JUL−AUG 2015 Changi General Hospital Magazine A HEALTHIER, HAPPIER LIFE 中文由第26页起 WORK IT RIGHT IN THE GYM 8 common mistakes you should avoid JUST A PINCH OF SALT Watch out for hidden sodium in common foods PLANNING FOR THE FUTURE Rest easy with a Lasting Power of Attorney CGH celebrates our veterans’ lifetime of service SALUTING OUR PIONEERS
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Changi General Hospital Magazine · yourself in case you cannot make decisions for yourself one day (page 18), I hope you will pick up something useful. Wishing all you dear readers
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
JUL−AUG 2015 Changi General H o spi t al Magazine
A H E A LT H I E R , H A P P I E R L I F E
中文由第26页起
WORK IT RIGHT IN THE GYM8 common mistakes you should avoid
JUST A PINCH OF SALTWatch out for hidden sodium in common foods
PLANNING FOR THE FUTURE Rest easy with a Lasting Power of Attorney
CGH celebrates our veterans’ lifetime of service
SALUTING OUR
PIONEERS
A Note fr om the Editor Our nation turns 50 this August! As we look back on the road we’ve
travelled, CGH pays tribute to our own pioneers, who share the memories of all their trials and triumphs (page 8).
We continue to bring you tips to help you lead a healthier, happier life. Be it getting the most out of your workout (page 14), or learning how you can safeguard yourself in case you cannot make decisions for yourself one day (page 18), I hope you will pick up something useful.
Wishing all you dear readers the best of health, and for Singapore, many glorious 50 years ahead!
EDITOR’S NOTE
Poon Jing TingEditor
Supervising EditorLim Ee GuanEditor Poon Jing TingContributorsElizabeth Soh Elena OwyongTranslators Yip Laimei Elena Owyong Ho Seo TeckPhotographer Andy HoDesign & Production Publicitas PublishingEmail: [email protected] Specialist: Merlyn Hor Email: [email protected]
Go Green!This publication was printed on paper produced by an environmentally-friendly mill and pulp obtained from sustainable forests.
Share your copy of with others or recycle it. is also available online at www.cgh.com.sg/CARING
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is published bi-monthly for Changi General Hospital by Publicitas Publishing
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MCI (P) 122/01/2015. Company registration number: 198904226R. All rights reserved. No part of this publication can be reproduced in any form or by any means without the permission of the publisher. The views and opinions expressed or implied in are those of the authors or contributors and do not necessarily reflect those of the publisher.
USEFUL NUMBERS
Pharmacy enquiries 1800 787 8787
Feedback 1800 850 2823
Appointments and general enquiries 6850 3333
CONTENTSISSUE 137
JUL – AUG 2015
02 JUST A PINCH OF SALT Watch out for hidden
sodium in common foods
04 OBSESSIVE COMPULSIVE DISORDER Break free from OCD with the right treatment
08 A LIFETIME OF CARING CGH pays tribute to two of
our pioneering staff
14 WORK IT RIGHT 8 common gym mistakes to avoid
18 PLANNING FOR THE FUTURE
Get peace of mind by making a Lasting Power of Attorney
22 YOUR SAY
23 SUBSCRIBE TO CARING
25 HEALTHY EATS Stuffed mustard
cabbage boats
26 少点盐,多点健康 注意日常饮食中所摄取的钠
28 一生的奉献 樟宜综合医院向两名建国一代
职员致敬
32 强迫症 适当的治疗可让患者重获新生
36 未雨绸缪 立一份持久授权书,以为将来做
好打算
40 吃出健康 鸡肉馅芥菜小舟
Feedback 1800 850 2823
08 28
18 36
25 40 04 32
2 J U L– A U G 2 01 5 C A R I N G
JUST A PINCH OF
SALT Watch out for hidden sodium
in common foods
Sodium is a mineral found naturally in food. However, most of the sodium we consume comes from salt and sauces that are
added during processing and meal preparation.
WHY IS REDUCING SODIUM INTAKE IMPORTANT? It is recommended to consume less than 2,000mg of sodium per day, the equivalent of one teaspoon (5g) of salt. This is because we only need a small amount of sodium to maintain a normal fluid balance. Excess sodium acts like a sponge to retain water in your body. This leads to an increase in blood volume, which increases your blood pressure.
Excessive sodium intake is a key risk factor for the development of high blood pressure, which increases the risk of stroke, heart attack, heart and kidney failure. Studies have shown favourable effects when daily sodium intake is reduced in people who have kidney, heart or liver problems.
TIPS TO REDUCE SODIUM IN YOUR DIET
WHEN EATING AT HOME
+ Choose fresh food such as fruits and vegetables, meat, poultry and fish.
+ Limit processed food such as canned, salted, cured, smoked or pickled food or convenience/pre-packaged food.
+ Try seasoning food with natural flavourings such as:
• Fresh or dried herbs (parsley, coriander, mint, basil, onion, garlic, ginger, chive and spring onion)
• Spices (cinnamon, cardamom, cumin, pepper, curry powder, five spice and chilli)
• Vinegar, lemon, lime or fruit juices• Sesame oil or olive oil
+ Cook with tomatoes, corn, mushrooms, celery or carrot to enhance flavour naturally.
+ Taste food first before adding salt and/or sauces. If needed, add sparingly. Gradually reduce the amount of salt and sauces added in cooking and at the table for your tastebuds to adapt.
+ Substitute salty snacks such as potato chips and salted nuts with fresh/dried fruits or unsalted nuts.
WHEN EATING OUT
+ Ask for less or no gravy.+ Ask for less or no salt/sauces in cooking.+ Avoid drinking the soup when having
soupy dishes.
Text by Dietitic and Food Services, CGH
FOOD SERVING SIZE
AMOUNT OF SODIUM (MG)
HEALTHIER OPTIONS / AMOUNT OF SODIUM
Salt 1 teaspoon 2,000
Season with natural flavourings, such as
herbs and spices with less sodium
Stock cube 1 cube 1,840
Monosodium glutamate (MSG) 1 teaspoon 620
Oyster sauce 1 teaspoon 345
Light soy sauce 1 teaspoon 365
Dark soy sauce 1 teaspoon 200
Chilli sauce 1 teaspoon 70
Tomato ketchup 1 teaspoon 60
Remember… you only need 2 ,000mg of sodium a day!
+ Limit sauces or adding extra salt at the table.
+ Choose plain rice instead of flavoured rice.
WHEN SHOPPING FOR FOOD
+ Read the food labels, compare and choose products which contain less sodium such as those labelled as “reduced salt”, “low in salt”, “no added salt” or “salt-free”.
HEALTH NOTES
+ Choose products with the Healthier Choice Symbol, which contains less sodium than similar products in the same category.
+ Avoid choosing products that list salt or sodium as one of the first three ingredients on the ingredient list.
+ Salt substitutes may help you cut back on sodium. However, they are high in potassium and may not be suitable for some medical conditions. Check with your doctor, dietician or pharmacist before using salt substitutes.
Chinese salted cabbage 100g 1,860 Fresh cabbage (34mg)
Chicken rice 1 plate 1,290 Opt for plain rice (10mg)
CANNED/
PROCESSED FOODS
COMMON LOCAL DISHES
SODIUM CONTENT IN COMMON FOODS
SAUCES AND SEASONINGS
Source: Health Promotion Board
4 J U L– A U G 2 01 5 C A R I N G
OBSESSIVEText by Dr Poon Ngar Yee, Associate Consultant,
Psychological Medicine
OCD behaviours may seem uncontrollable, but with the right treatment, you can break free!
COMPULSIVE DISORDER
4 J U L– A U G 2 01 5 C A R I N G
In the movie As Good As it Gets, Jack Nicholson plays a character with Obsessive Compulsive Disorder (OCD). Obsessed with the fear of contamination, he wears gloves
whenever he leaves his home and is constantly seen using hot water and bars of soap to wash his hands.
Another obsession is doubt. He needs to constantly assure himself that his door is securely locked and that the switches in his apartment are switched off when he leaves the house, so he turns his locks and flips his switches a fixed number of times before he is satisfied.
HEALTH NOTES MENTAL WELLNESS
6 J U L– A U G 2 01 5 C A R I N G
All this might seem strange and even laughable to us but for those suffering from OCD, it is something they cannot control. DYSFUNCTIONAL THOUGHTS AND BEHAVIOURS OCD is more common than most people realise. According to the Singapore Mental Health Study in 2010, around three in 100 people in Singapore suffered from OCD at some point in their lives. It is the third most common mental disorder in Singapore (after depression and alcohol abuse).
OCD is an anxiety disorder that is characterised by:
Thoughts that make a person anxious (obsessions)
Anxiety the person feels as a result of the obsessions
Behaviour rituals (compulsions) the person does to reduce anxiety
Obsessions can come in the form of thoughts, images in the mind, or doubts. Common obsessions include:
Fear of contamination Doubts about electrical appliances being switched off, or doors being properly locked
Sexual or violent themes that are out of character for that person
Brooding over and arguing with themselves even when making simple decisions
OCD is an anxiety disorder that makes one feel fearful or guilty, and compels one to perform certain behaviours
Dr Poon Ngar Yee is an Associate Consultant in Psychiatry at CGH. She received her MBBS from the University Of London. She completed her psychiatry specialist training in Singapore in 2014. Dr Poon is a member of the Royal College of Psychiatrists.
HEALTH NOTES MENTAL WELLNESS
Although these thoughts are unwelcome, they repeatedly intrude into the sufferer’s mind, against their will.
As a result, a person with OCD may feel anxious, fearful, guilty or a combination of these. In order to reduce these intense feelings or to prevent a feared outcome, a person with OCD is compelled to perform certain acts or rituals such as checking or washing, as coping strategies to ‘neutralise’ these bad feelings.
Initially, they may feel less anxious or guilty after compulsive acts or rituals. However, in the long run, these ‘coping strategies’ will actually reinforce the person’s irrational need for these behaviours in the first place! As a result, these poorly formed 'coping strategies' merely perpetuate the person’s OCD and further disrupt the person’s quality of life and daily activities.
BREAK FREE! The exact causes of OCD are unknown, but there are some possible contributing factors. These include one’s genetics, a chemical imbalance in the brain, stressful life events, personality traits such as perfectionism, an extremely strong (possibly dysfunctional) sense of responsibility, or a ‘worst case scenario’ mindset.
Sadly, many people with OCD do not seek professional help, believing that their obsessions and compulsions simply cannot be controlled, and instead try to cope on their own. The good news is that treatment is available with the symptoms of OCD is available. A combined approach using medication, behaviour and cognitive therapy is often effective in treating OCD.
Medication One of the causes of OCD could be an
imbalance of a brain neurotransmitter called serotonin. So, Selective Serotonin Reuptake Inhibitors (SSRIs) like Prozac, Setraline and Faverin, or anti-depressants like Clomipramine, have been shown to improve and control OCD symptoms effectively.
Often where the clinical improvement is partial, the addition of one or more drugs can help improve the results. Higher doses of these medications may also be required. These medications are generally safe and non-addictive in nature. However, some people could experience side effects such as headaches, feeling ill, or having ‘dry mouth’ in the initial stage of the treatment.
Exposure and Response Prevention (ERP) therapy
The basic idea behind ERP therapy is that when a person is exposed to an anxiety-provoking situation, the person’s anxiety level would initially increase and then subside if the exposure duration is sufficient enough. ERP therapy combines exposure – confronting the thoughts, images, objects or situations that trigger anxiety in a person with OCD – with response prevention, which involves training and helping the person refrain from carrying out their typical compulsive response when exposed to these anxiety triggers.
Cognitive Therapy Often, persons with OCD know that their
thoughts are irrational but they are not able to control them. In this form of therapy, the sufferer’s illogical beliefs are highlighted to
them and are challenged on rational grounds using various techniques,
such as identification of their dysfunctional thinking, helping
them explore their ability to generate alternative thoughts and responses, and empowering them to be able to test these alternatives out in practical situations.
If you know of someone who suffers from OCD or are
struggling with OCD yourself, remember that with appropriate
treatment, people with OCD can break free from dysfunctional beliefs
and begin to lead normal, productive and abundant lives!
8 J U L– A U G 2 01 5 C A R I N G 8 J U L– A U G 2 01 5 C A R I N G
CARING
Between plaster technician Joseph Wee (left) and orthopaedic surgeon A/Prof Low Boon Yong, they have given nearly 100 years of service to public healthcare
CGH pays tribute to two of our pioneering staff
Text by Poon Jing Ting, Editor
COVER STORY
As Singapore celebrates its 50th birthday, it is fitting to pay tribute to the pioneers who toiled during the early years to literally build the nation. CGH too, remembers our veteran
staff who have given over 50 years of dedicated service to healthcare and witnessed all the hospital’s milestones. Let’s walk down memory lane with two of our amazing pioneers. To all the pioneers, thank you and we salute you!
The Old Changi Hospital in the 1990s
A LIFETIMEOF CARING
1 0 J U L– A U G 2 01 5 C A R I N G
MENTORING A NEW GENERATION OF PHYSICIANS
A/Prof Low Boon Yong planting a tree in CGH in the 1990s to raise funds for needy patients
Associate Professor Low Boon Yong, 69, is a senior consultant in orthopaedic surgery. When Toa Payoh Hospital and
Changi Hospital merged to form New Changi Hospital in 1996 (later renamed Changi General Hospital), he was the Chief of the Accident & Emergency (A&E) Department. The A&E now is always so crowded and busy! Was it like that in the past as well? A/Prof Low: Oh, we were very, very busy. I was Chief of A&E in Toa Payoh Hospital before coming over as well, and there were about 80 patients a day. When we came over to New Changi Hospital, there were 300 to 400 patients every day. It was a huge difference. And we had no computers then. Wow, managing the busiest department in the hospital with everything done manually, is not easy. How did you lead the department’s transformation and modernisation? A/Prof Low: Well, it was not too difficult. Many of the doctors and nurses were young, and could pick up the new system, though I myself am not so adept at it (laughs). We were actually one of the first hospitals in Singapore to establish a fully computerised system in A&E. Many who have worked with you before say that you are a good mentor, and some of your protégés are now holding senior positions all over Singapore. In fact, the current Chief of Orthopaedic Surgery, Dr James Loh, says he is grateful that you gave him a second chance when he was once deemed unsuitable for orthopaedics as a young doctor. Can you share with us your philosophy behind mentoring young doctors? A/Prof Low: I don’t need to do much. All of them are bright people, like James. All talented people. We just need to recognise their interests, help them see the bigger picture and shape their ideas.
What about outside of work? Do you have any personal pursuits or hobbies? A/Prof Low: I have been volunteering with the Spastic Children’s Association of Singapore for many years. These children need a lot of help. It’s common for them to have orthopaedic issues such as difficulty in walking and sitting. Beyond that, helping them find good jobs so that they can take care of themselves, become a little independent and integrate into society – that’s very important. We reach out to companies to allow some of them to set up booths selling simple craft. There’s one in CGH, too. They can make a few hundred dollars each month, which is enough for them. It makes them happy. After such a long and illustrious career, are you looking forward to when you can finally retire? Any post-retirement plans, like travelling around the world? A/Prof Low (laughs): I have a lot of plans actually! I have ideas about the hotel industry, F&B, childcare… you know, becoming an entrepreneur. There’s a lot to do. Sounds like a very busy and exciting retirement! Finally, what would you like to say to Singapore as we reach this significant milestone of 50 years? What would you like to see in the future? A/Prof Low: I hope that every Singaporean can have good health coverage. It’s very important to have peace of mind, especially when you enter into old age.
COVER STORY
“We need to recognise (young doctors’) interests, help them see the bigger picture and shape their ideas.”
1 2 J U L– A U G 2 01 5 C A R I N G 1 2 J U L– A U G 2 01 5 C A R I N G
Plaster technician Joseph Wee has worked in many departments in his 56 years in healthcare, including a stint in a mobile dispensary in the 1960s (opposite page)
COVER STORY COVER STORY
kinds of people in my 56 years in healthcare. I help out not just in the clinic, but also in the wards and in A&E (Joseph is one of two plaster technicians in CGH). Sometimes, I’m also asked to train nurses and medical students in cast-making.
Every day at work is interesting to me. I will continue to work as long as I am needed here.
How about your personal life? Do you have any hobbies you enjoy? How do you relax outside of work? Joseph: I cook for my family, when I have time. My favourites are ayam buah keluak, babi pongteh… because I’m Peranakan, you see. I also go to the airport every weekend, just to walk and look around. Singapore is turning 50! Any wishes for the nation or even yourself? Joseph: I wish Singapore all the best. Personally...I hope my grandchildren marry and have children! (laughs)
"I rotated among different departments such as housekeeping and dispatch. I also travelled to villages with the mobile dispensary, to bring medication to sick people in the villages."
Joseph Wee, 76, is a plaster technician with CGH’s orthopaedic clinic. He was with Changi Hospital through the handover from
the British armed forces. What was it like during those days? Joseph: We were a very small team, fewer than 10 of us. As more and more of the (British) troops left, there were fewer patients too. Some days, there would only be one patient a day! So what did you do before that? Joseph: I joined SGH in 1959. Those days, we were called medical health servants. My starting pay was only $97 a month! We didn’t even get paid for the first three months during probation. We had to borrow money from seniors to survive.
At SGH, I rotated among different departments such as housekeeping and dispatch. I also travelled to villages with the mobile dispensary to bring medication to sick people in the villages. After that, I also worked at Middle Road Hospital and the Police Academy, working as a telephone operator and medical records keeper. Tell us more about your job at CGH. What are some of the challenges you face and what keeps you going? Joseph: I am a plaster technician in Clinic U (orthopaedic clinic). I help patients apply and remove casts for hand and leg injuries. Depending on where the injury is, the swelling can be quite big sometimes and it can be tricky. I have to assure patients who are scared – no, it’s not painful; you need to have the right technique.
We can also be very, very busy. Sometimes, we can have a few hundred patients each month. Most of them are okay, but now and then, you get unappreciative patients or even if the patient is nice, their family members can be nasty. But I’m used to it. I’ve already seen all
APPLYING THE
HEALING TOUCH Ministry of Information and the Arts Collection, courtesy of National Archives of Singapore
WORK IT
Text by Tong Yuyan, Sports Trainer, Singapore Sports Medicine Centre
8 common gym mistakes to avoid
RIGHT
1 4 J U L– A U G 2 01 5 C A R I N G
Hitting the gym is getting more popular these days, but work out the wrong way and you could undermine the
effectiveness of your workouts, or even injure yourself. Here are eight points to note.
DID YOU WARM UP AND COOL DOWN?
Warming up before exercising is an important transitional phase to increase your body temperature. This allows the body to adjust to the changing demands imposed during the exercise session and decreases the potential for muscle soreness following exercises. Heart rate and blood pressure tend to be higher following exercises and metabolic end products are produced from the muscles used during the workout. Not only does cooling down allow a gradual recovery of heart rate and blood pressure to normal, it enables the muscles to contract and assists the heart in clearing out ‘waste products’ in the body system produced from exercise. Both warm up and cool down are typically done at a minimum of 5–10 minutes between low to moderate intensity.
IS YOUR FORM AND TECHNIQUE CORRECT?
Exercising with poor form and technique is both ineffective and potentially dangerous. You may not notice the effect, but over time, poor form or technique can result in injuries. Always progress gradually and execute the exercises through the full range of motion for maximum muscular development. If your form is compromised, reduce the weight and practise the correct exercise movement before progressing. Even something as seemingly simple as using a jogging machine can benefit from advice and instruction.
ARE YOU USING THE CORRECT WEIGHTS?
Many enthusiastic folks tend to try lifting weights that are too heavy for them, with the misconception that “the heavier, the better”. It all depends on your training goals – are you training for muscle size (‘bulking’) or for strength? If your goal is to increase muscle size, you actually should go lighter on the weights but with more repetitions. If it’s for muscle strength, this is usually around 80% of 1 Repetition Maximum (1RM) or greater, with fewer repetitions. 1RM in weight training is the maximum amount of force that can be generated in one maximal contraction. If you are unsure about how to calculate your RM, consult a gym trainer or sports trainer.
ARE YOU RESTING IN BETWEEN SETS?
Research has shown that both acute responses and chronic adaptations to resistance training are affected by the rest interval between sets. However, many often overlook this, using durations that are either too long or too short. For an effective, efficient and safe workout in resistance exercise prescription, it is vital to understand the interaction among training variables such as intensity, number of sets and repetitions, mode of exercise, the speed of performing an exercise and the optimal rest interval between sets. Depending on your training goal, a combination of moderate-intensity sets with shorter rest intervals of 30–60 seconds will be good for muscle hypertrophy (building muscle size), while longer rest intervals of 3–5 minutes with high-intensity sets will be appropriate for strength training.
HEALTH NOTES
Exercising with poor form and technique is both ineffective and dangerous
FEATURE
WARM UP: Try the high kick (opposite page) and butt kick (above) to get your heart rate up. The butt kick should be done in quick succession – left leg then right leg, repeated several times
1 6 J U L– A U G 2 01 5 C A R I N G
Mix up your exercise order, type of exercise and intensity to prevent staleness
DID YOU NEGLECT TRAINING YOUR CORE AND FLEXIBILITY?
Many day-to-day tasks – from picking up items to walking and running up and down the stairs – involve core muscles. The core comprises muscle groups such as the transversus abdominis, multifidus, pelvic floor and diaphragm, running generally from your rear end to your shoulders. Having strong core stability helps protect the spine and surrounding musculature during static and dynamic movements, thus lowering the risk of injury. Movements such as push ups, overhead squats and deadlifts are functional exercises that involve the core. It is important to engage your core and maintain a neutral spine position while performing these exercises.
Following exercise or physical inactivity, muscles may become tight and stiff. Muscle tightness can limit the joint range of motion which affects your exercise performance and increases the risk of injury. So keep your muscles flexible by doing stretching exercises at least 2–3 times a week, for at least 10 minutes each time. Each stretch should last between 20–30 seconds to maintain or improve flexibility.
DO YOU GET SUFFICIENT
REST AND RECOVERY? ARE YOU OVERTRAINING? While it is good to stay active, we must balance it out with adequate rest as well. If there is insufficient
COOL DOWN: Try the forearm stretch and piriformis stretch (below) for your cool-down exercise
SQUATS: Back should be straight, not rounded
OVERHEAD SQUATS: Arms should be straight (at the ear) and not pulled too far back
symptoms of overtraining include a decline in physical performance, insomnia, emotional instability, an elevated heart rate and elevated blood pressure. To prevent overtraining, avoid monotonous training and vary your training with mandatory rest phases. Keep a training log to monitor your progress, noting down items such as the distance, intensity, volume and level fatigue. Significant changes in any of these could signal overtraining.
ARE YOU REPEATING
THE SAME EXERCISES? Just as our brain needs to be stimulated to prevent boredom, the same applies to muscles as well. If we keep performing an exercise in the same manner for long periods of time, this can lead to ‘staleness’ of exercise, and affect performance. Try to mix things up by playing with the exercise order, type of exercise and/or intensity during your workout to prevent staleness.
LADIES – ARE YOU AVOIDING RESISTANCE TRAINING?
There are many benefits gained from doing resistance training. However, most women fear developing bulky muscles so many of them do not use enough weight during resistance training, or worse exclude weight training from their exercise regime altogether! This is a common misconception. A woman would have to do a lot of such exercise and eat a lot for her to become a ‘She-Hulk’! A complete exercise programme for ladies should include some form of resistance training and this maintenance of muscle mass becomes especially important as women get older.
rest and recovery from exercise, body regeneration cannot take place and over time, performance may deteriorate as a result of ‘overtraining’. The impact of overtraining can be serious, requiring weeks, even months to recover. Some signs and
Tong Yuyan is a Sports Trainer and Exercise Physiologist in the Singapore Sports Medicine Centre (SSMC). She works with athletes to improve their sports performance and also assists people who are undergoing rehabilitation and weight loss programmes.
1 8 J U L– A U G 2 01 5 C A R I N G
Get peace of mind by making a Lasting Power of Attorney
FUTURE PLANNING FOR THE
Text by Elena Owyong
1 8 J U L– A U G 2 01 5 C A R I N G
FEATURE
FUTURE FEATURE
James (not his real name) is a 55-year-old teacher at a secondary school. He has been teaching for nearly 30
years and loves his job. In his spare time, he enjoys spending time with his family, especially his son, who has just graduated from university.
At his age, James is considered by many of his friends as fairly healthy. Although he, like his father and brothers, has high blood pressure and high cholesterol, he avoids fried food and tries to squeeze in some exercise when he doesn’t have too many papers to mark.
But one day, James suddenly suffers a major stroke. A few weeks later, he suffers a second stroke. The recurrent strokes severely affects all his functions. He can no longer walk, feed himself or dress himself. Worst of all, his mental capacity
is significantly diminished and he can no longer make decisions for himself.
Devastated, his wife Linda and his son Ryan take over all his affairs. But they disagree on certain things, such as whether James should be admitted to a nursing home or looked after by a maid at home, and what to do about his various bank accounts and investments. All these complex decisions take a toll on Linda and Ryan, who are still in shock at the sudden events. SAFEGUARD YOURSELF AND YOUR LOVED ONES Such a scenario is not uncommon. Even seemingly healthy people can suffer debilitating conditions like stroke, dementia or brain trauma from accidents, which result in them losing their mental capacity.
2 0 J U L– A U G 2 01 5 C A R I N G
The importance of planning for the unforeseeable future cannot be understated. One of the best ways to
safeguard yours and your loved ones’ interests in such a situation is to make a
Lasting Power of Attorney (LPA).What is a LPA? In short, it is a
legal document that allows you to empower someone you trust to make decisions on your behalf, should you lose your mental capacity.
In a LPA, the decision making lies in two broad areas:
Personal welfare. This includes your healthcare, where you live and your social activities
Property and affairs matters. This includes your finances, selling of your house/car, and taxes
Besides safeguarding your interests by officially appointing a trusted proxy decision maker (called a “donee”), the LPA helps alleviate the stress faced by your loved ones as it allows you to detail
the powers that the person(s) you appoint has. MAKING A LPA To sign up for a LPA, you need to apply to the Office of the Public Guardian. The forms are available on its website: www.publicguardian.gov.sg
In the form, you can grant your donee(s) general powers
or customise certain powers, depending on your requirements. The donee(s) must be:
21 years old and above
Cannot be bankrupt (if granted powers to decide on property and affairs matters)
You can appoint more than one
donee. However, complications
A LPA CAN ALLEVIATE STRESS FACED BY YOUR LOVED ONES
FEATUREFEATURE
may arise if there are too many donees and they cannot agree on the decisions to be made. You should choose donees who are able to work out any differences together so there is no deadlock.
The LPA forms must be signed and certified by a certification issuer. This person can be a practicing lawyer, registered psychiatrist or accredited medical practitioner. The Office of the Public Guardian’s website has a directory of suitable certification issuers for reference.
After submission of the forms, there will be a mandatory six-week waiting period, after which your LPA will be registered if there are no objections.
However, this does not mean that all your decisions will henceforth automatically be
made by your appointed donee(s). The LPA will only be used if you lose mental capacity. As long as you still possess mental capacity, your donee(s) should not step in to make decisions even after the LPA is registered.
Up till August 2016, the application fee will be waived for Singaporeans who use the first form – LPA Form 1, which caters to those who grant general powers to their donee(s). Singaporean applicants will only need to pay professional fees charged by LPA certificate issuers. Permanent Residents (PRs) and foreigners need to pay $50.
The information above is provided by the Office of the Public Guardian. To find out more, call 1800 226 6222, email [email protected] or visit www.publicguardian.gov.sg
FAQS
1 WHAT IF I DON’T MAKE A LPA?Not making a LPA means you do not have a donee to make important decisions on your
behalf. Thus, in the event that you lose your mental capacity, your family member or friend will need to apply to the courts to be appointed as your deputy.
2 CAN A LPA BE MADE FOR PEOPLE WITH INTELLECTUAL DISABILITIES? An LPA can only be made by a person with
mental capacity.Parents of children with intellectual disability may apply to the Court to be appointed deputies if the children are likely to be still lacking in capacity after 21 years of age.The parents may also apply to the Court to appoint successor deputies as future decision-makers for their children with intellectual disability in the event the parents are no longer around or are unable to make those decisions.
3 CAN I REVOKE MY LPA?Yes, you can. As long as you have the mental
capacity, you can revoke your LPA. You will need to sign a revocation form, notify all donees as well as the Office of the Public Guardian. A revocation fee of $25 applies.
4 ARE THERE OTHER SITUATIONS WHERE MY LPA OR THE DONEE'S POWERS WILL BE REVOKED?Apart from the revocation (termination) of your
LPA, it will be cancelled or the appointment of the donee will be terminated in the following circumstances:s You or your donee diess Your donee lacks mental capacity to act as a donees Your donee formally declines the appointment s If your donee is your spouse and you get divorced s You or your donee becomes a bankrupt or if your donee
is a licensed trust company, the company is liquidated, wound up, dissolved or under judicial management
s A Court order is made to cancel the LPA or your donee's powers – this can happen if your donee has not acted in your best interest
5 IF I HAVE MORE THAN ONE DONEE, HOW SHOULD THEY DECIDE ON MATTERS ON MY BEHALF?
If you appoint more than one donee to make decisions about the same matters, you can appoint them to either act:s Jointly: The donees have to act together
and cannot act separately ORs Jointly and severally: The donees can
take the decisions together or separately. Both types of decisions are valid.
If there was no specification, the law assumes the donees will act jointly.
2 2 J U L– A U G 2 01 5 C A R I N G
I appreciate the article “Caring for the
Caregiving”. I t reminds us of the self lessness of these caregivers, their physical and mental toi l , and the importance of loving and looking after themselves as much as they care for the family members they look after. I wil l recommend sharing this article with family and fr iends for awareness.
Yeo Xiu Wen Punggol
I really appreciate the article on caregiving. I t is an aspect
that is not often talked about but is very important! I t is not easy to be a caregiver and it is a t imely reminder for us to
take care of ourselves before we can take care of our loved ones. Kudos to that!
Yap Hui Ting Bedok
WE WANT TO HEAR FROM YOUIf your letter is published in the next issue, you’ll get a free Sebamed Shampoo, which is soap-free and alkaline-free for healthier scalp and hair! Send your letter by 7 August 2015: 5 Tampines Central 1, Tampines Plaza #08-01/05, Singapore 529541
YOUR SAY
Caring...Dear
CARING Mar–Apr 2015
ONLINEVisit www.cgh.com.sg/caring to read past issues of CARING – your guide to a better, healthier life!
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C A R I N G J U L– A U G 2 01 5 2 3
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C A R I N G J U L– A U G 2 01 5 2 5
HEALTHY EATS
This dish is easy to prepare, and is low in calories and high in fibre
WHAT YOU’LL NEED Mustard cabbage, with leaves separated, washed and drained (400g)
STUFFING Chicken thigh or drumstick, deboned and diced (200g)
Water chestnuts, peeled and diced (100g)
Prawns, peeled and minced (150g) Spring onion, finely chopped (1) Shallots, peeled and chopped (2) Fresh breadcrumbs (2 tbsp) Salt (to taste) Ground white pepper (to taste) Water (3 tbsp) Egg, beaten (1)
METHOD Trim leafy part off mustard cabbage and discard. Place leaf stalks with hollow side facing down. Using a sharp knife, carve stalks into ‘boats’. Set aside.
Prepare stuffing. In a mixing bowl, combine all ingredients and mix well. Spoon stuffing into hollow of stalks.
Place stuffed stalks in a steamer and steam over high heat for 5–7 minutes, or until stuffing is thoroughly cooked.
Garnish as desired and serve immediately.
This recipe was first published in A Cookbook for Diabetics by a Dietitian and a Chef.
C A R I N G J U L– A U G 2 01 5 2 5
NUTRITIONAL INFO (PER SERVING)Energy 146kcalCarbohydrates 12.4gFat 3.4gCholesterol 139.2mgFibre 4.5g
For more info, visit http://www.easternhealth.sg/homecareassist
Call 6850 2741 to lend a hand today!
As we celebrate Singapore’s 50th birthday,let’s do our part for the needy among us.
tax deduction just for this year!
HomeCare Assist helps needy patients with chronic illnesses orconditions to continue being cared for in their own homes. Thischarity programme is supported by the Changi Health Fund(UEN number 201133557D). All donations are tax-exempted.