I had dinner with my classmates a few weeks ago. Yes, the class of SNC’78.

I’m glad I did. I almost didn’t as I only had a two-hour window, and I didn’t want to be that party pooper who had to leave early. Particularly as I hadn’t seen this lot in a while. And, I wanted to learn about our friend, who passed away in late April from some of them, who were present and helped selflessly at the hospital and with the funeral arrangements.

Catching up was sad, fun and enlightening. I didn’t know this. One friend has elderly in-laws living with her and her family. Another, who is still working, jointly cares for her over 94-year-old mum with her sister. The third friend, who lives in England, recently returned to celebrate her older sister’s birthday. Diagnosed with dementia, the sister, who was a resident at a ‘reputable’ care-home up north, had developed serious bedsores that needed immediate attention. With the assistance of our mutual classmates, she transferred her sister to a new care-home in Penang. At quite a scarily high cost of RM16,000 per month. Even for her, when converted in English pounds. Once the medical care for the bedsores was done, the bill per month would/could be reduced to RM7,200. Still high.

I thought I’d be helpful by suggesting a personal caregiver like Kalyani. Not live-in. My friend politely explained that while she liked the idea of the one-on-one attention, 24×7 care and surveillance were needed for her sister’s condition. Personal care would mean at least two caregivers for the day and night shifts. A helper/staff to organise food, medicines, household items, utilities and general maintenance. And, she’d have to buy or rent a house/condo as the family home was no more. Expenses and considerations. My friend has since returned with her husband to her two children, and a granddaughter in England.

Caregiving made me think of my ex-colleague, who gave up her high-flying job in Jakarta, to help her older sister look after her mum who was diagnosed with Alzheimer’s. The sisters moved their mum to a care-home after their younger brother was unable to cope with the stress of caregiving. The older sister, who has three young children, also houses her elderly dad. Both sisters take turns visiting their mum. 

Back to dinner with my classmates, I thought how unassumingly jolly we all looked and acted on the outside whilst we shouldered real, on-going responsibilities of caring for parents, siblings and in-laws. Not entirely by choice. I say this because I love my mum unconditionally but I also like my time and space to do the things I want, when I want. To have a ‘normal’ life such as spend time with my husband doing nothing or maybe watching TV and not the clock, have leisurely dinners and go on holidays in the spring and autumn when the weather is cool and sun-less instead of going somewhere/anywhere when family visits. Like my friends, who have husbands and their own children, albeit grown-up, and grandchildren. And, just like presumably, everyone else.

My friends and I are caregivers, physically on-site and/or financially. We’ve worked in various professions in our past lives, and are now retired, bar one. Most of us don’t have monthly pensions or regular incomes except for savings meant for our leisure, emergencies, and old age. Hence, my two think-out-loud questions. Who should/must care and for whom? And, should caring be limited to the nuclear family or include the extended family?

‘A nuclear family or immediate/elementary/conjugal family is a social unit that consists of parents and children. An extended family is a social unit that includes parents, grandparents, aunts, uncles, cousins, adult children, and dependent children[1]. This is but one definition. Naturally, different countries and cultures perceive and value family relationships differently.

‘… in more developed countries in particular, intergenerational co-residence has declined dramatically in recent decades. Most older persons in these countries live either in single person households or in households consisting of a couple only or a couple with their unmarried children[2].

Nearer home, my palliative doctor’s paternal great grandmother was 99 until she passed away this year. She was looked after by her daughter who was in her 70’s. Four generations lived/live under the same extended family roof. Hmm…

‘Traditionally the care needs of older persons have been met – for better or worse – within co-habiting extended families and most often by the female members of those families, including older women. Most caregivers – both paid and unpaid, in formal and informal sectors – are women. This is a common phenomenon across regions and across countries of different income levels. Globally, women spend an average of over 50 minutes per day on unpaid care work – such as taking care of children and older persons – more than double the time spent by men[3].

So how?