Family values

When I visited Venice and Rome, I saw many older people walking in the streets, shopping or going somewhere leaning on the arm of another adult. I like to believe that those other adults were their family members or close relatives. I’ll call them the older persons’ family, because it makes me feel better. When these seniors paused to sit down at a sidewalk cafe, the younger adult would take great care to help them sit. They were patient and respectful. It was a heartwarming sight.

The situation is very different in Hong Kong. Here, the younger adults are busy working, and it is domestic helpers who take on the responsibilities of caregiving, day in and day out. Nonetheless, families do care about their elderly relatives in Hong Kong. In the housing estate where I live, there are many domestic workers who walk and exercise with seniors on a daily basis. You can see how well they relate to each other by observing how they interact.

Some domestic helpers talk amongst themselves—for example, a group of seniors and an equal number of maids gather separately each morning in the estate’s garden—while others stay close to carefully observe the seniors in their care. There are those who walk fast and drag the seniors with them along the way, and there are also those who allow the seniors to take their time. It is only during weekends and public holidays that you see more local adults taking care of their parents. You will find them in teahouses, parks, shopping malls and so on.

Filial piety has diverse manifestations in different countries.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

How should we relate to the misfortunes of this world?

I traveled with my sister after attending the board meeting of interRAI, an international health care research group, in Nuremberg, Germany. I am not a member of this group, but my teacher—my doctoral thesis supervisor—is. Thanks to her, I was invited as a guest. I thought this would be a good chance for me to learn.

After the meeting, I traveled with my sister to Vienna, Venice and Rome. I don’t know why, but the most disturbing thing for me on this trip was the panhandlers and beggars. There are beggars in all three cities. I am aware that I live a fairly comfortable life, sheltered and secure. I am also aware that there are many people who are very unfortunate. But I had no idea I would react this way. This was not the first time I had traveled overseas and definitely not the first time I had seen people who were very poor.

I believe that Hong Kong has no beggars who are from Hong Kong. We have homeless people, but no beggars. We used to have Hong Kong people who begged, but not anymore. I believe that the beggars we see on the streets of Hong Kong come from across the border (mainland China) to make a living. Because the social welfare system of the Government of Hong Kong has developed gradually over the years, no one needs to beg. For me, as a citizen of Hong Kong, this is an immensely comforting fact.

There I was in Europe, traveling as a tourist, enjoying myself, spending money as I chose. But there were people begging for money. I found myself not knowing how to relate, both to them and the situation. I looked at their faces, and sometimes our eyes met. I did not give to those I judged to be “professional” beggars. I gave a euro or two to those I thought might be in dire need. And then I moved on.

There were some old gypsy men and women in Rome who sat in front of churches begging for money. I knew in my heart that day in and day out, they sat there asking passersby for money. Begging has become a way of life for them. I didn’t give them any money, but I was so filled with remorse that I looked at them and apologized. I kept saying, “I am sorry,” “I am sorry.” Even professional beggars are beggars because they have the misfortune to be on a life path that, clearly, no one who had a choice would choose.

Phil Collins recorded a song called “Another day in paradise.” I am very much the person he described: Someone in the street “called out” for help but I pretended not to hear it. Streams of locals and tourists walked past these unfortunate people, just like me.

So what should I do? How do I relate to these people who are less fortunate than I am? Do I go back to my usual life and continue to live as I did, selfishly? Do I give up my limited resources and donate them all to charity? Do I take up charitable causes and live my life as a crusader?

I know I can’t do that. I can’t give all my money away. My sense of security is important to me. What then should I do? How should I live my life? I find my silly self asking the questions I asked when I was a young adult, passionately seeking a purpose in life. Should I not be past that stage by now?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

So what do we do after retirement?

I used to tell my sister to keep working and not retire too soon. If we live until 90 or 100 years of age, which doesn’t seem so unbelievable, then retiring at 60 or so means spending a third of our lives not engaged in full-time employment. And that is a long time. Work has many advantages, as we all know. It keeps us in touch with the world, helps maintain social contacts, brings in income and daily gives us a sense of purpose and usefulness. If the job is also interesting and meaningful to us, so much the better.

In Hong Kong, the retirement age is 55 for civil servants and 60 for employees of most companies and agencies. There has been talk of deferring the retirement age to 65 for certain jobs, such as that of academics.

I think that women (or men) who stay home to raise their kids are wonderful. Their children are so blessed. It is an extremely important job but often not recognized. I think that women who try to be working moms are superwomen. It is not easy dealing with competing roles.

If I say that females are the tougher sex, will I be called a sexist?

Inventory on display.

Open and ready for business.

Waiting for another passenger.

May I help you?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Form over substance

Appearance (or should I say packaging?) is overrated, but it is all we are focusing on these days—the presentation, the form, the look. As a teacher, I am sometimes frustrated by the demand or expectation that every lecture I give must be entertaining and that it should use the latest technology, or whatever is in vogue.

I wonder whether people in the audience (be they be the public or students) realize the amount of time that is needed to produce some interactive elements or to build some simulation exercises into a lecture. The use of multimedia in teaching is quickly becoming the norm, but it takes a tremendous amount of time to get the prep work done.

Some would argue that it is only the initial setup that is time consuming, that after that’s done it becomes easier. Not always. Imagine that you have produced a video clip and made a certain point (fact or argument, it doesn’t really matter). Later on, you want to revise your statement based on the latest research findings. What do you do then? Redo the entire video shooting or just make a corrective statement at the end of your clip?

I once watched a TV program about how a researcher in one of the local universities was trying to use virtual simulation, using computers to help children who were autistic. I cannot convince myself that this is a good idea at all. Imagine all the resources and effort required to produce a virtual simulation environment. But a child does not need a game. The child needs a person who loves, cares about and understands him or her and his or her condition, someone who is able to teach things and be patient when the child fails to cope with the demands of the situation and becomes withdrawn. Also, there is no guarantee that the skills one has learnt in a simulation environment can be transferred into real life.

Yes, I am aware that we must move on, that it is only with repeated use of technology that we become proficient. But the essence is not in the novelty of a communication technology. The essence is about the human connection. Nothing can replace it, not Facebook, not Twitter.

Nobody these days seems to be able to sit through lectures and concentrate on the knowledge—the substance—shared by the speaker. Yes, I am aware that, to learn, students need to be interested. Anything that is multimedia is, of course, interesting, more interesting than the words or syllables that make up the sound of words.

But, as a teacher, I do not believe it is my business to put on a show in every class I teach. Is that really necessary? What is the role of students in learning? Is it to learn only if the subject matter or the presenter is interesting? Unfortunately, what is interesting is different for different individuals.

I believe I need to motivate students to learn. I believe that, sometimes, my time is better spent on efforts to make the content of my talk cutting-edge knowledge. When time is short, my choice is always the substance, not the form.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Integration: The final developmental challenge of older adults

According to Erik Erikson, a person’s last developmental task in life is to overcome the psychosocial task of “integration and despair.” Either you integrate your life experiences and rise above them or become desperate for failing to meet the challenge.

I have read Erikson’s writings about the psychosocial task of old age. I have even discussed his perspectives in an assignment for a master’s course I took. But do I really know what integration means?

Does it mean making meaning out of one’s entire life experience? Does integration require us to determine what achievements we have made in our long life? Or to accept the fact that we really are small beings and have led ordinary lives? Does it involve finding out which relationships still bother us and settling all grudges with those we dislike? If that is not possible, does it mean we accept that we will never be able to make peace with those people we can no longer reach, to let it go and not let it bother us again? Or is it about forgiving ourselves for being silly, cruel, vain and stupid at various times in our lives?

What is integration, really? Is it possible? How do you forgive yourself for the tempers you have thrown and the cruel things you have said or done to people? How do you integrate odd and unsettling experiences that, over the years, you purposely have tried to forget? How can things be put into perspective when you cannot make sense out of these weird experiences?

Can integration occur if, after long introspection, you don’t like who you are or have far too many regrets? Can it happen only when you can see yourself in a positive light?

How, in old age, do we integrate all the things that have happened to us over a lifetime? As a gerontologist and a person, I am intrigued. I realize that I don’t really know.

Older people have a lot of work to do in meeting this developmental challenge. And only they can provide firsthand knowledge.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

“All older people are vulnerable.”

The above statement is from the lecture notes of an established global nurse leader at a conference on institutional care of older people, which I attended recently. The statement caught me by surprise. No offense intended, but I could not disagree more.

First, it’s patronizing. I don’t think all older people hold similar beliefs about themselves. I think health professionals should be caring and empathic, but certainly not patronizing. We do not always know what is best for others. We would like to think we do, but we don’t, at least not always.

Second, the message seems to imply that people can be categorized purely on the basis of age, according to whether they are fully capable of looking after their own affairs or not. In our society, we generally agree that children and disabled people are vulnerable and require protection, but if we follow the conference speaker’s logic, it would mean that only those in the well adult population are fully capable beings. So where does that leave us? Should we allow only well adults to lead the world?

Vulnerability should be perceived as a multi-dimensional concept when applied to humanity and should be not used as a descriptive label. A disabled person can be physically handicapped and, therefore, vulnerable to environmental barriers they come across in their daily life. A physically frail person can be vulnerable, in that he or she easily falls ill. A terminally ill person may be vulnerable to “assaults” on his or her humanity when the need for analgesics is ignored. A cognitively impaired older person may be vulnerablebecause his or her power of discretion is compromised.

But not all older people are vulnerable. They should not be. An elder with no loss of mental faculties, even though physically frail, can adequately manage his or her own affairs. Whenever we refer to the vulnerability of older adults, qualifying statements are required so that we are not disempowering our older clients.

The first baby boomers reached 65 in 2006. Let us not forget that future cohorts of older people are better educated and economically more secure than their predecessors. They certainly are in a much better position to manage their own affairs, and we should respect that.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. 

Engagement in life

I came across a new term, “the potentialist,” in an inflight magazine aboard Air Canada on my annual visit to Toronto to see my mother. A potentialist is someone who lives life to the fullest. I love the idea. The magazine was describing a couple who, in late adulthood, have found new meaning in life and want to spend every minute of it doing meaningful things, such as tapping into their physical potential, combining vacation with charitable activities, and so on. This is admirable. I have a lot of respect for such an attitude toward life. But wouldn’t it be extremely tiring as well?

There is a Chinese saying about the careful use of time that we all learnt when we were small. I don’t think elementary schools teach these things nowadays, because I have never heard kids talk about it. “An inch of time is like an inch of gold. Yet, an inch of gold cannot buy an inch of time.” What an apt description, if you truly love time.

As children, we were indoctrinated into believing the idea that we shouldn’t waste time. I would feel terribly guilty if I wasted any significant blocks of time. I love to account for things I do. Checking off tasks on a list gives me a sense of control and, more importantly, a sense of accomplishmentand the confidence that I have not wasted my life away.

Yet, I am aware that I am not that self-disciplined. I have wasted and still do waste my time every now and then, largely by doing nothing, doing silly things, or doing things that are unimportant while many more-important tasks lie there awaiting my attention. I can’t help it. I am only human.

I bet nurses are all more or less alike. We multitask a great deal, we hate to waste time and we like to check items off lists. Although, when I think about it, I don’t know if it is because we are nurses, or the fact that most nurses are female, that we exhibit such behavioral characteristics. Quite honestly, I can’t tell.

Coming back to where I started, I would love to be a potentialist sometimes, maybe more often than not. Still, not all the time. Not for me.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Are we set in our ways?

Are we set in our ways when we grow old? Do we become more stubborn in our old age? People ask questions about the possibility of changes in personality in older age.

Stage theorists maintain that personality changes over time, as a person progresses from one stage to another. Trait theorists argue that personality is stable, and cite personality-inventory studies indicating that a person’s traits remain stable during adulthood.

Life-span theorists of human development pose that human beings have considerable potential for becoming what they want to become and accomplish in a lifetime. However, other theorists suggest it is people’s habits that change—habits related to health, vigor, responsibilities and life circumstances—and not their basic personalities. In short, the foregoing can be interpreted to mean that many so-called personality differences are generational.

Is it not reassuring, then, to know that the theory that “as one grows older, one becomes more stubborn” has been debunked? If we are flexible and adaptable when we are young, we will still be flexible and adaptable when we grow old. If we are rigid in our ways at a young age, we will likely remain so as we accumulate years in life.

It is unfair to associate old age with stubbornness. The other message to take home is that, to better prepare for old age, we should nurture open-mindedness and adaptive coping responses.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Fast-changing images

My eldest sister used to live in Wanchai, on the island of Hong Kong. She died of stomach cancer in March 2010. Because she lived there for so many years after getting married—not in the same apartment but in the same district—I knew the area pretty well, too, because I visited her often, ever since I was a child.

I knew the streets, the buildings and the shops. I still go to my sister’s place, because that is where my cousins live. Because I visit the area quite often, I can usually follow the changes that are occurring in the landscape.

I wasn’t quite prepared for what I saw one day, though. Traveling on the tram from Central to Wanchai, I tried to look outside the tram window, through a packed carriage full of passengers, to see if I had reached my stop. I knew I would be close. I was somewhat taken aback by the view of an unfamiliar landscape. The shops and neon lights that met my eyes were unfamiliar to me. Where were the places I once knew?

As in all fast-growing economies, Hong Kong is one of the places in the world that undergoes frequent and rapid changes to her city landscape.

If I become sentimental about lost images in a city, what is it like for our senior citizens? Whenever I teach introductory concepts of age and aging, I ask my students to try to imagine what seniors in their 80s or 90s must have gone through. A senior who is 90 years of age would have gone through the First World War, the Second World War, the war against Japanese occupation (1937-45), the Chinese Civil War (1945-49) and the Cultural Revolution of China (1966-76).

I try to help my students understand why seniors like to save and not waste anything, and why they go a long way to save a few pennies. I hope that, through such reflections, young people will come to appreciate that such “odd” behaviors represent strengths, not weaknesses. However, I have never asked my students to imagine the landscape changes seniors have seen in their lifetimes.

If we consider for a moment what seniors have gone through, it must be a most amazing experience. They have been to places we have not and seen things we have not. We should know, therefore, that all seniors likely have something to teach us, regardless of their background or educational level.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Domestic workers, a godsend for Hong Kong women

If you go the Central (district) or Causeway Bay area of Hong Kong on weekends and public holidays, you will find masses of female (and some male) domestic workers gathering in parks, on designated pedestrian walkways, in the courtyards of huge commercial complexes and along the walkways of overhead pedestrian bridges. It is quite an amazing sight, and it forces you to realize the magnitude of Hong Kong’s foreign domestic workforce.

People grumble about all these spaces being occupied by immigrant workers because they, themselves, can no longer use them. Those who grumble have probably forgotten one very important fact: These domestic workers have freed the women of Hong Kong from the burden of being the main caregiver in their household.

The majority of domestic workers in Hong Kong are Filipinos, with an increasing proportion coming from Indonesia. Those from Indonesia are becoming more popular, as many of them can speak Cantonese, the local dialect, while those from the Philippines speak only English. A small proportion of the workers come from Thailand. While writing this , I learned from Wikipedia that foreign domestic workers make up approximately 3 percent of the local population. There were 284,901 of them in 2010.

We have been hiring domestic workers since the late 1970s. As I recall, they were initially hired to take care of babies and children in a family. In more recent years, many of them are being hired to look after seniors. Historically, women have been the main caregivers in society, and this is still the case. Women are expected to provide care to those in need within a family. For better or worse, domestic workers have set us free. For many, to support a family, both husband and wife need to work. Given the disappearance of large, extended families, the woman of the family often needs help if she is to work outside the home.

After having babies, Hong Kong women go back to work more frequently than women in Western countries. It is rather uncommon for local women to give up careers to stay home and raise their kids. The advantage may be more secure income for the family. The down side is that working parents sometimes over-compensate for lack of time spent with their children by spoiling them. Some of my friends and acquaintances may be highly educated, but they indulge their children just the same. To mitigate the guilty feelings they have for not spending enough time with their kids, they buy expensive toys and gifts, or allow poor choices of foods and games.

There may be many problems associated with having a domestic worker to help us run a home, but I still think that it is great for women in Hong Kong to have this option. A Hong Kong woman can live her life the way she wants. She can raise her kids at home but, if she chooses to have a career, she can hire a domestic worker.

Back to where I started—I think we shouldn’t grumble. We should be appreciative of foreign domester workers’ contribution to Hong Kong.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

I love TV!

Television, “human’s best friend”—from the movie “Son of the Mask”—is the symbol of idleness. A person who sits all day in front of the TV is a “couch potato,” lazy, sloppy and lacking in imagination and creativity.

But I do love TV. I love drama, and easily identify with the emotions of people portrayed in a dramatic series. Nowadays, when there is so much “reality TV” around, it is easy to get carried away and feel as if you have participated. There are many interesting stories in these shows: the rich guy who bravely takes to the streets and tries out life as a homeless person for a few days; a man or woman with a regular job in metropolitan London who briefly gives up all creature comforts and lives a tribal life in a remote part of the world. “The Deadliest Catch” helps me appreciate why king crabs are so expensive when they finally arrive on our plates.

I don’t necessarily agree with what these people do. For example, what right do these people from “civilization” have to intrude into the world of these tribes? But listening to the story of a young rich kid who became homeless made me more mindful of how I relate to and interact with homeless people.

TV provides free entertainment and, if you choose wisely, offers great entertainment. How else would I learn so much about the world of reptiles, wildlife rescues and the intelligence of the octopus, if not from “Animal Planet”? How else would we learn what to do in the “Worst Scenario” and what myths to debunk if not for the Discovery Channel?

TV is our connection to the world. I remember reading an article describing how some seniors who were not very mobile and had to stay indoors a lot had a kind of control center set up around them. They would sit in their most comfortable chair in the living room, with the TV in front of them and a remote control by their side. The telephone was also within arm’s reach. The way they were positioned, they could also see whatever was going on outside their living room window. I found this most interesting, and think maybe I will do the same when I am old.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Immediate versus delayed gratification

When I was small, new clothes or new toys were only for special occasions, such as the New Year. So whenever my mom or big sister bought us a new dress, it had to be saved until the New Year before we could wear it. We were so excited and anticipation mounted as the time drew near. We were on Cloud Nine when we finally put on our new clothes.

Not so now.

I watch my nephews. Whenever I buy a new T-shirt for them, if they love it, they wear it immediately. They are very much part of a here-and-now generation.

When I was small, senior members in the family often told us to work hard, and said that hard work would earn us future opportunities. I watch the news. Young people nowadays do not really believe that. While in the past we grabbed hold of any job opportunity that came along if we needed a job, the younger generations in Hong Kong will only work if they can find the job they want. I can understand the sentiment. Unfortunately, the right job does not always come along that easily in life.

When we were kids, our parents told us to spend money wisely and keep our savings in the bank. We were often preparing for harder times, because we never knew what was coming next. Nowadays, the banks are pushing for a larger market share in credit-card business among college students. Some college students have acquired the habit of spending over their credit limit, accumulating large credit-card loans even before they graduate.

Some of my students think it is more important to spend money on the latest iPhone model than to buy textbooks. In fact, they can borrow a textbook from our school for the meager sum of HK $50 (US $6.40) a year, but not many do so.

Today, everyone in the world wants immediate gratification. Everything is about me, I, now.

You may think I am unsympathetic to the younger generation. Not so. This is the world we created for them. If we don’t like the way they are behaving, it is likely we are to blame, at least in part.

As a teacher, I am privileged to be able to mix with some really caring and conscientious young people. I know quite a number of them well, as they work for me as student assistants in my projects. Sometimes, when I look at them, I am happy knowing that, despite what we see and hear in the news, we do have a fine younger generation coming along.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Life is bearable because there is hope

A friend of mine died of leukemia a few months ago. He retired about three years ago and then was suddenly taken ill. Two weeks ago, I went with a colleague to visit his widow. She treated us at a restaurant to dim sum, a customary meal of local Chinese people.

Sundays are family days, and many families go for morning dim sum together. If your friends are visiting, they will be treated, as well. The widow’s son, daughter-in-law and 1-year-old granddaughter were all there. She seemed to be coping well, and we chatted away merrily. Soon, it was time to leave, and she came with us to the minibus stop to see us off. Suddenly, she told us, “I still miss him terribly,” and then burst into tears.

Life must be unbearable for her, because they were married for almost four decades and were very close. My colleague tried to comfort her by asking her to be brave, and to think of her current responsibilities of looking after the rest of her family and her granddaughter. We were in a public place and didn’t really have the chance to talk in depth. She stopped sobbing, and then we parted.

After I got home, I kept thinking of her—her grief and her loss. I wrote her a card. I wish I had had more time and been in a quieter place with her, so that she could cry her heart out. I wish I had had the courage to stop my colleague from talking. The woman needed a chance to express her true feelings.

As a nurse, I am expected to know how to therapeutically communicate with people in need. But, sometimes, I find myself tongue-tied, especially when I am with friends. I do not pretend to know how other people feel, because I don’t. I can’t. I can only imagine. But every individual’s experience is private and special. Nobody else can experience something in the exact same manner. Often, it is good enough simply to be there and listen. Let the person’s grief flow out. It is only in companionship that we feel supported. It is only in telling that we start to heal.

I often tell my students it is unnecessary to fill every moment with sounds when you are with a patient. The ability to tolerate needed silence in a conversation says much about a person’s skills in communication.

Although I am concerned about my friend’s wife, who is now a widow, I think time will be her best friend. The family is close, and she finds immense joy in playing an important part in her granddaughter’s life. In a young life, one can see joy and hope. We can find pure joy in simple matters in a child. Looking at him or her, we see hope for a happier, better future.

Life becomes bearable because there is hope.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Honor

I read this piece of news in the papers. A father sold his home and then worked very hard every day with his wife, making fishing nets to pay off his deceased sons’ debt. Three of his four sons died in a super storm four years ago, owing huge sums of money. The couple is expected to work for years to come, in order to finish paying their sons’ debt. The father said he would do this for his sons. He is honoring his sons by paying their debt. It is not just the love of a father or a strong sense of responsibility that compels the man to do this. I call it honor. He is an honorable man. He is now 82 years old.

I see honorable seniors every day in Hong Kong. They may be old, and some may be a little messy. They are those ordinary people to whom you may not give a second glance when you meet them in the street. Some can be rather peculiar in their behavior, but they are all honorable people to me, just the same. They are respecting life by doing the best they can.

I see many seniors selling all sorts of stuff on the streets. I don’t think they are trying to make money. I doubt they can make good money out of the items they sell—pediclips, hairclips, buttons, rubber bands, candies and so on, which are usually worth no more than a few dollars. What I see is that they are trying to spend their time doing something useful.

An older woman listening to a Walkman and selling goods in a bag; an older man scrubbing the outer shell of an electric fan to remove the rust; a barber cutting hair on a pedestrian walkway under a bridge; a group marking their place every morning outside the train station to collect used free newspapers from passersby for recycling: All these sights tell me about seniors’ ingenuity in finding meaningful occupations for themselves. I find it an admirable virtue.

Senior cleaning rusty fan.

Fan repair king.

Selling phones and other electronic devices.

Seniors collect and recycle newspapers.

Senior retailer interacts with customer.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

On uselessness and being

I saw a couple in my Health and Cognitive Assessment Clinic one day. It was the husband who needed to come, upon the urging of his daughter. However, it was clear that the wife needed help, too.

Her physical health was greatly compromised 15 years ago as a result of complications from spinal surgery. She had been through great pain. She told us that, if it hadn’t been for her husband and her children, she would have been dead a long time ago. As we talked more, she became sad. She said she was coping well, because she didn’t talk about something that had happened to her. Whenever she would talk about this experience with someone, she would cry.

She didn’t go out, except for grocery shopping, and pretty much restricted her social activity to her small family circle. She told me how great her children were, supporting her both emotionally and financially. Her husband, in spite of minor memory problems, took good care of her. She pretty much couldn’t do anything for herself now, except take responsibility for her own hygiene. Her husband did the cooking and all the rest of the household chores. She was sad, feeling totally useless.

She didn’t know that her worth was in her being.

I wish all seniors knew that their worth is in their being. Just being there is good enough. Just being there and allowing their loved ones to serve them is a good and useful existence. Imagine the children’s loss and feeling of emptiness and loneliness at not having a mother, or a husband at having lost his wife—it is unbearable. Think of the joy and satisfaction of the children when they are able to take care of their beloved parents.

I sometimes think of one day losing my mother, who is now in her 80s. My father passed away a long time ago; when my mother dies, there will be no vertical lineage that I can claim. I will be all by myself, even though I have siblings. I will be someone without a mother. The mere thought makes me feel disconnected in this world.

Imagine the peace of mind and sense of completeness of a child at having a parent for whom he or she loves to care. Worthiness of existence is not counted by what we can or cannot do, but simply by who we are.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Love of a mother

While I was recuperating from radiotherapy, my mother came to stay with me for a few months. Because she has memory problems, she could not remember that I was suffering from cancer. My brother and sister told her, but it didn’t register. Every now and then, my brother and sister and I would talk about my illness, such as taking my traditional Chinese medicine or going for follow-ups, etc. On these occasions, my mother would be reminded of my illness and then remember that she must thank the gods for me. Most Chinese people in Hong Kong have no particular religion, except worshipping their ancestors. My mother is this way.

One day, she asked us to buy a cooked chicken, fruits and Chinese rice wine, in order for her to thank the gods for having mercy on me. I bought a whole chicken, as is the traditional Chinese custom when you want to worship or show your gratitude to the gods.

It was a bright and sunny afternoon. We got the table ready, with the dim sum, fruits, teas and wines all properly arranged, just as Chinese people do when they make offerings to the gods. We even got some incense sticks burning.

My mother kowtowed to the gods for me. While on her knees, she softly mumbled her prayers, asking our ancestors to continue to bestow mercy on me. It had been a long while since I had seen my mother kneeling down praying to the gods. Nowadays, we are her “representatives” to go sweep the graves during the Ching Ming Festival. She is somewhat wobbly on her feet.

We were to go to my older brother’s home for dinner that evening. After appeasing the gods, the next thing to do was to cut the chicken. We wanted to share it with him. Western people use a knife or kitchen scissors to cut, but we use a chopper. As a child, I saw my mother chop up a whole chicken on a chopping board many times. I am aware that my mother is growing older and frailer, but I didn’t realize how weakened she has become.

I have vivid memories of my mother chopping up an entire chicken and then putting the pieces back together again in the shape of a whole chicken. She now struggled with the chopper and did not have the strength to cut the chicken into halves. After a couple of unsuccessful attempts, I took out my scissors, and then Mom used it to cut the chicken into pieces. I offered to help, but she said that I wouldn’t know how to do it. She forgot that I am a grown woman. My heart ached to see that my mother could no longer do things that she was good at. I was not cognizant of the full picture of what my mother has lost to aging. The gulf between the images from back when I was small and the image I saw at that moment made me mourn my mother’s loss.

All these years that my mother has slowly been growing old, we have gradually been doing more and more things for her. My mother no longer takes care of us. We take care of her. She is used to not doing anything in particular and keeps calling herself “lazy.” But she actively took charge when she wanted to please the gods for her daughter.

This will probably be the last thing that my mother will do for me.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.