up with the care and health of your parent(s) – find out if they are mistreated – and maintain the touch-points with the family unit. Maintaining kinship is one of the fabrics that keeps families and society running. Be a good example to your next generation or you could live to live through the experience you put your parents in.

At the end of the day, whether is it ethically wrong to send one’s parent(s) to a nursing home really depends on our motive and intent behind the proposed move. It’s like how we view the home, is it a nursing home where they can receive the well-deserved and much-needed care that they should have as they celebrate their golden years, or do we view it as an old folk’s home – a place where we can chuck them away because they are a liability.

Did love caused my mom to put my grandmother in a nursing home? Yes and No. Yes, because the proper care could be rendered to the mother she so dearly loves. And no, love wouldn’t want a loved one to be far away but life sometimes dishes one with limited choices.

Personally, it will only leave me gutted if I have to one day choose between keeping my parent(s) at home or sending them to a home, of which I pray that I will make the right decision when the time comes. I love my parents a lot, I really mean A LOT. I can’t give my word on that I will never consider such an option because, what is man but flesh? Only God is constant and only He is truly capable of keeping all His word. But as best as I can, I will try not to let my parents stay in a home because I want them around my kids.

There is so much our parents can contribute to the next generation, I mean I learnt so much from my now-decreased grandfather and grandmother from my father’s side. And boy, they sure doted on me. My grandpa frequently brought me to eat wanton mee and my grandma is just a dear, she’s the best. Till today I still remember their faces and how they doted on me albeit losing them around a decade ago but telling you readers all that will only bore you out.

Before I end, I think the healthcare workers – nurses from hospitals, nurses from nursing homes and IMH deserve a sword salute, a standing ovation and honor of the highest merit for all that they have contributed to Singapore and the otherwise unseen spectrum of the high and mighty, prosperous Singapore so that Singapore can be who She is. You are our unsung heroes who do what many of us can’t do. Government, please la, up their salary can?

Writer’s Note:
This article is wholly presented in the author’s personal point of view and should be taken with a pinch of salt. This article exist to challenge conventional and changing mindsets in this growing society, thus readers are invited to not take the article in its entirety at wholesale value. Any part of the article can be used at no charge, but should be credited back to the right source.

References:
http://sg.news.yahoo.com/picking-nursing-home-parents-160000493.html
http://www.aic.sg/uploadedFiles/Individuals_Caregivers/Understanding/Care_Services_Available/Nursing_Homes/MOH-Supplement-on-Nursing-Home-Charges1.pdf
http://www.healthxchange.com.sg/News/Pages/The-nursing-home-crunch.aspx
http://en.wikipedia.org/wiki/Confucianism
http://singaporemind.blogspot.sg/2012/06/dire-consequences-of-policy-of-over.html
http://www.healthxchange.com.sg/News/Pages/Long-Term-Care-Nursing-Homes.aspx

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