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Bringing Dental Care to the Bedside

On 24th June 2017, Tzu Chi conducted its first dental outreach at Lee Ah Mooi Old Age Home and signed an agreement with the institution to provide one year of free monthly dental services to its residents.

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The CEO of Tzu Chi Foundation (Singapore), Mr Low Swee Seh (second from left), signed a two-year agreement with Lee Ah Mooi Old Age Home’s person-in-charge, Mr Then Mun Wah (second from right), for the Foundation to provide two years of dental outreach in the nursing home. Photo by Chua See Siew

The windows open out to a peaceful vista of greenery, and there is a natural flow of air through the premises. In the afternoons when it gets a little hotter, the able-bodied elderly residents will get up to walk about and talk with other residents, and there will also be some resting on their beds while the electric fans on the ceiling spin with a quiet whirring hum… This is Lee Ah Mooi Old Age Home. Tucked away in one corner of Thomson road, the rustic building of the nursing home still retains some sense of Kampong style, as if it is a haven away from the hustle and bustle of the teeming city outside.

On 24th June, a TIMA (Tzu Chi International Medical Association) dental team arrived at Lee Ah Mooi Old Age Home to provide free dental services to its elderly residents. On the same day, the CEO of Tzu Chi Foundation (Singapore) signed a Memorandum of Cooperation with the person in-charge of Lee Ah Mooi Old Age Home, to formally establish Tzu Chi’s provision of two years of monthly dental services to the nursing home. This agreement came after another dental outreach agreement between the Foundation and two nursing homes under the umbrella of Ren Ci Hospital.

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On the day of the dental outreach and signing of the memorandum, Tzu Chi volunteers work together to decorate the venue and to prepare some light refreshments in one corner. Photo by Mulias Lian

Continuation of Love Forges a New Affinity

In November 2016, through the referral of the Agency for Integrated Care (AIC), Tzu Chi was notified of Lee Ah Mooi Old Age Home’s need for dental services. The nursing home has 110 elderly residents, many of whom have chronic diseases, such as diabetes, mental illnesses, heart diseases, dementia, etc. Close to half of the residents are physically immobile, and some are even bedridden and have to depend on tubes for feeding. For the residents who are physically unable to take care of themselves, the staff of the nursing home would assist them to wash and clean their mouths a few times daily to maintain their oral hygiene. But some of the mentally unsound residents would refuse to be cleaned, and over time, this led to gum and teeth problems.

Even though the nursing home has doctors and nursing staff to monitor the health of the residents, they cannot administer dental treatments. As such, if the elderly residents require dental treatments, the home will need to request their family members for funds to arrange for ambulance transport to a hospital or a dental clinic. However, some of the families cannot afford the additional expenses, and some residents do not have any living kin; moreover, there is a staff shortage at the nursing home. Hence, the residents’ dental problems are a severe challenge to the home.
Mr Then Kim Yuan, who witnessed the signing of the memorandum, said, “Over the past three to four years, we have tried approaching various charitable organizations for assistance in providing dental services, but our attempts were unsuccessful.” When he heard that Tzu Chi was able to help and support the nursing home in this area, Mr Then was overjoyed as this would bring a lot of convenience to the home’s elderly residents.

Serving with Patience and Compassion   

After the signing of the memorandum, the leader of the TIMA dental team, Dr Eugene Tang, introduced the medical team to the grounds and the dental equipment. He also reminded the team to be alert of their etiquette during their interactions with the residents as well as any possible challenges they might encounter. “Many of the residents are physically immobile, or may have other ailments, please treat every resident with care,” he said.

The first resident to receive treatment was over 90 years of age. He relied on tube feeding and was also unable to communicate with others. Having lost practically most of his teeth and left only with a few sharp roots, he often bit his own lips. After discussing among themselves, the team of dentists decided to extract the remaining roots of two teeth. But because the resident clammed his mouth shut, the entire process took a long time.

Dr Yang Guo Sheng, who was once a member of the Tzu Chi Collegiate Youth Association in Australia, shared that it is very important to have patience during interactions with the elderly: “Some of the elderly or those with dementia are not able to follow the doctor’s directions, and thus need to be guided slowly. Compared with other nursing home residents that are generally younger, we need to spend more time and effort to communicate with these elderly residents here, and make them feel at ease first.”

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Even though it was Hari Raya Aidilfitri on the following day, Dr Samsuddin (third from right), who is a Muslim himself, still took the opportunity to serve at the dental outreach. Photo by Mulias Lian

“They really need a lot of love…” said Dr Samsuddin, who was Dr Eugene Tang’s former classmate in the medical school. Even though the day after the dental outreach was Hari Raya Aidilfitri, yet as a Muslim himself, Dr Samsudin still took this opportunity to serve.

Faced with residents who refused to open their mouths, he relied on his many years of experience to coax them like little children, and quickly extracted their teeth. Then, he carefully stitched up their wounds. “The residents in this home are very advanced in age; in addition, they suffered from other diseases. So we must stitch up the wound after an extraction, to stop the bleeding. If we only made them bite the gauze to stop bleeding, they may accidentally swallow it,” he said.

Seeing many elderly patients who were bedridden and wary of others at the same time, Dr Samsuddin felt for them. He had a good rapport with the elderly patients, and as they could feel his love and care for them, they were willing to open their mouths to receive treatment.

Besides treating the patients, Dr Samsuddin also gave hands on opportunities to the younger dentists, while guiding them by their side. “I really hope that more younger dentists would join us. The dental outreach is a very good platform for them to hone their skills.”

He hoped that the younger doctors would not only pick up more dental skills, but also learn to show care and love to the elderly.

Inspired and Moved by Selfless Charity

“Is it my turn now?”

Whenever the residents asked this question, the accompanying Tzu Chi volunteers would start a friendly chat with them to keep them occupied, asking about their daily lives, talking about their past work experiences, etc.

Newly enlisted volunteer Liang Jia Wen arrived very early and started helping with the cleaning duties enthusiastically. As it was his first experience serving the elderly, he carefully assisted from the side, but never dared to start any conversation with them.

After a few participations in Tzu Chi’s recycling activities and nursing home visits, Liang Jia Wen witnessed heart-warming interactions between the volunteers and the elderly, and also saw how the dentists offered different dental treatments according to the varied needs of the patients while treating them with loving care. Knowing how to converse in the Hokkien dialect, he expressed his hope to have more interactions with the elderly patients during future visits.

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The medical team brought portable dental equipment to the nursing home, and even arranged for the patients to be treated in their most comfortable positions - whether sitting or lying down - according to their individual physical conditions. Photo by Mulias Lian

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Members of the dental team wave goodbye to the residents before departing from the nursing home, and made an agreement to see them again in a month’s time. (Photo by Mulias Lian) 

Representative from the Agency for Integrated Care Ms Gong Ying Hong witnessed the selfless giving of the Tzu Chi volunteers, and what she saw left an indelible impression in her. She shared that half of the nursing or old age homes in Singapore lack dental services, and although there are organisations that provide free dental services, the residents have to travel to their clinics to receive treatments. This requirement proved to be a major challenge to the staff of the nursing homes, because most of their residents have mobility issues.

Gong was very moved by how Tzu Chi volunteers made painstaking efforts to make the dental outreach possible, overcoming many difficult challenges to reach the bedridden seniors for treatments. Their efforts had greatly reduced the burden of the nursing home’s staff. She expressed her sincere hope that in the days to come, Tzu Chi’s dental teams could make themselves available to more nursing homes or homes for the aged.

The Lee Ah Mooi Old Age Home was established in 1973 by ex-nurse Mdm Lee Ah Mooi. Mdm Lee felt the plight of helpless elderly people who had no one to look after them, and out of a compassionate heart, used her lifetime savings to establish this home for the aged. After her passing in 1992, the home was handed over to her sons, Then Mun Wah and Then Mun Tat. Presently, it is being managed primarily by her grandson, Then Kim Yuan.

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