COMMENT A relative of mine, who is 64 years old and suffering from dementia, had swallowed about 100 pills while under the care of a new nursing home in SS3 Petaling Jaya, yet the caretaker and owner of the home, could tell his daughter, “Look, your father is still okay!”

Pills of all sorts – 20 pills of Doxazocin (4mg), 10 pills of HCT (25mg), 40 pills of Prozocin (1mg), 10 pills of Amlodipine (5mg), one to two tablets of Micardis (80mg) and another 40 pills of Finmtorzle (5mg) – were swallowed about 2am on Thursday, Dec 11.

About 10am that Thursday morning, I was there with a friend, to visit him. The caretaker had not even mentioned a word about the incident that had happened in the very early hours of the day. All that he said was that this relative of mine is “super-super crazy” and he could no longer accept him at the nursing home.

About noon, when the relative’s daughter was there to pick up her father for a doctor’s appointment at University Malaya Medical Centre (UMMC) at 2pm, I was told that the caretaker finally broke the news.

What shocked me the most is when I heard that the caretaker was not even remorseful when he counted the number of pills swallowed; and what was more shocking is that the medicines were never locked away. This was a sheer act of negligence.

Although this is a new nursing home, there is no excuse for the medicines not to be under lock-and-key. This is a basic rule of thumb in a nursing home, where the residents are prone to any untoward incident.

When the doctor was told about the incident, some 13 hours later, the relative had to be hospitalised immediately. He has been in hospital for over a week now.

What is incriminating is that the caretaker had personally taken the boxes to show the doctor, and gave her a full list of the medicines swallowed by my relative.

From Seremban to Petaling Jaya

Two years ago, this relative was placed in a nursing home in Seremban, where there are over 30 residents in a single-storey bungalow house near the Seremban Hospital.

He was restrained to the chair, and soaking with urine, yet no one changed the pants for him. He was totally confused, and wondering why he was being restrained to the chair.

When we wanted to take him out for breakfast, the Indonesian maid asked him to remove his trousers in front of some 20 other residents sitting down in the living room. How undignified! My friend immediately intervened, and asked him to be taken into a room to change.

In Seremban, the family was paying about RM800 to RM900 per month. Because of the condition that he was in, we took him to another nursing home in Damansara Perdana, where we thought he would be given better care.

There, he was bashed up by the caretaker. At that juncture, I was still defending the caretaker thinking that he had just lost his temper after being punched by this relative. No police report was lodged, and the relative continued to stay there.

Admittedly, aggressive form of dementia is not easy to take care, because the patient can be still physically strong. In his case, he can punch people in between the eyes if you do not know how to handle him. After nearly a year of learning from experienced people, I have finally overcome my own fears.

All you need is some proper medication, and a technique of persuading him. It takes a lot of patience, but it is not impossible to help him feel secure under your care. Yet, most nursing homes would not accept him, the moment they know he can be aggressive.

When this caretaker decided to start his own, the owner of the nursing home in Damansara Perdana immediately told the daughter that her father has to leave the place. Within a short span, we had to scout for nursing homes.

Most would not accept him, and even if they do, it would cost more than RM2,000 per month. With another RM1,100 per month for the medicines, it is taxing on the two siblings funding their father’s stay in the nursing home.

This sum does not even include the cost of miscellaneous items such as pampers, which alone could easily cost RM200 to RM300 a month.

One nursing home finally accepted him, but the monthly fee is RM1,300. The first night he was there, the nursing attendants told his daughter that he walks around too much. The residents had complained about his behaviour; therefore, they had to restrain him to the lazy chair.

We were told by his roommates that at night, he was still being restrained to the lazy chair, without being transferred to the bed. If this true, imagine him having to sit on the lazy chair day and night!

Relief, but no relief

When the caretaker finally set up his home, and he was willing to take on my relative, the family thought it was a relief. Charging RM1,600 per month, it was already taxing to the family but they had no choice because the other nursing homes would not accept anything less than RM2,000 a month.

It is understandable, since any nursing home set up would have to be commercially viable and there are a lot of costs involved, but the fees become a burden to children.

Within less a week, this is when the tragedy happened. The rest is history!

But what baffles me is the way how the caretaker and owner of the nursing home responded to advice given by the experts.

When he was given a severe round of reprimand by the UMMC doctor, he walked out of the Emergency Ward, refusing to listen to the doctor again.

When my friend advised him how to tackle the challenging behaviours of this resident, he immediately told us that he has experience looking after 500 elderly people. Of course, later, we found out that it was nothing but one big fat lie!

This caretaker had joined the nursing home in Damansara Perdana for only two years. He had come without any experience in looking after elderly folk.

For the mistake that he had made in not locking up the medicines, we would have given him the benefit of doubt - only if he had reported to the relative’s daughter first thing in the morning.

Nothing was done, and the caretaker could still say the medicines were not harmful to the relative.

Now, that my relative is not to be placed there, we hope that he will at least find some solace in another new nursing home where he will be placed upon discharge from the hospital. All we want is for him to have a few more good years of his life. For dementia, or Alzheimer’s disease, we know that his condition can only deteriorate with time, as the brain shrinks.

Part 2: Miserable state of some nursing care homes

STEPHEN NG is an ordinary citizen with an avid interest in following political developments in the country since 2008.