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SINGAPORE \u2013 A woman who went to pick up her 91-year-old mother from a dementia daycare centre when the latter was unwell said she found her mother alone in the reception area, soiled and with vomit on her clothes. <\/p>\n
The daughter, a single woman in her 40s who is the sole caregiver, said her mother has moderate dementia and sometimes gets confused. <\/p>\n
When the centre called to inform her that her mother was sick on April 1, she rushed from work to Ren Ci@Woodlands, a dementia daycare centre. <\/p>\n
\u201cMy mother had asked the staff to call me and she spoke to me, saying she had vomited and wanted me to pick her up. When I got there… I found her sitting in a wheelchair alone,\u201d said the executive, who declined to give her name or her mother\u2019s name for fear the publicity would affect her career.<\/p>\n
When contacted by The Straits Times, a spokesman for the centre said staff had been in her mother\u2019s vicinity at all times.<\/p>\n
\u201cWe checked our CCTV and confirmed that there were staff (members) present in the client\u2019s vicinity the entire time she was waiting for her daughter,\u201d he said.<\/p>\n
\u201cWe also cleaned her up as best as we could after the incident of vomiting. When the client was in the toilet, our staff waited just outside. At no time did the staff walk away.\u201d <\/p>\n
The spokesman added that the client had refused to let the staff check whether she was wearing a diaper \u201cand we respected her privacy\u201d. <\/p>\n
\u201cThere were also no clear signs of soiling while she was at the centre,\u201d he added.<\/p>\n
On the daycare centre\u2019s website, it is stated that the facility \u201cis able to manage the challenging behaviours exhibited by dementia clients through therapeutic or non-pharmacological activities\u201d. <\/p>\n
But the woman\u2019s daughter questioned how the centre could have overlooked the potential seriousness of her mother\u2019s condition. <\/p>\n
\u201cI learnt (online) that when an elderly person, like my mother, vomits and has diarrhoea, it is potentially dangerous as they are at a higher risk of dehydration and can result in health complications. What more, the vomit and diarrhoea were black,\u201d she said.<\/p>\n
\u201cSince the daycare (centre) is just next door to Woodlands Hospital, why did they not take her there immediately, instead of letting her call me to come take her home?\u201d she asked.<\/p>\n
The executive said she did not take her mother to Woodlands Hospital immediately as she was afraid of being charged private rates should her mother be admitted. Instead, she took her mother to Sembawang Polyclinic for a referral to get a subsidy. <\/p>\n
She is unaware that the Ministry of Health website states that means testing is a standard, automatic process at public hospitals to determine the level of government subsidy a patient will receive when admitted to a ward from accident and emergency (A&E) department. Lower-income households can receive higher subsidies of up to 80 per cent compared with higher-income households.<\/p>\n
After they arrived at the polyclinic at around 1.30pm, her mother was assessed, and they were told she needed \u201cimmediate care\u201d. <\/p>\n
\u201cThere were no doctors available then, so we were given an appointment at 4.20pm. Since it was a couple of hours of wait, I decided to take my mother home to clean her up,\u201d the daughter said.<\/p>\n
It was at home when she realised her mother was not wearing a diaper and had continued to soil her dress despite having spare diapers in her bag and at the centre.<\/p>\n
During the consultation at the polyclinic later that afternoon, the doctor advised the daughter to take her mother to the emergency department as her condition had worsened. <\/p>\n
The daughter declined the polyclinic\u2019s offer to call an ambulance and took her mother to Woodlands Hospital in a private-hire car. <\/p>\n
On reaching the hospital at 6pm, the elderly woman was triaged and taken to the Extended Diagnostic Treatment Unit, a 24-hour short-stay observation ward where patients are observed, sent for further testing, or given specialised treatment before a doctor decides whether to discharge or admit them.<\/p>\n
She was discharged after a few hours. The daughter declined to give details of the medical conditions. <\/p>\n
A spokeswoman for NHG Polyclinics (NHGP) told ST that the elderly patient and her daughter arrived at Sembawang Polyclinic on April 1 at 1.38pm. The patient vomited and had diarrhoea and was attended to promptly at 1.40pm when a triage nurse assessed her. <\/p>\n
Based on her vital signs and conditions, a doctor assessed that she was clinically stable to be seen at her scheduled consultation at 4.20pm.<\/p>\n
\u201cAs (the elderly patient) arrived at the clinic with vomitus on her blouse, our nurse helped her to clean up. Subsequently, her daughter informed the nurse that her mother might have soiled herself… When the nurse offered to help clean her, her daughter declined as she preferred to take her home to do so,\u201d the spokeswoman said.<\/p>\n
During the consultation with the doctor, there was a change in the patient\u2019s clinical condition, and she was advised to seek further evaluation and management at the A&E department.<\/p>\n
The spokeswoman added that structured processes are in place at NHGP to ensure that all patients are promptly identified and cared for according to their conditions.<\/p>\n
Staff stay observant and may approach patients to find out if there are signs of urgent needs. <\/p>\n
Those requiring medical assistance are assessed through triage by trained nurses, who evaluate their condition based on current symptoms, vital signs, and other clinical observations. This allows patients to be prioritised according to their medical needs. <\/p>\n
If there are signs of a medical emergency, the cases are escalated for urgent medical attention and attended to by a doctor, the spokeswoman added.<\/p>\n
The clinic head of Sembawang Polyclinic, Dr Lim Ziliang, has since contacted the patient\u2019s daughter to understand her concerns and offered additional assistance to better support the patient. <\/p>\n
\u201cWe explained to her that if the doctor had been informed that her mother had vomited and was in a soiled state, he would have seen the patient earlier,\u201d said the spokeswoman.<\/p>\n
\u201cWe are sorry for the distress caused. We will learn from this experience and further improve our processes to support patients and their caregivers.\u201d <\/p>\n
The daughter said Ren Ci@Woodlands has also apologised to her. <\/p>\n
\u201cRen Ci told me the staff in question at the daycare centre had been counselled,\u201d she added.<\/p>\n
In response to questions from ST, the Ren Ci spokesman said: \u201cOur staff have engaged the daughter, and we have come to a mutual understanding on her mother\u2019s care.<\/p>\n
\u201cWe recognise that this situation has been difficult, and are committed to continue partnering the client and her family in providing the best possible care.\u201d <\/p>\n
He added that the centre \u201cfollowed clear procedures to safeguard the well-being of all clients\u201d. <\/p>\n
\u201cWhen a senior exhibits signs of illness, our trained staff promptly assess and monitor their symptoms and vital signs. Caregivers are informed without delay. For mild symptoms, we recommend that the caregiver take the client to a GP or polyclinic for evaluation.<\/p>\n
\u201cShould severe symptoms be present, such as indications of a heart attack, stroke, fracture or shortness of breath, we immediately activate emergency ambulance for conveyance to the emergency department,\u201d he said. <\/p>\n<\/div>\n