The Caregivers - Daughter & caregiver

Cancer struck three times

They come from all walks of life – parents, spouses, children, even strangers – but the trials they face are similar. Long hours often on top of a full-time job, emotional and physical strain, and all too often, financial stress as well. Yet they toil on, day after gruelling day, driven by love and family bonds.

She was just nine at the time, but Maehysha Yim, now 34, remembers her cancer-stricken mother bent over in a hospital carpark "puking her guts out", cradled gently in her father's arms.

She remembers how her mother, Madam Chan Ching Han, gasped for air towards the end, dying at age 46. And she remembers the years her father threw himself into his role as a single parent, ferrying her from school, cooking and cleaning.

So when retired businessman Yim Wing Yam fell prey to prostate cancer in 2008, his only daughter took an extended break from her job as an events management executive to care for the man who was both mum and dad to her. She has an older brother who is married.

Through radiation, surgery, chemotherapy and endless hospital visits, she was her father's main support. She also brought forward her marriage to former colleague Maspol Husain to give her father something to look forward to. His cancer was in remission, and he was there on their happy day.

Between caregiving and preparations for her wedding, Ms Yim began losing weight. She attributed it at first to a wisdom tooth extraction, and then to caregiver stress.

In late 2009, barely two months after her wedding, she was diagnosed with stage 2 breast cancer. "It was bizarre - beyond belief, really," she recalled. "You just don't think this can happen to you at age 30."

Her father turned caregiver again as she went through surgery and chemotherapy herself.

In August last year, shortly after her cancer went into remission, he got news that his was back, this time in an incurable form.

"It was quite the emotional roller coaster," Ms Yim said in her four-room Woodlands flat, surrounded by pictures of her parents. "We could each bear the news of our own illness. But it's hard seeing your loved one suffer."

Mr Yim died in April this year, aged 77, and Ms Yim's cancer is in remission. She is rebuilding her life with her 35-year-old husband.

The emotional burdens of caregiving can be harder to bear than the physical ones, she said. "Towards the end, I could see my father was afraid of death. But he was a part of the strong, silent generation - he refused to share his fears."

When she was told last August that he had only six months to live, she decided not to tell him. "I broke down and cried, but had to hide it from him. I did not want him to feel worse."

Still, racked as he was by fever, pain and vomiting - unable to eat anything but ice cream - he might have known his end was near. He lost 26kg. He kept the doors and windows of their flat closed. He shunned friends and relatives. The television became his lifeline.

One of her most trying tasks was keeping well-meaning relatives and friends from smothering him with pity. "They all loved him and would come and say, you must eat, you will get well," she said. "But I think he knew those were false hopes."

Terminally ill patients, she said, should be left to do what makes them happy, as long as it does not compromise their safety. "He wanted to eat ice cream five times a day and I let him," she said.

Ms Yim feels lucky that not only did she have her husband and some close friends with her every step of the way, but she also received counselling from HCA Hospice Care, Singapore's largest home hospice provider. They would visit her father once or twice a week.

"They focused not just on him, but also on me, always asking me how I was feeling, and giving me some time off when they paid a home visit. My father could be quite rude because he felt he did not need any help, but they never complained," she said.

Her husband was her strongest support, she said, though she sometimes gave him a hard time about his long working hours. He took it in his stride, with humour.

"Caregiving is hard work, and it's normal for caregivers to be stressed out and unreasonable," said Mr Maspol. "They need love, patience and support."