Marissa C. Marasigan is based in Manila, the capital of the Philippines. Her mother was diagnosed with dementia in 2009. On top of caregiving for her mother, she balances a full-time job, caring for her nephew, and finding time to lead her life. She shares her journey and the problem of dementia in her local community.
By Marissa C. Marasigan
My mother has Alzheimer’s disease, a form of dementia. Living with a person who has Alzheimer’s has its low moments, but once you get past (with the help of medicine) the heart-wrenching stage of her asking “Are you my daughter?”, it can be interesting. For instance, sometimes my mother thinks she is my daughter. (I don’t have a daughter.) At other times, she thinks she is my sister. (I don’t have a sister either.) Indeed, life has become like a box of chocolates. I never know who I’m going to be in her mind next.
The problem of dementia in the Philippines
A 2014 report of Alzheimer’s Disease International states that in the Philippines, the number of people with dementia is projected to increase from 301,000 (estimated) in 2015 to 1.15 million in 2050. The same report estimates the 2015 costs in the Philippines of dementia at $599 million, broken down as follows: medical costs, $167 million; non-medical costs, $83 million; and informal care costs, $349 million. At the average 2015 exchange rate of US$1:₱45.5028, the average cost per year per Alzheimer’s patient is ₱90,552 — certainly nothing to sneeze at.
Sadly, countries with low or middle income like ours have larger costs associated with informal care while care costs in high-income countries are relatively evenly distributed across informal and social care.
Support for caregivers in the Philippines
Filipinos with Alzheimer’s receive little or no support — financial or otherwise — from the government or other organizations. The Alzheimer’s Disease Association of The Philippines, Dementia Society of the Philippines and the Gerontology Nurses Association of the Philippines are private associations of doctors and nurses, respectively, that cater to the needs of people with Alzheimer’s. But for sure, these specialists do not come cheap.
In contrast, people with Alzheimer’s in the UK can receive from the National Health Service a personal health budget to pay for a wide range of items and services, including therapies, personal care, and equipment. People affected by or interested in dementia can attend free monthly Alzheimer Cafe meetings, where they can socialise, listen to and interact with experts, and learn in a relaxed environment. In the United States, up to six family members or friends can share the cost of paying an elderly individuals unsecured Alzheimer’s care loan. Most pharmaceutical companies in the United States also offer prescription assistance programmes.
“In our culture, the unmarried daughter usually takes care of the parents when they grow old. I take care of my mother because I love her and cannot imagine her living separately from me.”
I am my mother’s carer
The UK Government’s Carer’s Strategy defines a carer as someone who spends a significant proportion of their [lives] providing unpaid support to family or friends. In our culture, the unmarried daughter usually takes care of the parents when they grow old. I take care of my mother because I love her and cannot imagine her living separately from me. Occasionally, I have a paid, live-in helper to attend to her immediate needs because in addition to having Alzheimer’s, my mother is bed-ridden. And when I don’t have a helper, my teenage nephew Droilan and I take turns in taking care of her, depending on our respective class schedules. We manage by the grace of God.
The sandwich generation and the aging population
I am also part of the sandwich generation, which is made up of people in their 40s and 50s who take care of both parents and children. In a study by Yan Qu from the Central China Normal University, the author looked at household elderly care in China, the Philippines, and Japan. The study concludes that all of the three countries are [with] no exception facing the phenomenon of population aging despite their differentiated rates of population aging and various stages of economic development. Although there are shared cultural values among these countries that favor the family as the center for care, the pace of industrialization, urbanization, and migration means that changes are occurring unprecedented.
In most Asian countries, patterns of living arrangements among the older population reveal in a most concrete way of support extended to older people by their children and relatives. With the aging of the population, there are increasing numbers of older persons, some of whom will suffer from ill health and disabilities resulting in the need of care and support by others. Thus, the demography of population aging is increasingly concerned with the family ability both emotionally and economically. The constant aging process will still have potential contributions to its development efforts as well as special needs for social services. This demographic shift coupled with economic development processes has tremendous social, psychological, and economic implications for social planning and policy, especially for China and the Philippines.
The need for workplace flexibility
I am blessed to live near and work for a university, where I do not have to follow an 8-to-5 schedule. But not every carer enjoys these same advantages. And so, we carers look for help from both the government for financial support and from our employers for flexible work arrangements such as telecommuting, flextime schedules, compressed workweeks, expanded leave, and perhaps even work and family programs (in which employers assist their employees in child care and elder care).
I dedicate this article to my mother, who turns 90 years old today. Happy birthday, my precious Mama!
Marissa C. Marasigan is vice-chair of the Management and Organization Department of the Ramon V. Del Rosario College of Business of De La Salle University. She teaches Business Communication and Lasallian Business Leadership, Ethics, and Corporate Social Responsibility.