Staying Away, Reaching Out: Offering Parents Support During the Pandemic

The ‘circuit breaker.’

I brace myself as I look over the names printed on my patient list. Our developmental pediatric unit has started an initiative to call our more vulnerable families during the COVID-19 pandemic.

Chan J. DOB: 12/10/2001. As I scan the electronic notes, I learn that mum is the main caregiver of not one but two boys with autism spectrum disorder who require a high level of support. They both usually attend special school, but the school is currently closed because of social distancing measures. We are in lockdown, or ‘circuit breaker’ as we call it in Singapore, and both children have been at home for the past three weeks. My heart sinks in anticipation as I punch in the numbers.

“Hello,” a voice hesitates at the other end.

“Good morning, Mrs. Chan,” I say, putting on a cheery tone. “My name is Jia Yi and I am a nurse from the child development unit. We are checking in with our families and I wonder if you have some time to speak with me?”

“What about?” This mother sounds tired.

“Oh, just checking in on how you are getting on and whether there is anything we can do to help.”

‘”It’s hard,” she says. I hear her stifle a sob. “Never-ending.” Several long seconds pass as I wait.

“My younger boy, David. He doesn’t know how to use the toilet.”

“What’s been happening?” I prompt her, trying to sound encouraging. But I begin to feel afraid at asking questions I may not have answers for.

“He passes motion anywhere and everywhere in the house, and urine too. It’s been a mess. When I smell something, I need to check where it’s coming from to clean it up right way. It’s happening so many times a day now that they are not in school. I don’t want the boys to get sick from it.”

I can imagine the dank ammonia of urine and the gasp-inducing odor of stools seeping through the phone line. My heart cries out for this mother and I try to keep my voice steady as I struggle to think of solutions.

“I am so sorry, Mrs. Chan,” I say. “Do you have any help?”

“My husband is the only one working to earn just enough for our family,” she tells me. “I used to have a volunteer come to help me but now with the circuit breaker they can’t come. Can you help me or send someone please?”

My heart instinctively answers her plea: “Yes, yes, I can help! I will come and help you clean up and look after the children.” But the voice inside my head shouts, “But we’re in lockdown. And you need to be in the clinic to reach out to other children, too.”

I take a deep, quiet breath and then hear myself say, “I would love to come and help you, but the circuit breaker rules apply to us too and we can’t enter homes we don’t live in.” As I say this, I feel helpless and guilty.

“It’s easier if I just stay with him in the bathroom for an hour and then clean him up after,” she says. She begins to weep.

“I am sorry you are having such a hard time, Mrs. Chan. I wish I could do more to help,” I say as I hear her cry quietly on the other end of the line.

“Have you tried diapers?” As I offer this suggestion, I think to myself, “Of course she would have tried this!”

But she doesn’t notice my blunder.

“He doesn’t like the feel of it and refuses to let me put it on. We just need to wait for the circuit breaker to be over,” she sighs, as she collects herself.

I can imagine her wiping away her tears. “I try to keep the boys occupied,” she continues. “There are school activities online but I just don’t have the energy. I just let them watch TV, but then am afraid it will be too much.” I hear the hint of guilt in her voice that mirrors mine from a moment earlier.

‘I think you know what works best for you, Mrs Chan,” I tell her. “Don’t worry about school activities. Do what you can to get through the day and try to get some rest.” As I encourage her, I wonder if even this suggestion is achievable.

Reaching out matters.

“Mrs. Chan,” I tell her as the conversation nears an end, “you are really at the front lines. I know it is hard but you are not alone. We are here for you.”

Am I a fraud for saying this? The emptiness of my words rings through me.

There is a long pause, as if she is gathering her thoughts. “Thank you,” she says. “Thank you for calling.”

It has been 45 minutes since I first dialed and the call is now over. I feel the weight of this mother’s burden. How have I really helped? Mum is back to the grind of managing her two children, pretty much alone. She is exhausted and she needs someone to help her. What have I done to help? A little voice whispers in my ear, “You have listened and she has been heard. You have shared in her burden.”

Just taking time to really listen and offer a few words of comfort, deeply felt and sincerely spoken. This is all we can do and must do, to reach out when we have to stay away. I’ve realized that even if we can’t meet our patients in person, we can still care for them. And as we show compassion to others, it helps to remember that we too are deserving of that same compassion for ourselves.

The author, Jia Yi Bong, is a pediatric development and behavioral nurse working on a child development unit at a hospital in Singapore.