Social worker Nicodemus Lim and his team at COMNET make headway in the local eldercare industry with innovative ideas and a heart that simply cares.
By Yong Yung Shin
To the untrained eye, the 50-odd residents gathered at the Seniors Activity Centre (SAC) at the void deck of Block 26 in the Sin Ming area look just like ordinary grey-haired senior citizens. Most were chatting with one another; others kept to themselves.
But with one glance, Nicodemus Lim can sift out those battling depression, schizophrenia and dementia, among others. He can also tell you who among them have not been taking their medication, and who is on the brink of a relapse.
Lim is a social worker who heads the elderly support service (COMNET) of the Ang Mo Kio Family Service Centres (AMKFSC). Since Sep. 2010, it has been operating from the void deck of a one-room rental block which has a high incidence of residents suffering from mental health issues. About 300 of this block’s residents are elderly citizens above age 60. In addition to providing weekly care for them, COMNET has serve more than a thousand clients since its inception in 2007.
“When we first began our outreaches, we saw many doors and walls that had been vandalized by residents suffering from mental health and addiction issues who, driven by poverty and hunger, frequently extorted money from their neighbors,” says Lim.
The center became a refuge for the elderly. Over time, it began to address the needs of the perpetrators, linking them up to social agencies and providing them daily brunch since early 2011. In November 2011, COMNET started receiving sponsorship for daily lunch freshly prepared by Jin Shan, a fine-dining restaurant at Marina Bay Sands.
“For a long time, COMNET Elderly Services was the only social work-led eldercare service in Singapore. It actively reaches out to isolated elderly residents, holistically addressing their bio-psycho-socio-emotional-citizenry needs,” explains Lim.
“While the many helping hands approach had worked by spreading the burden and risks among various social services, it can be confusing for the elderly. As social workers, we seek to design a holistic, one-stop, responsive, and accessible service which connects the elderly to community resources and essential social systems,” adds the 33-year-old, who is also on the working group with the Agency for Integrated Care on community mental health protocols.
One of the things that has made COMNET sustainable is its active advocacy for governmental aid and corporate sponsorship in order to make its services free of charge for its beneficiaries. Other than that, its physical location in the immediate vicinity of their beneficiaries allow for more hands-on and frequent care.
“We want to minimize cases these elderly people dying at home alone,” says Lim. His team carries out door-to-door visitations once or twice a week to about 300 isolated and vulnerable elderly.
By forming personal relationships with the community stakeholders such as the police, the Resident Committees and the Community Centres, Lim and his team are able to provide more stable support for their beneficiaries. For example, police patrol the area three times a day. “We’re a tight team. Nobody bullies us,” he laughs.
Its befriending service, undergirded by a Carers Scheme, was highlighted in the Committee of Supply Budget Debate in March as an example of the Asset-Based Community Development (ABCD) model. Under this model, able-bodied residents living in the same constituency are recruited under a flexi-work scheme and trained to provide individualized care to those in need, particularly those staying alone.
In one case, carers persisted in visiting an elderly man who suffered from severe depression. Acutely malnourished, he rarely stepped out of his house in the last three years, but after a month of repeated visits by carers who showed him much love and encouragement, he finally relented and had a haircut. His condition began to improve thereafter.
Such personalized care is tricky and resource-intensive, more so considering that many of the 300-plus elderly residents suffer from mental disabilities. But COMNET’s modus operandi is based on a surprisingly simple “kit”—a whiteboard divided up into grids, each square representing one residential unit, hung on the wall of the staff office.
Colored magnets in each square indicate the level of attention each resident requires: green denotes regular participants, yellow denotes those who require closer monitoring as they typically stay alone and red denotes those who are on home visit follow-up.
“A new spectrum of services will be rolled out in the next few years, involving specialized casework and counselling, outreach, monitoring and weekly home visits to the elderly.”
Activities at the center kick off with daily morning exercises and newspaper reading. When lunch hour arrives, staff, carers, and volunteers apportion the food to residents waiting in queue. Subsequently, the rest of the food is delivered to residents who are less mobile or unable to come to the center by themselves. Most of the time, there is enough food to feed all.
The residents occupy their afternoons with Bingo and board games. Often, students from international schools will visit and spend time with the residents playing Wii games and doing arts and craft, or simply amusing them with their fair skin, blonde hair and blue eyes.
FINDING HIS CALLING
It was in 1999 when Lim was serving as a volunteer for JAMs (a ministry for the intellectually disadvantaged at City Harvest Church) that he saw the great shortage of help in the social work sector.
“There is a saying that the need is the call, and so I was prompted to go into social work. It was a radical move for me as my family was poor and I was doing very well in electronic engineering, which could have secured me a scholarship, career, and stable income.”
Lim vividly recalls his mother crying for three days when he told her he wanted to pursue social work, but things fell in place for him with this switch of plans when he was offered a full scholarship from the University of New South Wales to pursue a bachelor’s degree in social work.
Upon his graduation in 2006, he worked with the Ministry of Community Development, Youth and Sports as a Child Protection Officer before transferring to the Institute of Mental Health (Woodbridge Hospital) as a medical social worker.
After two years of intensive exposure working with the mentally-challenged, he joined AMKFSC, and it was here that he really found his groove. In fewer than three years, he was promoted a total of eight times.
ON THE GROUND
When asked what a typical day at work is like, the father of two boys, Jayvon, 4 and Xavier, 17 months, laughs and replies, “My work days are never really typical. There are quiet ones when I can catch up with my administrative backlog. More often than not, I would be responding to a crisis. In a year, I would see several suicides. Calling the police, the SCDF and paramedics is a weekly affair.
“Once, the Senior Activity Center had to call the police three times in a day to break up different fights. Four times last year, a resident smashed his own head and bled all over our office and the void deck. This year, I was greeted with a horrific sight of a resident lying motionless just outside my office.”
Earlier this week before this interview happened, the team narrowly avoided an explosion when a particularly distressed resident locked himself in and turned on the gas.
On top of operational work, Lim attends meetings, focus groups and consultations, conducts trainings, prepares reports and proposals, and networks with partners and donors.
PARTNERSHIPS AND RECOGNITION
On Sep. 2, COMNET was nominated by its advisor, Member of Parliament for Bishan-Toa Payoh GRC and Minister of State for Finance and Transport Mrs. Josephine Teo to receive a check from Prime Minster Lee Hsien Loong, donated through the PAP Community Foundation.
In recognition of Lim’s “contributions to build an inclusive society”, an invitation was presented to him through NCSS to attend the recently concluded F1 Grand Prix dinner at the Temasek Suite hosted by PM Lee and graced by the President, foreign heads of states and ministers.
“Every time a beneficiary passes on, I am affected emotionally. It is something that I would not want to be desensitized of as it provides valuable motivation to strive on. On the other hand, I am easily delighted by the fruits of my labor, be it in working out a simple database system that eases our documentation efforts or receiving recognition at a high level. To me, every bit of progress and success helps to make the service better and impacts the lives of our beneficiaries more positively. At the end of the day, I see myself as a steward fulfilling a call bigger than myself,” says Lim.
COMNET’s outreach efforts and monitoring system, which has gone beyond the conventional SAC model, caught the attention of the media and was subsequently featured in the evening news on major local television channels including Channel 8, Channel U, and Channel NewsAsia.
With the impending challenges faced by an ageing demographic, more can be done for and in Singapore. “The eldercare sector is currently underdeveloped and underequipped to face the issue,” notes Lim. “Recently, we hosted a group of Taiwanese government and NGOs heads; they were surprised that COMNET’s standard of services is an exception rather than the norm. Even then, our outreach and monitoring capability is at least 15 to 20 years behind Taiwan’s.”
Nonetheless, Lim notes that the Singapore government has taken steps to address the issue and “hopefully we can catch up with the standards of other developed countries.” But even as the eldercare sector prepares for the silver tsunami, there is an urgent need for more individuals like Lim to become professional carers and help develop the eldercare industry.