Singapore, 2024-
At the Singapore Christian Home (SCH) in Sembawang, there is a space adorned with colourful, animal-themed wallpaper and bustling with staff in bright pink uniforms.
Chatter and music fill the air on some days, while colourful toys and learning materials lay around the room.
Once in a while, special guests make an appearance, such as fictional characters Elsa, Captain America, Iron Man and Wonder Woman.
This is a ward for children and young people who require long-term medical care, the only such ward in a nursing home in Singapore.
Located on the seventh floor of SCH, it is home to 23 residents of different races and religions, from five to 30 years old – each with four to six chronic medical conditions that require round-the-clock care.
All but two of the residents have intellectual disabilities.
One of the residents, an 11-year-old boy with Duchenne muscular dystrophy which causes progressive muscle degeneration, also has kidney problems, metabolic deficiency and developmental delay.
On top of that, he has dysphagia or difficulty in swallowing, so he requires constant attention and extensive care support.
The ward is unlike disability homes for children, which are equipped to deal with disabilities and behavioural issues, but not medical conditions.
It was set up in 2017 within SCH, a not-for-profit nursing home that was established by three Christian friends in 1960. The home has 190 elderly residents who occupy four floors of the building.
Once the children and young people turn 21, they are expected to move to the adult ward.
However, due to the complexities of their conditions, many remain in the paediatric ward after reaching adulthood and continue to be closely monitored.
While several hospitals in Singapore have paediatric wards, they are meant for acute care and short-term stay.
Before 2017, children who needed round-the-clock nursing care were placed in various nursing homes, living alongside the elderly residents.
At SCH, a team of nurses and therapy aides work tirelessly to meet the different needs of the young residents.
“Due to some of their conditions, the children can be abusive as they lack the social engagement skills to express themselves adequately. Hence, they pinch, punch, bite, slap and scratch nursing staff at times,” said Dr Betty Khong, director of nursing, who oversees the ward’s 27 nurses and therapy aides.
One of the nurses, Ms Stephanie May Tijam, said: “Besides taking care of their medical needs, we also pay attention to their social and emotional needs, which play a big part in their behaviour as they grow up.”
Ms Stephanie, who has been at the ward since 2017, added: “It’s like raising a child.”
While 90 per cent of the residents belong to low-income families, almost half come from socially complex backgrounds.
Home care can be difficult, with some family members absent because of reasons like incarceration.
The nurses naturally step into the role of parental figures.
“Our nursing staff are a part of the residents’ surrogate family – being mothers, sisters and friends to our children,” said Dr Khong.
Although the general staffing ratio is one nurse to one resident, only two nurses cover the night shift.
During that time, ward lights are dimmed but not switched off, and children who are more prone to emergencies are moved to sleep next to the nurses’ station.
The rest of the ward is kept under constant supervision.
As many residents have reduced bed mobility, the nurses help to turn them every two hours to improve blood circulation so that they do not get bed sores.
For tube-fed patients, feeding has to be spaced out throughout the day to aid digestion, with the nurses managing the feeding routines till about 1am daily.
About two-thirds of the residents are able to attend special schools or daycare centres outside SCH. Back in the ward, their time is spent on physiotherapy and other forms of therapy like art and music.
Volunteers also play a big role in the ward, such as a group who have been coming to play with the children on Wednesdays and another group who read them bedtime stories on Mondays.
Although running the ward is a mammoth task, the reward comes in the form of unbridled affection from the children.
“They will run to you and hug you. When we come back from days off, they will tell us that they miss us,” said Ms Stephanie.
“There are definitely bad days, and they are bound to throw tantrums, but we always remember that because they are... special kids, they need a lot of understanding, a lot of patience and really a lot of love”.
