According to the World Health Organization (WHO), there were over 55 million people worldwide living with dementia in 2020 and the number is expected to rise to 78 million in 2030. In Singapore, one in 10 Singaporeans or about 100,000 people aged 60 and above, suffer from the illness. As caring for a dementia patient can be exhausting and overwhelming for the caregivers, a nursing home is often considered as an option for their loved ones who require more medical attention and care than they are able to fulfill.
Azraini Azri Alfred, 31, who is a healthcare assistant in a dementia care home in Broxburn, Scotland, believes that patience is a vital trait when working with dementia patients. She shares the challenges she encounters while working and living in Scotland with The Karyawan team.
Q: Could you tell us more about yourself and your family?
Azraini: As I was born and raised in Singapore, I am a big foodie and absolutely love my holidays, near or far. I came to the UK in late 2015 when I was 24 to complete my Master of Science degree in Applied Psychology. I have been living in Scotland since then while my parents and two brothers still live in Singapore together with our cat, Simba. Whilst studying, I took up a part-time job and that was when I met my Scottish husband. After dating for a few years, we got married and I decided to permanently move to the UK. He just could not survive the heat in Singapore! My in-laws have never visited Singapore or Malaysia, so over the years, I have slowly introduced our cuisine to them, mostly the non-spicy ones. It’s always interesting to hear their feedback on our food, especially given how different it is from theirs.
Q: What drew you to a profession in the healthcare industry? What does your job entail?
Azraini: I was drawn to a job in the healthcare industry as I like helping others and feel like I am able to make a direct impact in improving other people’s lives. I always have so much respect for anyone in the industry as it’s a crucial role that most times go unappreciated unless you’re a doctor. When COVID hit us and I heard about the need for manpower in the healthcare industry, I decided to join despite the risks of being a frontliner. As a healthcare assistant in a dementia care home, I help the residents with their daily routines – from getting them washed, dressed, to assisting them with preparing and consuming meals. I have to identify the different needs of each resident and adapt the approach of care I provide.
Q: How has your experience in Singapore helped you in your work in Scotland?
Azraini: Having grown up in multi-cultural Singapore, it has helped me adjust to the culture in Scotland. With English as my first language, it has definitely given me a big advantage compared to the other foreigners who come to the UK. I had less to adjust to as I’ve been exposed to the British culture through social media and the environment in Singapore.
Q: What are some of the challenges you encounter in your line of work?
Azraini: A challenge I face at times is being underestimated when it comes to my ability to understand the instructions given as many people would assume that because I’m Asian, I would not have a good grasp of the English language, or come from a conservative and close-minded culture. There have been many occasions where I’ve been told my English is great. Another challenge I face at work is to do with the very nature of being in a care home. Unlike a hospital, those who enter a care home don’t expect to get treated, recover and leave. Their health just continues to deteriorate until it gets to the point where they pass on. In order to provide good care, I need to get to know them, and develop a bond with them. This makes it emotionally difficult to deal with when they’re at the end of their life and pass on.
Q: What kind of qualities do you need to work with dementia patients?
Azraini: Patience is a trait that is vital when working with dementia patients. They are almost always unaware of what they say or do. Their emotions are all over the place. Especially when they’re not living in the present, it’s challenging to calm them down and reason with them. They lose control of their bodily functions too. A caring nature is also crucial as these patients are mostly helpless and unable to shout for help. It is very important to treat them with dignity and respect despite any circumstances they are in. I feel that emotional intelligence is also necessary to help understand how they are feeling and in identifying signs of distress or deteriorating health so that we can provide them with the treatment they need. At that age, they are very vulnerable and considered high risk.
Q: Apart from your full-time job, you are also running a home-based business. What do you sell and why did you choose to sell these products?
Azraini: For my home-based business, I sell Southeast Asian treats like mooncakes, pineapple tarts, curry puffs and a bunch more. I started selling them after making mooncakes for a friend who was craving them, then I posted a photo of my mooncakes on a Facebook group called ‘Malaysian Food in UK’. I received so many requests for me to start selling them as they would really like to order them. I love baking so I thought if people would appreciate it, I would be happy to sell them some of my bakes. As a Singaporean who is always missing food from home, I understand the excitement that comes with being able to get authentic home food to cure homesickness, especially when travelling back home isn’t possible with the current pandemic. I’ve been really blessed as the reception for my treats has been amazing. The majority of my clientele are Southeast Asians. I‘ve had to reduce my hours at work in order to accommodate the orders I’ve been getting and have since expanded my menu to include other local delights from back home that are almost impossible to get from the shops here, especially in Scotland.
Q: Do you have plans to expand your home-based business, like opening a shop or a café?
Azraini: I do intend to expand my business, but not at the current moment. I don’t have the experience in running a business and would really like to build the knowledge so as to reduce any risks. I would also like to test the market much more before deciding to open a shop. For example, start with selling my bakes at a local café. With food that is somewhat different from the food we get locally in Edinburgh, I would like to see how receptive the non-Asians would be.
Q: What were some of the challenges you faced when you first moved to Scotland, and how did you overcome them?
Azraini: Some of the challenges I faced were the lack of Southeast Asian food, the absence of dining options after 10pm, the weather, and living far away from friends and family, to name a few. The lack of food choices was what drove me to learn how to make them on my own, hunting around the city and online for supplies. As for the weather, I have acclimatised to an extent where I don’t live in my thermals anymore. My cold tolerance has improved but it still has a long way to go compared to the locals. I remember the times I used to be in five layers of clothing going outside and my husband would just be in a T-shirt! Now I go out with three layers, or even two on rare occasions! As for missing my social circle back home, I’ve made attempts to meet new friends here. Although I’ve not met any other Singaporeans or Malaysians my age living near me, I’ve made other international friends and it’s been great learning about their cultures and lifestyles. I also phone home whenever possible, but the eight hour time difference doesn’t make it easy!
Q: How different is the culture and lifestyle in Broxburn compared to Singapore?
Azraini: The lifestyle is more laid-back and slow-paced. Most people I came across have been very friendly. One of my favourites is the practice of saying thank you to the bus driver when getting off the bus. In a big country like the UK, we don’t have the same convenience of getting to places as easily or the wide variety of shops as we do in Singapore. Shops are more spread out with local businesses everywhere, and fewer chain shops in sight outside the city centre. As a big part of the Scottish culture is alcohol, it can be found everywhere at a very cheap price, leading to a big health concern here.
Q: What are some of your memorable experiences working and living in Scotland so far?
Azraini: I love that hiking trails or country walks are never too far away here. I’ve grown to appreciate them even more during the pandemic as it allows me to get outdoors while not putting myself at a high risk of catching the virus. I also love the freedom of expression and acceptance that people here embrace.
Q: Do you have any advice for youths who intend to move overseas for work?
Azraini: My advice is to go for it, but to always remember to keep an open mind. A new culture and lifestyle take time to adjust to but never give up and be open to change. There’s a Singaporean/Malaysian community in most countries that you go to, so seek them out if you’re homesick. The experience of living and working overseas is invaluable. It also helps you to appreciate the aspects that are different. It’s all about perspective.
Q: Do you intend to return to Singapore one day?
Azraini: I definitely intend to return to Singapore one day. As much as living in the UK is a wonderful experience, and as cliché as this sounds, Singapore is where my heart is. It’s where I belong. Yes, there are a lot of challenges living in such an expensive (and small) country, but there are also a lot of benefits. Teenage me had always wanted to leave Singapore and move overseas. But now that I’ve done it, I think Singapore is still where I’d rather be. ⬛
1 World Health Organization. Dementia. 2021, September 2. Available at: https://www.who.int/news-room/fact-sheets/detail/dementia
Nur Diyana Jalil is currently an Executive at the Centre for Research on Islamic and Malay Affairs (RIMA), managing its social media, events and publication.