Through the experience of a caregiver who had to take care of both her parents while raising four children, a social worker who continues to upskill and a researcher looking to change the perspective of caregiving, it is time to build compassionate communities to make a difference.

Looking back on the last few years of Koh Mei Ting’s life, some might wonder how she held it all together. At 36, she works full-time as an administrative manager while also raising four children, ages 6, 13, 15, and 18. She has also been a caregiver for two loved ones with serious illnesses: her late grandmother, who had advanced skin cancer, and her father, who lives with vascular dementia.

For Mei Ting, the two caregiving journeys could not have been more different. Her late grandmother wished to spend her final days at home rather than in hospital. Every day, Mei Ting would reach her grandmother’s home by 6am, patiently sitting by her bed to clean and dress the wounds that had opened across her face and neck. Her skin had grown paper-thin and blistered, sometimes bleeding from the lightest touch. Mei Ting learnt to apply cream with the gentlest pressure, to soothe and to comfort without causing pain.

“It was very painful to witness,” Mei Ting recalled. “My role was to keep her comfortable.”

The Tzu-Chi Foundation’s (Singapore) home care staff assisted Mei Ting, guiding her through wound care and palliative measures. Their presence gave comfort and reassurance when she had a lot of questions or required help at 2am to administer the fentanyl injection.

Her father’s condition, by contrast, is a long unfolding journey. When he was working as a driver, he suffered a stroke, got into several accidents and started to show signs of memory loss.

These days, Mei Ting tries to maintain his feeling of normalcy by allowing him to continue his long-standing habit of buying breakfast for the family at the market or riding his bicycle around the neighbourhood. To keep his mind active, she engages him with simple mathematics games and has installed an app on his phone to track his location during his daily walks. He also carries a card with his address in case his phone runs out of battery.

“He’s like my fifth child,” she said with a wry laugh. “Sometimes he thinks it’s 1999 or that he’s still in his twenties and asks for treats like McDonald’s. We even give him a bit of cash to motivate him. We joke about it instead of getting upset — that’s how we handle the stress.”

However, humour doesn’t always help to relieve stress. She becomes frustrated when he refuses to help her monitor his blood pressure, becomes angry out of confusion, or when she must play the “bad cop” role.

Despite the emotional weight, Mei Ting carries a calm optimism, perhaps shaped by years of being the eldest child who had to shoulder the most responsibility. Thankfully, her workplace has been flexible, allowing her to work from home when needed. Her mother, husband and children have become part of the caregiving ecosystem too. When Mei Ting is at work, her mother looks after her father and ensures the latter brings his phone with him when he goes out. Her daughters help with home care tasks like using the oximeter or checking blood pressure, while her husband takes leave to accompany her father to medical appointments. “Caregiving is a family affair,” she said. “Maybe I do more, but everyone has a role. They give me moral support.”

From caregiver to care partner

Stories like Mei Ting’s are far from rare, and yet, experts say, society still tends to see caregivers only through the lens of sacrifice. 

Professor Andy Ho, Director of Research of the Palliative Care Centre for Excellence in Research and Education (PalC) and Professor of Psychology and Medicine at Nanyang Technological University, Singapore, believes it’s time for a shift in perspective.

“The support structure for caregivers has traditionally focused on skills — how to provide wound care, manage symptoms, and handle breathlessness or constipation,” he said. “But true caregiving goes beyond competence. It’s also about emotional readiness and resilience, to be able to witness and stay with suffering, to know that no matter what you do, you can’t always make it better, yet I am still going to offer a compassionate presence.”

Prof Ho calls for a paradigm shift — one that recognises caregivers not as passive helpers or recipients, but as care partners. “They possess strengths, wisdoms, and intimate knowledge of their loved ones — things that even doctors and nurses may not fully know,” he said. “We need to recognise their competencies and work with them; it must be a partnership.”

In practice, this shift means moving away from a top-down medical hierarchy toward a more collaborative model, where caregivers help shape decisions and patient wishes guide the process. Prof Ho noted that this requires more than goodwill: caregivers need the resources, knowledge, and confidence to work alongside healthcare teams in planning the best care for their loved ones.

Caregiving, he added, is not just about attending to a patient’s needs but managing stress on multiple fronts. When caregivers are excluded from the process, tension and blame can arise within families. There is a need to empower the primary caregiver to make informed decisions while ensuring emotional support from others. Such empowerment, Prof Ho stressed, must come with compassion-based training, emotional resilience building, and the practice of self-care “so caregivers can sustain not just their role, but their own well-being”.

At PalC, Prof Ho and his team run programmes that support both family and professional caregivers through skills-based and psychological interventions. One of their signature initiatives is Mindful Compassion Art-based Therapy (MCAT), a six-week group programme that combines mindfulness practice, expressive arts and self-compassion exercises to promote mental wellbeing and holistic wellness.

“The sessions help caregivers put words to their feelings and emotions of caregiving,” said Prof Ho. “The sense of identity, purpose, and life’s meaning begins to emerge.”

Professional caregivers, including hospice nurses, physicians, and allied health staff, not only provide medical and emotional support to patients but also play a critical role in guiding families through end-of-life care. Prof Ho emphasised that these caregivers, too, need permission to be vulnerable.

“These are professional caregivers who need not just capability but also the confidence to be vulnerable and to ask for help,” Prof Ho said.

Caregiving, he noted, often involves “living losses”— the daily grief of watching a loved one decline and losing one’s identity, career or social connections in the process. “We need to talk more about grief, not only after death but during care itself,” he said. “Caregivers live with anticipatory grief — experiencing and coping with the slow physical and psychological declines of their loved one until death ensues.”

To that end, he advocates for a national grief and bereavement strategy, similar to initiatives in Australia and Canada that combine sustainable public education to foster death and grief literacy in society, driven and informed by rigorous university-based empirical research, supported and maintained by government funding.

As Singapore moves toward building more compassionate communities, Prof Ho envisions a network of community support that combines practical help, emotional care, and professional guidance. Neighbours can assist with groceries or housework to provide respite for caregivers.

Meanwhile, wellness coaches, acting as allied health professionals, provide consistent check-ins, motivation, and guidance on resilience and goal-setting. Prof Ho said, “When caregivers feel heard and supported, their well-being improves, and so does the quality of care they provide.”

Holding space for caregivers at home

Those on the ground witness how fragile and complicated caregiving can be. Lim Yi Xi, a senior social worker at the Singapore Cancer Society, has spent the last three years assisting families through the home hospice care programme. She works together with doctors, nurses, and therapists to visit patients at home.

“Many caregivers are caught off guard,” said Yi Xi. “Some suddenly find themselves responsible for everything — medical decisions, daily care, finances — while also grieving the reality that death may be near and that there may be more to the patient’s needs.”

Caregivers often face practical demands that can feel overwhelming, from making split-second decisions to managing routines and appointments. At the same time, they grapple with emotional challenges: the loss of identity, feeling undervalued, and a mix of stress, frustration and grief, she said.

She recalled a caregiver who had looked after her mother with cancer and advanced dementia for more than a decade. In that time, the woman put her life on pause — quitting her job and putting her daughter’s schooling and health on hold — to provide round-the-clock care. Yi Xi said, “That is one of the hardest parts of caregiving — the invisibility. Many don’t feel seen or appreciated, and they lose their sense of self.”

With families shrinking and professional care becoming more expensive, caregiving often falls on a single person, such as an unmarried daughter or an elderly spouse. Support needs vary — some families require financial assistance first, while others need emotional guidance. Once immediate needs are met, caregivers are helped to anticipate and plan for the challenges that arise as their loved one’s condition progresses, said Yi Xi.

What keeps Yi Xi going is the ethos of dignity and personhood that underpins palliative social work. “We see patients and caregivers as individuals with stories, cultures, and relationships,” she said. “Our role is to help them live and love well, even in the face of loss.”

Each year, Singapore Cancer Society hosts its annual flagship event, Relay For Life, at the National Stadium, showcasing an exhibition with palliative patients and caregivers’ stories to demystify death and spark open conversations about palliative care.

Yi Xi underlines that professional caregivers, especially palliative care social workers, require ongoing training and self-care resources. To support both patients and caregivers, other professionals use narrative therapy, family dignity interventions, solution-focused counselling and brief therapy, and play therapy.

The heart that holds

Caregiving is fundamentally an act of unconditional love, albeit one that is often messy and stressful. Mei Ting understands this all too well.

When fatigue sets in, she carves out small moments of rest, whether it is a quiet lunch with friends at the mall or a pause to gaze at the sky. “It helps me recharge,” she said. Over time, caregiving has reshaped her from within, teaching her patience, resilience, and even creativity in the face of daily challenges.

“Sometimes caregiving can feel like such a lonely road, so it really means a lot to have someone listen with care and understanding,” she said. “To all caregivers out there, may you always find strength in small moments, comfort in the people around you, and peace in knowing that what you do truly matters.”

For Prof Ho, the focus is on reframing how we see compassion. He hopes to dispel the myth of compassion fatigue. “Compassion doesn’t deplete us,” he said. “It replenishes us. Repeated neuropsychological research prove that when we engage in compassionate thoughts and actions, we feel more connected, more grounded. Compassion breeds compassion. It’s what keeps our species alive.”

He believes compassion training should be built into the curriculum for doctors, nurses, and all healthcare professionals. “When we nurture compassion, we strengthen our shared humanity. Compassion,” he concluded, “is ‘the key element for the survival of our species.”

Perhaps that’s what caregiving reminds us: that in caring for others, we hold one another through the hardest seasons of love and remember what it means to be human.

Photos by: Koh Mei Ting, Singapore Cancer Society