Trigger warning: References to suicide. This tale was shared in partnership with the Lien Foundation .
All images by Isaiah Chua unless stated otherwise, for RICE Media.
"Each day, I would retreat to the restroom for a good cry without anyone noticing my anguish," shares Richard Ashworth, 71, as he describes his experience with caregiving.
At age 46, Richard stepped down from work prematurely to care for his foster father, John Ashworth, who was fighting against colorectal cancer.
However, it wasn't the cancer that imposed the greatest burden on his caregiving responsibilities. Instead, it was the diagnosis of severe dementia in John back in 2012 that did so.
Richard indicates a chipped front tooth—a consequence of one of his father’s aggressive episodes. Dementia changed John’s character, transforming a mild-mannered individual into someone who was prone to uncontrollable fits of rage.
Richard remembers, 'As a child, he was always so tender and friendly.'
Every month, he consistently donated to a boys' home and provided scholarships for underprivileged students to attend university. However, as his dementia progressed, he grew increasingly confrontational, leading to daily conflicts.
Minor disagreements turned into constant conflicts, encompassing both emotional outbursts and physical altercations. The individual Richard formerly admired appeared to drift farther from him, with scarcely anything he could undertake about it.
During the last half year before John’s passing, Richard found himself with even fewer options for action. He would hear his father struggle to breathe as he received nutrition via a feeding tube. Richard often woke during unusual hours of the night, perpetually anxious that this might be when his father took his final breath.
It marked the gloomiest phase of his existence. Richard was grappling with his heart ailment and had to be perpetually medicated during this timeframe.
Unhealthy or dark musings are not rare occurrences for individuals. fatigued caregivers . According to the Ministry of Health , physical disabilities along with mental health issues like depression and various life stresses increase the likelihood of suicide among older adults.
As a patient’s condition worsens, a caregiver increases their efforts. With no respite or assistance, weariness gradually sets in. Food remains untasted, slumber becomes restless, and tiredness starts to define daily existence.
Fostered on the foundation of filial piety In Singapore, caregivers—regardless of whether they volunteer for the role or not—are burdened with immense expectations, frequently at the expense of their own health and happiness.
For individuals looking after dementia patients, the weight of responsibility is particularly heavy. As their beloved family members drift away into oblivion, ensnared by the mist of forgotten recollections, the caretakers also start to feel a sense of loss and disconnection.
When they begin to overlook their own needs, they lose sight of the fact that they also deserve attention and care.
The Initial Step Is The Toughest
Richard concedes retrospectively that maybe his father's dementia had started earlier than they thought. However, he remained unaware since "he didn’t have a clue about dementia."
Only after a certain day did Richard find himself riding with his dad during a trip to his workplace in Tuas. His father, who once commanded ships at sea, had always been adept at navigation without needing a GPS system.
However, on that particular day, his father circled about in random loops with evident confusion. It was at this juncture that Richard realised something was amiss.
"I contacted a neighbor, who fortuitously had cared for a family member with dementia. She suggested I take my father to the polyclinic for an examination," Richard remembers.
Under the pretense of a "routine examination," Richard took his father to the polyclinic for an overall assessment. Following several tests, his father received an official diagnosis of dementia.
He couldn’t even consider putting his father in a nursing home. What if the care wasn't adequate? How would his father’s meals be handled? Would he feel at ease there?
"I wish to repay everything he has bestowed upon me over the years," Richard says. He owes his life to John, the British man who welcomed him into his home at age 21.
Richard had a tough upbringing. Born as one of 12 children in a run-down place in Chinatown, he struggled with speaking English. During his teenage years, he fell in with the wrong crowd and began using drugs excessively.
His adoptive father rescued him and provided a fresh start, instructing him in English and endorsing his artistic pursuits. This backing molded his destiny—Richard later achieved career triumphs and ultimately earned an award for his sculptural work.
This is what motivated Richard to dedicate himself entirely to caring for his father—a responsibility he wholeheartedly accepts, despite acknowledging that it required tremendous patience.
The coronavirus lockdown intensified Richard’s stress as a caregiver. What used to be daily strolls around his neighborhood in Jurong East became limited to just the confines of their house. He felt trapped. Despite Richard’s repeated efforts to inform his father about the necessary quarantine measures, his dad remained restless.
Finally, he was left with no choice but to come up with excuses like grass-cutting and ongoing construction work so that his father would cease insisting they leave the house.
To compound the issue, his father was hospitalized in a public facility due to pneumonia. Given his father’s unpredictable and aggressive actions stemming from dementia, Richard understood that being present would help soothe him. Nevertheless, under the constraints imposed by Covid-19 restrictions, this wasn't possible.
I didn't want the nurses to handle him because I was concerned about the safety of the hospital staff," Richard explains. "As soon as he becomes aggressive, he ends up hitting the nurses. I made sure to inform them about this.
Sadly, on two different instances, Richard’s father lost his temper and assaulted the nurses, resulting in one of them having a bruised arm.
During another instance, the physician aimed to take a blood sample from his father for examination. Upon Richard volunteering to assist, the doctor just responded with: "I'm an expert; I understand exactly what needs to be done."
Just as though someone had signaled him, his dad moved his arm towards the doctor, snapping the needle. Blood sprayed all around.
Richard could only observe as his father thrashed about in agony. Sadly, they needed to repeat the entire procedure from scratch. On this occasion, Richard held his father close to soothe him. During the second attempt, things went far more smoothly. Nonetheless, the ordeal left an unpleasant aftertaste for Richard.
"I'm frustrated. Is this really how family-centered care works? How come the doctors and nurses couldn't rely on me—the person familiar with my dad’s medical history? Ultimately, my father endured unnecessary suffering," he states.
Seeing his father in such condition was agonizing for him. To Richard, sorrow arrived not like a sharp shock but more akin to an insidious unraveling over time. Unlike death which can provide a definitive end, dementia gradually strips away one’s sense of self. While the physical form persists, aspects of personality such as humor, tales, and subtle insights vanish incrementally from this world.
The burden of emotion felt overwhelming. Regardless of his abundant love, Richard realized he wasn't strong enough to face this journey solo. What options are available for someone who cares exclusively for a parent suffering from dementia when they require support themselves? Who could truly grasp the intricacies involved?
Reaching Out
Pushed to the limit, Richard resorted to drinking alcohol as a way out—consuming three to four cans of beer daily, and even more during exceptionally stressful times. However, internally, he understood that unless he cut back, he was teetering on the edge of losing his grip entirely.
The ongoing emotional rollercoaster—one minute consoling his frightened, inner-child-like senior father, then having to fend off uncontrollable fury—had Richard precariously balanced on the brink.
He spent many grim evenings sitting alone, his hands tight fists as his mind whirled off to uncharted territories. Filled with resentment, guilt, and helplessness, these emotions became so entangled within him that distinguishing one from another was impossible.
How can he grieve for someone who is still alive, still seated right across from him, yet whose thoughts appear to be somewhere far out of his grasp?
Finally, he contacted a counselor at the Health and Mind Clinic of a polyclinic to discuss how he was coping with his father’s situation. During one of his final visits, Richard confided in her regarding his suicidal thoughts.
"Quietly, I expressed my feelings to her. I informed her about stopping alcohol consumption. I intended to seek assistance. However, instantly, she replied that I should consider admitting myself to the Institute of Mental Health," Richard says with exasperation.
Richard couldn’t possibly leave his father unattended. Considering how long it might take to get a consultation at IMH, who would look after his father’s unpredictable nature if he needed unexpected hospitalization there? So, he declined the counselor’s offer.
As these thoughts swirled around in Richard’s mind on the bus ride home, a phone call from the police interrupted him, demanding that he return home immediately.
Richard recalls his heart pounding fiercely. Has the counselor he spoke to contacted the relevant authorities about his thoughts of suicide?
Upon arriving at his house, Richard encountered four police officers stationed near his doorway. He begged them to allow him to remain at home since his father depended on him.
Despite his efforts, Richard had no option but to adhere to their demands. As he walked towards the police vehicle, he could sense his neighbors watching him.
"I felt as though I were a criminal," he remarks.
Ultimately, it turned out to be an unnecessary journey. The physician at IMH could not identify any issues and released him shortly after his arrival.
To this day, Richard remains upset about how he was treated when all he wanted was assistance.
Afterwards, Richard swore he would never again reveal the truth or express his feelings to any physician.
I'm worried that if I proceed, I'll end up being detained without cause once more.
Richard’s dad didn’t have any relatives he kept in touch with, and even though Richard got along well with the people living on his floor, he decided against asking for their assistance. He believes it wouldn’t be right to impose his problems onto someone else.
Nevertheless, he required assistance—as the procedure did not go without a hitch.
Regardless of numerous appeals made to the relevant authorities because of the unusual aspect of hiring a foreign domestic worker, Richard remained far from obtaining a male assistant for his father.
"After attempting for nearly two years, I felt like giving up. It was only through the efforts of Dementia Singapore and a doctor from the National University Hospital advocating on my behalf that my request for a malehelper was finally approved," he explains.
Eventually, Richard was permitted to employ two male assistants. With this burden removed, he understood it was crucial for him to concentrate on his own well-being now.
Helping Yourself Help Others
Ultimately, Richard participated in a caregiving course called C2C, organized by Caregivers Alliance Limited. The program he joined was tailored specifically towards dementia education for caregivers.
The sessions assisted him in grasping some of the behavioral challenges his father faced, and conversely, Richard received emotional support from the team as well.
"I recall they would reach out merely to inquire about my well-being and learn how I was coping. It brought me relief knowing that someone took the time to listen and converse with me," Richard shares.
I no longer felt isolated. I understood where to turn for assistance.
The significant effect was strong enough that he felt compelled to give back, even following his father’s death three years prior. Nowadays, Richard greatly appreciates dedicating his time to volunteer with Dementia Singapore and Caregivers Alliance Limited.
Even though he no longer works as a caregiver, Richard stays deeply involved with the community at Caregivers Alliance Limited. He frequently attends their classes and events to share his experiences, providing candor, support, and valuable wisdom gained from his journey.
He conducts workshops for other caregivers, offering them a special opportunity to leave their houses, get some respite from their responsibilities, and meet people who truly comprehend what they're experiencing.
There shouldn't be any shock that Richard has become a staunch supporter of caregiving assistance. He recalls how bewildered he initially felt regarding dementia and what steps were needed to care for his sick father. Without the organizations that supported him, he might still be fumbling through the darkness.
"You may believe you're not prepared just yet, or that caregiving responsibilities could never befall you. Perhaps you'd argue that your parents won't develop dementia. Nonetheless, I will persist in advocating for future caregivers to gain access to essential information, resources, and emotional support, ensuring these are available whenever needed," Richard explains with a grin.
Self or for Others?
Taking care of someone requires a lot of work and, in most situations, can be quite expensive—particularly when you also have to balance your own life and job responsibilities.
To Richard, it transcends the routine aspects of being a caregiver. He also grapples with witnessing the diminishing sparkle in his father’s eyes, supplanted by confusion, dread, and sudden bursts of rage. The gentle soul who formerly instilled in him a sense of worthiness and supported his aspirations towards artistry transformed into an unfamiliar figure who occasionally regarded him with mistrust, perhaps even animosity.
However, those days have turned into a far-off recollection. In June 2022, John Ashworth gently departed this life at home, embraced by family and friends. As Richard scans his surroundings, memories of his dad during their last several months flood back, causing him to shed tears.
"My greatest remorse is that I wasn't able to do more for him; however, I am aware that I did everything I could," Richard says, his voice breaking.
If Richard had succumbed to his struggle with alcohol addiction or yielded to the despair of his suicidal urges, he would have been unable to be present for his father during his last days—an farewell that held immense significance.
Richard highlights the importance of having a robust support network—if this safety net is missing, a challenging path becomes almost insurmountable. Ultimately, nobody can give from an emptiness within themselves.
We're not seeking special treatment," Richard asserts firmly. "I've brought up these issues with clinics, doctors, and nurses, yet nobody seems to be taking any action.
It's typical to find yourself pulled between duties and self-care, but it's crucial to acknowledge your boundaries. Understanding when to withdraw isn't a sign of frailty; it's essential for endurance. You can have profound affection yet still be aware when you're depleted.
Helplines in Singapore
Samaritans of Singapore (SOS) Emergency Hotline Call: 1-767 IMH Hotline Call: 6389 2222
Caregivers Alliance Limited at the IMH Caregiver Support Centre
Contact: 6388 2686 / 6388 8631 (Monday through Friday, except for public holidays, from 9 AM to 5 PM)
Support Services for Caregivers – Dementia Singapore
Call: 6377 0700
National Care Hotline
Call: 1800 202 6868
Singapore Association of Mental Health (Free-of-Charge Helpline for Counseling Support)
Call: 1800 283 7019
ec2 online counselling
Visit:
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This tale was delivered to you courtesy of Lien Foundation .
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