A blue-and-pink van from social service agency Montfort Care pulls up near a client’s home for the agency’s staff to unload a bathtub that is in two parts.
Donning face masks and hair nets, two staff members who are part of a three-person team, carry the 10kg disassembled bathtub into a lift.
With the $70,000 tub that was imported from Taiwan, Montfort Care started its home-bathing service in November 2018. As at April 2023, it had given 100 clients a combined total of 1,000 baths in their residences.
Fifty-eight-year-old Mr Lee has a bath once every two to three weeks, in his bedroom.
Immobilised from his neck down after a traffic accident in June 2018, the former engineer gets a thorough scrub from head to toe, and a good soak in water mixed to a comfortable 36 to 37 deg C.
His needs during the 30-minute bath are taken care of entirely by three staff members from social service agency Montfort Care.
As the home-bathers, carrying a two-piece bathtub, arrived at the Lee family’s flat in Jurong West on the morning of May 11, they were greeted warmly by Mrs Lee, who has engaged their services for her husband since 2019.
She has requested that they be known only as Mr and Mrs Lee to protect their family’s privacy.
The 47-year-old became her husband’s caregiver when he returned home in August 2019, after spending 11 months in a hospital and another three months in a nursing home.
Despite being trained to take care of her husband at home, Mrs Lee, who is a part-time childcare teaching assistant, found showering him challenging.
“I wanted him to have holistic care, so I tried,” said Mrs Lee. “Normal people like us take showers for granted – every day we must shower. But for him, it’s so difficult.”
Mrs Lee and the family’s helper managed to shower Mr Lee on their first attempt. However, on their second try, a hoist holding Mr Lee gave way, causing him to fall and Mrs Lee to hit her head on a pillar.
She told a social worker then: “I’m very stressed because I want to give him a proper shower, but I can’t do it with a helper because I have no confidence. Since he’s fallen down once, I don’t want it to happen again.”
Mrs Lee was subsequently introduced to Montfort Care’s GoodLife! home-bathing service, and that has literally lifted a load off her.
After greeting Mr Lee, Ms Moe Sapal, one of the three home-bathers who are in their 30s, gets down to work by checking his vital signs to ensure he is fit for the bath.
Among the items on her checklist are his body temperature, blood pressure and oxygen levels, as well as questions for Mrs Lee on when he was last fed – 7am – and when she administered his last dose of medication – 8.30am.
Then Ms Moe Sapal begins a visual examination. She looks for bruises and wounds on Mr Lee’s body that may rule out a bath, and checks to see if those found during the previous sessions are close to recovery.
“They are very good auditors,” said Mrs Lee in jest, referring to how the checks potentially reflect how well she has cared for her husband, with whom she has two children – a daughter and a son aged 17 and 12 respectively.
Having completed her checks, Ms Moe Sapal makes a video call to a registered nurse to report Mr Lee’s condition and seek approval to start the bath.
As Ms Moe Sapal conducts the checks, her colleagues, Ms Khaing Mar Lwin and Ms Charophina – who goes by one name – set up the bathtub next to Mr Lee’s bed.
The two halves are fastened tightly to prevent any leakage when the tub is filled, and a groundsheet is laid on the floor to keep it dry.
Little preparation is required by the client’s caregivers before each bath, apart from ensuring that a suitable water source is available.
Ms Khaing Mar Lwin lays out two sets of hoses and pumps – one inlet that pipes clean, warm water from the kitchen to the tub in the bedroom, and an outlet that drains used water from the tub.
In the kitchen, freshly-boiled water is mixed with tap water until it reaches an optimal temperature of about 36 deg C, which the team says is the temperature typically used as it improves blood flow.
A steel frame with a canvas sheet that will hold Mr Lee is placed on the tub, before he is transferred from his bed to the tub.
The team begins to clean Mr Lee, starting from his head.
Ms Moe Sapal and Ms Charophina bathe Mr Lee. Ms Khaing Mar Lwin gives cues, such as when Mr Lee needs to be shifted. She also ensures that his head is always a safe distance from the water.
The staff members are attentive to Mr Lee, even as they operate like clockwork.
Despite being unable to respond to them due to his condition, he is informed of each action before it is carried out.
The team also constantly asks Mr Lee if the water temperature is comfortable for him.
Such deliberate and direct communication to her husband left Mrs Lee impressed after his first session with Montfort Care in 2019.
“They treat him as a human and not someone who is invalid,” said Mrs Lee.
She has noticed that her husband is alert throughout the bath, making an effort to keep his eyes open and observe his surroundings, especially when the team members address him.
They clean him thoroughly and gently, from his head right down to his toes, and with utmost respect.
Towels are passed between the team members, not over Mr Lee’s face but over his body, and they protect his modesty by always covering his body – except for the areas being washed.
When his private parts are being cleaned, those who are not involved are required to leave the room.
After Mr Lee is soaped, each of the team members change into a fresh pair of gloves before rinsing him.
Mrs Lee says: “His skin is very different from when you touch him after just wet-sponging. I’m delighted that they are able to come and make him comfortable.”
She says the baths are a relief from the heat for Mr Lee, as she does not switch on the air-conditioner to keep him cool on the advice of a traditional Chinese medicine practitioner.
She often finds Mr Lee snoozing comfortably minutes after the team leaves.
After the bath, the team has to wash and disinfect the tub on the spot. By the time they freshen up and are ready to leave, about two hours have passed since they entered the Lees’ home.
Back at Montfort Care’s GoodLife! centre for seniors in Khatib, Ms Khaing Mar Lwin spends the afternoon training a new member.
Wearing back support braces – similar to the ones worn under the uniform at Mr Lee’s home – they start by practising how to remove the bathtub from the van.
They then run through a full bath sequence, with Mr Henry Kok, who drives the team’s van, role-playing as a client.
Ms Khaing Mar Lwin, a Myanmar national, has worked in Singapore for about 13 years. She took care of a cancer patient and worked in a nursing home before joining Montfort Care’s home-bathing team in 2019.
She says the previous stints gave her confidence to take on the role of home-bathing clients who are bed-bound and mostly in their 70s.
The 38-year-old says her most fulfilling assignments have been those where the team could connect well with the caregivers, enabling them to work together to improve the clients’ condition.
On what makes a good home-bather, she says one should be prepared for hard, physical work – the team wears knee pads due to the excessive amount of kneeling required.
The person should also be proactive in ensuring the client is safe and comfortable, and be a good team player.
She takes each training session seriously, as it is a valuable opportunity to impart skills to new teammates.
“I teach properly, and I teach deeply,” she says. “Our home-bathing service may always be here, but I will not always be here, so I teach well so that others may continue it.”
When asked if her work is meaningful, she tears up.
“Every day, when I return from the clients’ home, I feel complete.”
