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JUL−AUG 2015 Changi General H o spi t al Magazine
A H E A LT H I E R , H A P P I E R L I F E
中文由第26页起
WORK IT RIGHT IN THE GYM8 common mistakes you should avoid
JUST A PINCH OF SALTWatch out for hidden sodium in common foods
PLANNING FOR THE FUTURE Rest easy with a Lasting Power of Attorney
CGH celebrates our veterans’ lifetime of service
SALUTING OUR
PIONEERS
A Note fr om the Editor Our nation turns 50 this August! As we look back on the road we’ve
travelled, CGH pays tribute to our own pioneers, who share the memories of all their trials and triumphs (page 8).
We continue to bring you tips to help you lead a healthier, happier life. Be it getting the most out of your workout (page 14), or learning how you can safeguard yourself in case you cannot make decisions for yourself one day (page 18), I hope you will pick up something useful.
Wishing all you dear readers the best of health, and for Singapore, many glorious 50 years ahead!
EDITOR’S NOTE
Poon Jing TingEditor
Supervising EditorLim Ee GuanEditor Poon Jing TingContributorsElizabeth Soh Elena OwyongTranslators Yip Laimei Elena Owyong Ho Seo TeckPhotographer Andy HoDesign & Production Publicitas PublishingEmail: [email protected] Specialist: Merlyn Hor Email: [email protected]
Go Green!This publication was printed on paper produced by an environmentally-friendly mill and pulp obtained from sustainable forests.
Share your copy of with others or recycle it. is also available online at www.cgh.com.sg/CARING
Tell Us!We want to hear from you. Send your letter to 5 Tampines Central 1, Tampines Plaza #08-01/05, Singapore 529541
is published bi-monthly for Changi General Hospital by Publicitas Publishing
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MCI (P) 122/01/2015. Company registration number: 198904226R. All rights reserved. No part of this publication can be reproduced in any form or by any means without the permission of the publisher. The views and opinions expressed or implied in are those of the authors or contributors and do not necessarily reflect those of the publisher.
USEFUL NUMBERS
Pharmacy enquiries 1800 787 8787
Feedback 1800 850 2823
Appointments and general enquiries 6850 3333
CONTENTSISSUE 137
JUL – AUG 2015
02 JUST A PINCH OF SALT Watch out for hidden
sodium in common foods
04 OBSESSIVE COMPULSIVE DISORDER Break free from OCD with the right treatment
08 A LIFETIME OF CARING CGH pays tribute to two of
our pioneering staff
14 WORK IT RIGHT 8 common gym mistakes to avoid
18 PLANNING FOR THE FUTURE
Get peace of mind by making a Lasting Power of Attorney
22 YOUR SAY
23 SUBSCRIBE TO CARING
25 HEALTHY EATS Stuffed mustard
cabbage boats
26 少点盐，多点健康 注意日常饮食中所摄取的钠
28 一生的奉献 樟宜综合医院向两名建国一代
职员致敬
32 强迫症 适当的治疗可让患者重获新生
36 未雨绸缪 立一份持久授权书，以为将来做
好打算
40 吃出健康 鸡肉馅芥菜小舟
Feedback 1800 850 2823
08 28
18 36
25 40 04 32
2 J U L– A U G 2 01 5 C A R I N G
JUST A PINCH OF
SALT Watch out for hidden sodium
in common foods
Sodium is a mineral found naturally in food. However, most of the sodium we consume comes from salt and sauces that are
added during processing and meal preparation.
WHY IS REDUCING SODIUM INTAKE IMPORTANT? It is recommended to consume less than 2,000mg of sodium per day, the equivalent of one teaspoon (5g) of salt. This is because we only need a small amount of sodium to maintain a normal fluid balance. Excess sodium acts like a sponge to retain water in your body. This leads to an increase in blood volume, which increases your blood pressure.
Excessive sodium intake is a key risk factor for the development of high blood pressure, which increases the risk of stroke, heart attack, heart and kidney failure. Studies have shown favourable effects when daily sodium intake is reduced in people who have kidney, heart or liver problems.
TIPS TO REDUCE SODIUM IN YOUR DIET
WHEN EATING AT HOME
+ Choose fresh food such as fruits and vegetables, meat, poultry and fish.
+ Limit processed food such as canned, salted, cured, smoked or pickled food or convenience/pre-packaged food.
+ Try seasoning food with natural flavourings such as:
• Fresh or dried herbs (parsley, coriander, mint, basil, onion, garlic, ginger, chive and spring onion)
• Spices (cinnamon, cardamom, cumin, pepper, curry powder, five spice and chilli)
• Vinegar, lemon, lime or fruit juices• Sesame oil or olive oil
+ Cook with tomatoes, corn, mushrooms, celery or carrot to enhance flavour naturally.
+ Taste food first before adding salt and/or sauces. If needed, add sparingly. Gradually reduce the amount of salt and sauces added in cooking and at the table for your tastebuds to adapt.
+ Substitute salty snacks such as potato chips and salted nuts with fresh/dried fruits or unsalted nuts.
WHEN EATING OUT
+ Ask for less or no gravy.+ Ask for less or no salt/sauces in cooking.+ Avoid drinking the soup when having
soupy dishes.
Text by Dietitic and Food Services, CGH
FOOD SERVING SIZE
AMOUNT OF SODIUM (MG)
HEALTHIER OPTIONS / AMOUNT OF SODIUM
Salt 1 teaspoon 2,000
Season with natural flavourings, such as
herbs and spices with less sodium
Stock cube 1 cube 1,840
Monosodium glutamate (MSG) 1 teaspoon 620
Oyster sauce 1 teaspoon 345
Light soy sauce 1 teaspoon 365
Dark soy sauce 1 teaspoon 200
Chilli sauce 1 teaspoon 70
Tomato ketchup 1 teaspoon 60
Remember… you only need 2 ,000mg of sodium a day!
+ Limit sauces or adding extra salt at the table.
+ Choose plain rice instead of flavoured rice.
WHEN SHOPPING FOR FOOD
+ Read the food labels, compare and choose products which contain less sodium such as those labelled as “reduced salt”, “low in salt”, “no added salt” or “salt-free”.
HEALTH NOTES
+ Choose products with the Healthier Choice Symbol, which contains less sodium than similar products in the same category.
+ Avoid choosing products that list salt or sodium as one of the first three ingredients on the ingredient list.
+ Salt substitutes may help you cut back on sodium. However, they are high in potassium and may not be suitable for some medical conditions. Check with your doctor, dietician or pharmacist before using salt substitutes.
Chinese salted cabbage 100g 1,860 Fresh cabbage (34mg)
Salted egg 1 medium 1,800 Egg, boiled (68mg)
Instant noodles with seasoning
1 packet (85g, dried) 1,450 Rice/noodles/bee hoon/pasta
(88mg)
Canned sardines in tomato sauce 100g 780 Reduced salt canned
sardines or fresh fish (80mg)
Potato chips 1 small packet (85g) 510 Unsalted potato chips (15mg)
Roasted peanut, salted 100g 430 Unsalted peanuts (15mg)
Luncheon meat 1 slice (47g) 390 Lean pork, cooked, 50g (31mg)
Mee soto 1 bowl 2,680Opt for soup noodles
and leave soup behind
Noodles, dry 1 bowl 1,650
Char kway teow 1 plate 1,460
Fried Hokkien prawn mee 1 plate 1,420
Chicken rice 1 plate 1,290 Opt for plain rice (10mg)
CANNED/
PROCESSED FOODS
COMMON LOCAL DISHES
SODIUM CONTENT IN COMMON FOODS
SAUCES AND SEASONINGS
Source: Health Promotion Board
4 J U L– A U G 2 01 5 C A R I N G
OBSESSIVEText by Dr Poon Ngar Yee, Associate Consultant,
Psychological Medicine
OCD behaviours may seem uncontrollable, but with the right treatment, you can break free!
COMPULSIVE DISORDER
4 J U L– A U G 2 01 5 C A R I N G
In the movie As Good As it Gets, Jack Nicholson plays a character with Obsessive Compulsive Disorder (OCD). Obsessed with the fear of contamination, he wears gloves
whenever he leaves his home and is constantly seen using hot water and bars of soap to wash his hands.
Another obsession is doubt. He needs to constantly assure himself that his door is securely locked and that the switches in his apartment are switched off when he leaves the house, so he turns his locks and flips his switches a fixed number of times before he is satisfied.
HEALTH NOTES MENTAL WELLNESS
6 J U L– A U G 2 01 5 C A R I N G
All this might seem strange and even laughable to us but for those suffering from OCD, it is something they cannot control. DYSFUNCTIONAL THOUGHTS AND BEHAVIOURS OCD is more common than most people realise. According to the Singapore Mental Health Study in 2010, around three in 100 people in Singapore suffered from OCD at some point in their lives. It is the third most common mental disorder in Singapore (after depression and alcohol abuse).
OCD is an anxiety disorder that is characterised by:
Thoughts that make a person anxious (obsessions)
Anxiety the person feels as a result of the obsessions
Behaviour rituals (compulsions) the person does to reduce anxiety
Obsessions can come in the form of thoughts, images in the mind, or doubts. Common obsessions include:
Fear of contamination Doubts about electrical appliances being switched off, or doors being properly locked
Sexual or violent themes that are out of character for that person
Brooding over and arguing with themselves even when making simple decisions
OCD is an anxiety disorder that makes one feel fearful or guilty, and compels one to perform certain behaviours
Dr Poon Ngar Yee is an Associate Consultant in Psychiatry at CGH. She received her MBBS from the University Of London. She completed her psychiatry specialist training in Singapore in 2014. Dr Poon is a member of the Royal College of Psychiatrists.
HEALTH NOTES MENTAL WELLNESS
Although these thoughts are unwelcome, they repeatedly intrude into the sufferer’s mind, against their will.
As a result, a person with OCD may feel anxious, fearful, guilty or a combination of these. In order to reduce these intense feelings or to prevent a feared outcome, a person with OCD is compelled to perform certain acts or rituals such as checking or washing, as coping strategies to ‘neutralise’ these bad feelings.
Initially, they may feel less anxious or guilty after compulsive acts or rituals. However, in the long run, these ‘coping strategies’ will actually reinforce the person’s irrational need for these behaviours in the first place! As a result, these poorly formed 'coping strategies' merely perpetuate the person’s OCD and further disrupt the person’s quality of life and daily activities.
BREAK FREE! The exact causes of OCD are unknown, but there are some possible contributing factors. These include one’s genetics, a chemical imbalance in the brain, stressful life events, personality traits such as perfectionism, an extremely strong (possibly dysfunctional) sense of responsibility, or a ‘worst case scenario’ mindset.
Sadly, many people with OCD do not seek professional help, believing that their obsessions and compulsions simply cannot be controlled, and instead try to cope on their own. The good news is that treatment is available with the symptoms of OCD is available. A combined approach using medication, behaviour and cognitive therapy is often effective in treating OCD.
Medication One of the causes of OCD could be an
imbalance of a brain neurotransmitter called serotonin. So, Selective Serotonin Reuptake Inhibitors (SSRIs) like Prozac, Setraline and Faverin, or anti-depressants like Clomipramine, have been shown to improve and control OCD symptoms effectively.
Often where the clinical improvement is partial, the addition of one or more drugs can help improve the results. Higher doses of these medications may also be required. These medications are generally safe and non-addictive in nature. However, some people could experience side effects such as headaches, feeling ill, or having ‘dry mouth’ in the initial stage of the treatment.
Exposure and Response Prevention (ERP) therapy
The basic idea behind ERP therapy is that when a person is exposed to an anxiety-provoking situation, the person’s anxiety level would initially increase and then subside if the exposure duration is sufficient enough. ERP therapy combines exposure – confronting the thoughts, images, objects or situations that trigger anxiety in a person with OCD – with response prevention, which involves training and helping the person refrain from carrying out their typical compulsive response when exposed to these anxiety triggers.
Cognitive Therapy Often, persons with OCD know that their
thoughts are irrational but they are not able to control them. In this form of therapy, the sufferer’s illogical beliefs are highlighted to
them and are challenged on rational grounds using various techniques,
such as identification of their dysfunctional thinking, helping
them explore their ability to generate alternative thoughts and responses, and empowering them to be able to test these alternatives out in practical situations.
If you know of someone who suffers from OCD or are
struggling with OCD yourself, remember that with appropriate
treatment, people with OCD can break free from dysfunctional beliefs
and begin to lead normal, productive and abundant lives!
8 J U L– A U G 2 01 5 C A R I N G 8 J U L– A U G 2 01 5 C A R I N G
CARING
Between plaster technician Joseph Wee (left) and orthopaedic surgeon A/Prof Low Boon Yong, they have given nearly 100 years of service to public healthcare
CGH pays tribute to two of our pioneering staff
Text by Poon Jing Ting, Editor
COVER STORY
As Singapore celebrates its 50th birthday, it is fitting to pay tribute to the pioneers who toiled during the early years to literally build the nation. CGH too, remembers our veteran
staff who have given over 50 years of dedicated service to healthcare and witnessed all the hospital’s milestones. Let’s walk down memory lane with two of our amazing pioneers. To all the pioneers, thank you and we salute you!
The Old Changi Hospital in the 1990s
A LIFETIMEOF CARING
1 0 J U L– A U G 2 01 5 C A R I N G
MENTORING A NEW GENERATION OF PHYSICIANS
A/Prof Low Boon Yong planting a tree in CGH in the 1990s to raise funds for needy patients
Associate Professor Low Boon Yong, 69, is a senior consultant in orthopaedic surgery. When Toa Payoh Hospital and
Changi Hospital merged to form New Changi Hospital in 1996 (later renamed Changi General Hospital), he was the Chief of the Accident & Emergency (A&E) Department. The A&E now is always so crowded and busy! Was it like that in the past as well? A/Prof Low: Oh, we were very, very busy. I was Chief of A&E in Toa Payoh Hospital before coming over as well, and there were about 80 patients a day. When we came over to New Changi Hospital, there were 300 to 400 patients every day. It was a huge difference. And we had no computers then. Wow, managing the busiest department in the hospital with everything done manually, is not easy. How did you lead the department’s transformation and modernisation? A/Prof Low: Well, it was not too difficult. Many of the doctors and nurses were young, and could pick up the new system, though I myself am not so adept at it (laughs). We were actually one of the first hospitals in Singapore to establish a fully computerised system in A&E. Many who have worked with you before say that you are a good mentor, and some of your protégés are now holding senior positions all over Singapore. In fact, the current Chief of Orthopaedic Surgery, Dr James Loh, says he is grateful that you gave him a second chance when he was once deemed unsuitable for orthopaedics as a young doctor. Can you share with us your philosophy behind mentoring young doctors? A/Prof Low: I don’t need to do much. All of them are bright people, like James. All talented people. We just need to recognise their interests, help them see the bigger picture and shape their ideas.
What about outside of work? Do you have any personal pursuits or hobbies? A/Prof Low: I have been volunteering with the Spastic Children’s Association of Singapore for many years. These children need a lot of help. It’s common for them to have orthopaedic issues such as difficulty in walking and sitting. Beyond that, helping them find good jobs so that they can take care of themselves, become a little independent and integrate into society – that’s very important. We reach out to companies to allow some of them to set up booths selling simple craft. There’s one in CGH, too. They can make a few hundred dollars each month, which is enough for them. It makes them happy. After such a long and illustrious career, are you looking forward to when you can finally retire? Any post-retirement plans, like travelling around the world? A/Prof Low (laughs): I have a lot of plans actually! I have ideas about the hotel industry, F&B, childcare… you know, becoming an entrepreneur. There’s a lot to do. Sounds like a very busy and exciting retirement! Finally, what would you like to say to Singapore as we reach this significant milestone of 50 years? What would you like to see in the future? A/Prof Low: I hope that every Singaporean can have good health coverage. It’s very important to have peace of mind, especially when you enter into old age.
COVER STORY
“We need to recognise (young doctors’) interests, help them see the bigger picture and shape their ideas.”
1 2 J U L– A U G 2 01 5 C A R I N G 1 2 J U L– A U G 2 01 5 C A R I N G
Plaster technician Joseph Wee has worked in many departments in his 56 years in healthcare, including a stint in a mobile dispensary in the 1960s (opposite page)
COVER STORY COVER STORY
kinds of people in my 56 years in healthcare. I help out not just in the clinic, but also in the wards and in A&E (Joseph is one of two plaster technicians in CGH). Sometimes, I’m also asked to train nurses and medical students in cast-making.
Every day at work is interesting to me. I will continue to work as long as I am needed here.
How about your personal life? Do you have any hobbies you enjoy? How do you relax outside of work? Joseph: I cook for my family, when I have time. My favourites are ayam buah keluak, babi pongteh… because I’m Peranakan, you see. I also go to the airport every weekend, just to walk and look around. Singapore is turning 50! Any wishes for the nation or even yourself? Joseph: I wish Singapore all the best. Personally...I hope my grandchildren marry and have children! (laughs)
"I rotated among different departments such as housekeeping and dispatch. I also travelled to villages with the mobile dispensary, to bring medication to sick people in the villages."
Joseph Wee, 76, is a plaster technician with CGH’s orthopaedic clinic. He was with Changi Hospital through the handover from
the British armed forces. What was it like during those days? Joseph: We were a very small team, fewer than 10 of us. As more and more of the (British) troops left, there were fewer patients too. Some days, there would only be one patient a day! So what did you do before that? Joseph: I joined SGH in 1959. Those days, we were called medical health servants. My starting pay was only $97 a month! We didn’t even get paid for the first three months during probation. We had to borrow money from seniors to survive.
At SGH, I rotated among different departments such as housekeeping and dispatch. I also travelled to villages with the mobile dispensary to bring medication to sick people in the villages. After that, I also worked at Middle Road Hospital and the Police Academy, working as a telephone operator and medical records keeper. Tell us more about your job at CGH. What are some of the challenges you face and what keeps you going? Joseph: I am a plaster technician in Clinic U (orthopaedic clinic). I help patients apply and remove casts for hand and leg injuries. Depending on where the injury is, the swelling can be quite big sometimes and it can be tricky. I have to assure patients who are scared – no, it’s not painful; you need to have the right technique.
We can also be very, very busy. Sometimes, we can have a few hundred patients each month. Most of them are okay, but now and then, you get unappreciative patients or even if the patient is nice, their family members can be nasty. But I’m used to it. I’ve already seen all
APPLYING THE
HEALING TOUCH Ministry of Information and the Arts Collection, courtesy of National Archives of Singapore
WORK IT
Text by Tong Yuyan, Sports Trainer, Singapore Sports Medicine Centre
8 common gym mistakes to avoid
RIGHT
1 4 J U L– A U G 2 01 5 C A R I N G
Hitting the gym is getting more popular these days, but work out the wrong way and you could undermine the
effectiveness of your workouts, or even injure yourself. Here are eight points to note.
DID YOU WARM UP AND COOL DOWN?
Warming up before exercising is an important transitional phase to increase your body temperature. This allows the body to adjust to the changing demands imposed during the exercise session and decreases the potential for muscle soreness following exercises. Heart rate and blood pressure tend to be higher following exercises and metabolic end products are produced from the muscles used during the workout. Not only does cooling down allow a gradual recovery of heart rate and blood pressure to normal, it enables the muscles to contract and assists the heart in clearing out ‘waste products’ in the body system produced from exercise. Both warm up and cool down are typically done at a minimum of 5–10 minutes between low to moderate intensity.
IS YOUR FORM AND TECHNIQUE CORRECT?
Exercising with poor form and technique is both ineffective and potentially dangerous. You may not notice the effect, but over time, poor form or technique can result in injuries. Always progress gradually and execute the exercises through the full range of motion for maximum muscular development. If your form is compromised, reduce the weight and practise the correct exercise movement before progressing. Even something as seemingly simple as using a jogging machine can benefit from advice and instruction.
ARE YOU USING THE CORRECT WEIGHTS?
Many enthusiastic folks tend to try lifting weights that are too heavy for them, with the misconception that “the heavier, the better”. It all depends on your training goals – are you training for muscle size (‘bulking’) or for strength? If your goal is to increase muscle size, you actually should go lighter on the weights but with more repetitions. If it’s for muscle strength, this is usually around 80% of 1 Repetition Maximum (1RM) or greater, with fewer repetitions. 1RM in weight training is the maximum amount of force that can be generated in one maximal contraction. If you are unsure about how to calculate your RM, consult a gym trainer or sports trainer.
ARE YOU RESTING IN BETWEEN SETS?
Research has shown that both acute responses and chronic adaptations to resistance training are affected by the rest interval between sets. However, many often overlook this, using durations that are either too long or too short. For an effective, efficient and safe workout in resistance exercise prescription, it is vital to understand the interaction among training variables such as intensity, number of sets and repetitions, mode of exercise, the speed of performing an exercise and the optimal rest interval between sets. Depending on your training goal, a combination of moderate-intensity sets with shorter rest intervals of 30–60 seconds will be good for muscle hypertrophy (building muscle size), while longer rest intervals of 3–5 minutes with high-intensity sets will be appropriate for strength training.
HEALTH NOTES
Exercising with poor form and technique is both ineffective and dangerous
FEATURE
WARM UP: Try the high kick (opposite page) and butt kick (above) to get your heart rate up. The butt kick should be done in quick succession – left leg then right leg, repeated several times
1 6 J U L– A U G 2 01 5 C A R I N G
Mix up your exercise order, type of exercise and intensity to prevent staleness
DID YOU NEGLECT TRAINING YOUR CORE AND FLEXIBILITY?
Many day-to-day tasks – from picking up items to walking and running up and down the stairs – involve core muscles. The core comprises muscle groups such as the transversus abdominis, multifidus, pelvic floor and diaphragm, running generally from your rear end to your shoulders. Having strong core stability helps protect the spine and surrounding musculature during static and dynamic movements, thus lowering the risk of injury. Movements such as push ups, overhead squats and deadlifts are functional exercises that involve the core. It is important to engage your core and maintain a neutral spine position while performing these exercises.
Following exercise or physical inactivity, muscles may become tight and stiff. Muscle tightness can limit the joint range of motion which affects your exercise performance and increases the risk of injury. So keep your muscles flexible by doing stretching exercises at least 2–3 times a week, for at least 10 minutes each time. Each stretch should last between 20–30 seconds to maintain or improve flexibility.
DO YOU GET SUFFICIENT
REST AND RECOVERY? ARE YOU OVERTRAINING? While it is good to stay active, we must balance it out with adequate rest as well. If there is insufficient
COOL DOWN: Try the forearm stretch and piriformis stretch (below) for your cool-down exercise
SQUATS: Back should be straight, not rounded
OVERHEAD SQUATS: Arms should be straight (at the ear) and not pulled too far back
symptoms of overtraining include a decline in physical performance, insomnia, emotional instability, an elevated heart rate and elevated blood pressure. To prevent overtraining, avoid monotonous training and vary your training with mandatory rest phases. Keep a training log to monitor your progress, noting down items such as the distance, intensity, volume and level fatigue. Significant changes in any of these could signal overtraining.
ARE YOU REPEATING
THE SAME EXERCISES? Just as our brain needs to be stimulated to prevent boredom, the same applies to muscles as well. If we keep performing an exercise in the same manner for long periods of time, this can lead to ‘staleness’ of exercise, and affect performance. Try to mix things up by playing with the exercise order, type of exercise and/or intensity during your workout to prevent staleness.
LADIES – ARE YOU AVOIDING RESISTANCE TRAINING?
There are many benefits gained from doing resistance training. However, most women fear developing bulky muscles so many of them do not use enough weight during resistance training, or worse exclude weight training from their exercise regime altogether! This is a common misconception. A woman would have to do a lot of such exercise and eat a lot for her to become a ‘She-Hulk’! A complete exercise programme for ladies should include some form of resistance training and this maintenance of muscle mass becomes especially important as women get older.
rest and recovery from exercise, body regeneration cannot take place and over time, performance may deteriorate as a result of ‘overtraining’. The impact of overtraining can be serious, requiring weeks, even months to recover. Some signs and
Tong Yuyan is a Sports Trainer and Exercise Physiologist in the Singapore Sports Medicine Centre (SSMC). She works with athletes to improve their sports performance and also assists people who are undergoing rehabilitation and weight loss programmes.
1 8 J U L– A U G 2 01 5 C A R I N G
Get peace of mind by making a Lasting Power of Attorney
FUTURE PLANNING FOR THE
Text by Elena Owyong
1 8 J U L– A U G 2 01 5 C A R I N G
FEATURE
FUTURE FEATURE
James (not his real name) is a 55-year-old teacher at a secondary school. He has been teaching for nearly 30
years and loves his job. In his spare time, he enjoys spending time with his family, especially his son, who has just graduated from university.
At his age, James is considered by many of his friends as fairly healthy. Although he, like his father and brothers, has high blood pressure and high cholesterol, he avoids fried food and tries to squeeze in some exercise when he doesn’t have too many papers to mark.
But one day, James suddenly suffers a major stroke. A few weeks later, he suffers a second stroke. The recurrent strokes severely affects all his functions. He can no longer walk, feed himself or dress himself. Worst of all, his mental capacity
is significantly diminished and he can no longer make decisions for himself.
Devastated, his wife Linda and his son Ryan take over all his affairs. But they disagree on certain things, such as whether James should be admitted to a nursing home or looked after by a maid at home, and what to do about his various bank accounts and investments. All these complex decisions take a toll on Linda and Ryan, who are still in shock at the sudden events. SAFEGUARD YOURSELF AND YOUR LOVED ONES Such a scenario is not uncommon. Even seemingly healthy people can suffer debilitating conditions like stroke, dementia or brain trauma from accidents, which result in them losing their mental capacity.
2 0 J U L– A U G 2 01 5 C A R I N G
The importance of planning for the unforeseeable future cannot be understated. One of the best ways to
safeguard yours and your loved ones’ interests in such a situation is to make a
Lasting Power of Attorney (LPA).What is a LPA? In short, it is a
legal document that allows you to empower someone you trust to make decisions on your behalf, should you lose your mental capacity.
In a LPA, the decision making lies in two broad areas:
Personal welfare. This includes your healthcare, where you live and your social activities
Property and affairs matters. This includes your finances, selling of your house/car, and taxes
Besides safeguarding your interests by officially appointing a trusted proxy decision maker (called a “donee”), the LPA helps alleviate the stress faced by your loved ones as it allows you to detail
the powers that the person(s) you appoint has. MAKING A LPA To sign up for a LPA, you need to apply to the Office of the Public Guardian. The forms are available on its website: www.publicguardian.gov.sg
In the form, you can grant your donee(s) general powers
or customise certain powers, depending on your requirements. The donee(s) must be:
21 years old and above
Cannot be bankrupt (if granted powers to decide on property and affairs matters)
You can appoint more than one
donee. However, complications
A LPA CAN ALLEVIATE STRESS FACED BY YOUR LOVED ONES
FEATUREFEATURE
may arise if there are too many donees and they cannot agree on the decisions to be made. You should choose donees who are able to work out any differences together so there is no deadlock.
The LPA forms must be signed and certified by a certification issuer. This person can be a practicing lawyer, registered psychiatrist or accredited medical practitioner. The Office of the Public Guardian’s website has a directory of suitable certification issuers for reference.
After submission of the forms, there will be a mandatory six-week waiting period, after which your LPA will be registered if there are no objections.
However, this does not mean that all your decisions will henceforth automatically be
made by your appointed donee(s). The LPA will only be used if you lose mental capacity. As long as you still possess mental capacity, your donee(s) should not step in to make decisions even after the LPA is registered.
Up till August 2016, the application fee will be waived for Singaporeans who use the first form – LPA Form 1, which caters to those who grant general powers to their donee(s). Singaporean applicants will only need to pay professional fees charged by LPA certificate issuers. Permanent Residents (PRs) and foreigners need to pay $50.
The information above is provided by the Office of the Public Guardian. To find out more, call 1800 226 6222, email [email protected] or visit www.publicguardian.gov.sg
FAQS
1 WHAT IF I DON’T MAKE A LPA?Not making a LPA means you do not have a donee to make important decisions on your
behalf. Thus, in the event that you lose your mental capacity, your family member or friend will need to apply to the courts to be appointed as your deputy.
2 CAN A LPA BE MADE FOR PEOPLE WITH INTELLECTUAL DISABILITIES? An LPA can only be made by a person with
mental capacity.Parents of children with intellectual disability may apply to the Court to be appointed deputies if the children are likely to be still lacking in capacity after 21 years of age.The parents may also apply to the Court to appoint successor deputies as future decision-makers for their children with intellectual disability in the event the parents are no longer around or are unable to make those decisions.
3 CAN I REVOKE MY LPA?Yes, you can. As long as you have the mental
capacity, you can revoke your LPA. You will need to sign a revocation form, notify all donees as well as the Office of the Public Guardian. A revocation fee of $25 applies.
4 ARE THERE OTHER SITUATIONS WHERE MY LPA OR THE DONEE'S POWERS WILL BE REVOKED?Apart from the revocation (termination) of your
LPA, it will be cancelled or the appointment of the donee will be terminated in the following circumstances:s You or your donee diess Your donee lacks mental capacity to act as a donees Your donee formally declines the appointment s If your donee is your spouse and you get divorced s You or your donee becomes a bankrupt or if your donee
is a licensed trust company, the company is liquidated, wound up, dissolved or under judicial management
s A Court order is made to cancel the LPA or your donee's powers – this can happen if your donee has not acted in your best interest
5 IF I HAVE MORE THAN ONE DONEE, HOW SHOULD THEY DECIDE ON MATTERS ON MY BEHALF?
If you appoint more than one donee to make decisions about the same matters, you can appoint them to either act:s Jointly: The donees have to act together
and cannot act separately ORs Jointly and severally: The donees can
take the decisions together or separately. Both types of decisions are valid.
If there was no specification, the law assumes the donees will act jointly.
2 2 J U L– A U G 2 01 5 C A R I N G
I appreciate the article “Caring for the
Caregiving”. I t reminds us of the self lessness of these caregivers, their physical and mental toi l , and the importance of loving and looking after themselves as much as they care for the family members they look after. I wil l recommend sharing this article with family and fr iends for awareness.
Yeo Xiu Wen Punggol
I really appreciate the article on caregiving. I t is an aspect
that is not often talked about but is very important! I t is not easy to be a caregiver and it is a t imely reminder for us to
take care of ourselves before we can take care of our loved ones. Kudos to that!
Yap Hui Ting Bedok
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YOUR SAY
Caring...Dear
CARING Mar–Apr 2015
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C A R I N G J U L– A U G 2 01 5 2 5
HEALTHY EATS
This dish is easy to prepare, and is low in calories and high in fibre
STUFFED MUSTARD CABBAGE BOATSPREPARATION TIME45 minutes
SERVES
WHAT YOU’LL NEED Mustard cabbage, with leaves separated, washed and drained (400g)
STUFFING Chicken thigh or drumstick, deboned and diced (200g)
Water chestnuts, peeled and diced (100g)
Prawns, peeled and minced (150g) Spring onion, finely chopped (1) Shallots, peeled and chopped (2) Fresh breadcrumbs (2 tbsp) Salt (to taste) Ground white pepper (to taste) Water (3 tbsp) Egg, beaten (1)
METHOD Trim leafy part off mustard cabbage and discard. Place leaf stalks with hollow side facing down. Using a sharp knife, carve stalks into ‘boats’. Set aside.
Prepare stuffing. In a mixing bowl, combine all ingredients and mix well. Spoon stuffing into hollow of stalks.
Place stuffed stalks in a steamer and steam over high heat for 5–7 minutes, or until stuffing is thoroughly cooked.
Garnish as desired and serve immediately.
This recipe was first published in A Cookbook for Diabetics by a Dietitian and a Chef.
C A R I N G J U L– A U G 2 01 5 2 5
NUTRITIONAL INFO (PER SERVING)Energy 146kcalCarbohydrates 12.4gFat 3.4gCholesterol 139.2mgFibre 4.5g
2 6 J U L– A U G 2 01 5 C A R I N G
多点健康注意日常饮食 中所摄取的钠
钠是一种在食物里的天然矿物质。然而，我们所摄取的钠大多来自在处理和准备食物过程中所加入的盐和酱料。
为什么减少盐的摄取这么重要？ 良好的日常钠摄取量为不超过200毫克，相等于1茶匙的盐。这是因为您的身体其实只需要少量的钠便能够保持液体的正常平衡。多余的钠就好像一片海绵，把水份囤积在体内。这导致血量的增加，从而使得血压上升。因此，过量的钠摄取是导致高血压的一个主要因
素，而高血压则会提高中风、心脏病发、以及心脏和肾脏衰竭的风险。有研究显示当肾脏、心脏、以及肝脏病患者减少每日钠的摄取时，他们的病情便有了明显的改善。
减少钠摄取的小贴士
在家用餐时
+ 选择新鲜材料，如水果和蔬菜、肉、家禽、以及鱼。
+ 有节制地吃加工食品，如罐头食品、腌熏食品或即食套餐／包装食品。
+ 选用天然的调味料，如：
• 新鲜药草或干药草（如西芹、香菜、薄荷、九层塔、洋葱、大蒜、姜、细洋葱、以及青葱）
• 香料（如肉桂、小豆蔻、孜然芹、胡椒、咖喱粉、五香、以及辣椒）
• 醋、鲜柠檬、青柠、或果汁
• 麻油或橄榄油
+ 选用蕃茄、玉米、菇类、芹菜、或胡萝卜为食物增添天然风味。
+ 在加入盐或酱料前先试吃。若味道偏淡，加入少许即可。逐步减少烹调和上桌时所使用的盐和酱料的份量以便让口味适应过来。
+ 选用新鲜水果或干果又或者不加盐坚果来代替加了盐的零食，如薯片和加盐坚果。
在外用餐时
+ 要求少点肉汁或完全不要肉汁。
+ 要求厨师在烹调时放少点盐和酱料，或完全不要放。
+ 在吃带汤的菜肴时避免喝下汤汁。
+ 食物上桌后有节制的加入额外的酱料或盐。
+ 选择白饭而不是添加了调味料的米饭。
原文营养与饮食部门，樟宜综合医院
盐少点
食物 份量 钠（毫克） 较健康的选择／钠含量
盐 1茶匙 2,000
选用天然的调味料， 如药草和香料
高汤块 1块 1,840
味精 1茶匙 620
蚝油 1茶匙 345
酱青 1茶匙 365
酱油 1茶匙 200
辣椒酱 1茶匙 70
番茄酱 1茶匙 60
切记！您一天只需摄取 2,000毫克的钠
在选购食物时
+ 阅读食物标签，作比较并且选择那些钠含量低的食品，如那些标明“少盐”、“低盐”、“不加盐”、或“不含盐分”的食品。
+ 选择带有“较健康选择”标志的食品，它们的钠含量比同类食品要来得低。
保健小笔记
+ 避免选择那些在材料说明上有盐或钠排列在前3名的食品。
+ 盐替代品可帮助减少钠的摄取。但这些食品的钾含量高，因而不适合患有某些病症的人群。在使用盐替代品之前，先咨询您的医生、营养师或药剂师。
中式咸菜 100克 1,860 新鲜白菜（34毫克）
咸蛋 1粒 1,800 煮鸡蛋（68毫克）
快熟面加调味料 1包（85克，干） 1,450米饭／面条／米粉／意大利面 （88毫克）
罐头番茄酱沙丁鱼 100克 780低盐罐头沙丁鱼或新鲜鱼（80毫克）
薯片 1小包（85克） 510 不加盐薯片（15毫克）
加盐烧烤花生 100克 430 不加盐花生（15毫克）
午餐肉 1片（47克） 390 瘦肉，煮熟，50克（31毫克）
马来鸡汤面 1碗 2,680
选择汤面， 但不要喝汤
干捞面 1碗 1,650
炒粿条 1盘 1,460
炒福建虾面 1盘 1,420
鸡饭 1盘 1,290 选择白米饭（10毫克）
罐头／
加工食品
常见本地美食
常见食物和调味料中的钠含量
酱料和 调味料
资料来源：新加坡保健促进局
2 8 J U L– A U G 2 01 5 C A R I N G 2 8 J U L– A U G 2 01 5 C A R I N G
CARING
石膏包扎员黄明水和骨科高级顾问刘文荣医生相继在公共医疗界服务，二人的服务年数加起来差不到有100年
樟宜综合医院向两名建国一代 职员致敬
原文潘静婷，编辑
封面故事
新加坡庆祝成立50周年，也是我们向劳苦功高的建国一代致
敬的恰好时机。作为服务大众的樟宜综合医院，当然不会忘
记其老一辈职员50年来竭诚为病人服务，并与医院共同成
长，见证医院各个发展里程碑的美事。现在就让我们跟随两位建国一代
的职员，一起回顾他们当年的服务生涯。
1990年的樟宜综合医院
一生的
奉献
3 0 J U L– A U G 2 01 5 C A R I N G
辅导新一代医师
刘文荣（69岁）副教授是一名骨科高级顾问。1996年大巴窑医院和樟宜医院合并为樟宜综合医院时，他担任急诊部主管。
问：现在的急诊部总是人头攒动，非常忙碌！以前也是这样吗？ 答: 我们很忙，非常非常忙。当时我是在大巴窑医院急诊部服务，一天大约接待80个病人，合并以后来求诊的病人一天大约有300至400名，差别实在太大了，况且当初还没使用电脑。问：哇！在最繁忙的部门工作，一切靠手动，很不简单。那您是怎么领导急诊部过渡到现代化阶段的呢？ 答：还好，难度不大。很多医生和护士都是年轻一辈，他们很快便跟上新系统了，反倒是我适应得比较慢些，哈哈哈！其实，我们是首家在急诊部全面实施电脑化的医院。
问：许多曾和您共事过的职员都夸赞您是一名好导师。我们知道，您桃李满天下，有些学生现在还身居高位。就说现任骨科主任James Loh 吧，他很感激您的提拔。他年轻的时候曾一度因某种原因被认为不适合当骨科医师，可是您却给了他第二次机会。您是否可以跟我们分享您的管理理念好吗？答: 我无须耗费过多心力，他们个个聪明才智，James也不例外。我们只须认可年轻医生的志趣，引导他们朝着大方向，并且帮助他们确立观念就行了。
问：您业余从事什么活动和爱好？答: 我长期在新加坡痉挛儿童协会当义工。痉挛儿童亟待援助，他们的骨骼肌不正常，行走坐卧都不方便。协助这群病患寻找恰当的工作，以便自立、有点收入和融入社会很重要。我们和一些公司商量，游说他们应许痉挛儿童设立摊位售卖简单的手工艺品；樟宜综合医院内便有一个。他们对于这样的安排感到高兴，因为每个月可以赚到几百块钱生活费。
问：从事这么长时间的工作，成绩也很突出，您想过什么时候才退休吗？退休后有些什么计划，比如环游世界等。答: 我其实有好多计划！我想成为企业家，从事酒店业、餐饮业、托儿所等，可做的事有好多。
问：看来您会是个退而不休的人！最后想请您对建国50年发表感言，您对国家有什么期待？答: 我希望每一位国民都受到医疗照顾，以免除医药费之忧。人到晚年，尤其需要安心。
刘文荣副教授于90年代在樟宜综合医院栽树为贫病者筹款（上）
我们只须认可年轻医生的志趣，引导他们朝着大方向，并且帮助他们确立观念就行了
封面故事
包扎修复
在56年的保健生涯中，石膏包扎员黄明水在好多个部门工作过，包括60年代跟着流动药房到乡村服务（上）
黄明水（76岁）是樟宜综合医院骨科诊所的一名石膏包扎员。他忠于职守，从英军时期一直工作到樟宜医院阶段都不
曾离开过。问：请描述一下当年的工作情形好吗？答：我们的团队很小，少过10个人。随着英军一批批撤退，来看病的军人也越来越少，有时候，一天只有一个病人而已。
问：在樟宜英军医院任职之前您在哪里高就？答：我在1959年任职中央医院，那个时候我们的职称是卫生仆人，起薪只有97元，而且头三个月试用期内院方不支付薪水，必须向前辈借钱过活。供职中央医院期间，我得轮流在保洁部和派
送部工作，也须要跟随流动药房到乡村地区派送药品给患病的村民。之后，我也先后在密驼路医
我轮流在清洁部和派送 部工作，也须要跟随 流动药房到乡村地区派送 药品给患病的村民
院和警察学院担任过电话接线员和医药资料保管员。
问：请谈谈您在樟宜综合医院的工作，以及所遇到的挑战和工作推动力是什么？答：我在U诊所（骨科诊所）当石膏包扎员，专给手足致伤的病人包扎和拆除石膏。根据伤情，有些病人的伤位肿得厉害，包扎工作变得相当棘手。这时，我得安慰心理不安的病人，向他们确保包扎石膏不会导致痛楚；当然前提是掌握正确的包扎技术。有时候，我们相当忙碌，病人每个月高达好几百个。一般来讲，他们的态度都不错，只是偶尔会遇到一些不领情的，或者是病人好，家人不讲理，态度恶劣的。这些我都能适应，56年来我见过形形色色的人。我不单常驻诊所，也须到病房和急诊部帮忙（樟
宜综合医院只有两名石膏包扎员，Joseph是其中一位）。有时候，医院安排我负责教导受训护士和医学生如何包扎石膏。每一天的工作都乐趣满满，只要医院需要，我打
算继续工作下去。
问：谈谈您的个人生活好吗？您有什么爱好？业余如何松懈身心？答：时间准许的话，我喜欢下厨。我最喜欢的菜色是木瓜鸡和豆酱炖猪肉……你知道，我是土生华人。另外，每一个周末我都爱去机场闲逛。
问：新加坡建国快50周年了，您有什么感言和 期许？答：我希望新加坡国泰民安。个人嘛……就是希望孙子结婚，早生贵子咯，哈哈哈！
3 2 J U L– A U G 2 01 5 C A R I N G
强迫症原文心理医学助理顾问医生潘雅怡医生
这种焦虑症比我们想像的还要普遍，但适当的治疗可让患者重获新生
3 2 J U L– A U G 2 01 5 C A R I N G
在影片《猫屎先生》里由杰克・尼科尔森所饰演的角色患有强迫症。他非常洁癖，只要是出门就一定会戴上手套，并且经常用滚烫的热水和很多肥皂来洗手。
还有就是过度疑虑。在出门时，他必须不断的确定自己家里的大门已经安全地上了锁，还有家里的开关已经关上。因此他在出门前总会把门锁和开关固定的转上几遍才觉得满意。这种行为看似非常怪异，甚至可笑。但对于患有强迫症的人来
说，这是他们无法控制的。
强迫症
HEALTH NOTES 精神保健
3 4 J U L– A U G 2 01 5 C A R I N G
潘雅怡医生在樟宜综合医院的精神科部门里任职助理顾问医生。她拥有伦敦大学的医学学士文凭。她在2014年在新加坡完成了精神科专科医生的培训。潘医生是英国皇家精神科医学院的成员之一。
极度有责任感。此外，那些很悲观的人群较为容易患上强迫症，而使人感到有压力的事件也是肇因。不幸的是，许多患有强迫症的人并没有寻求专业帮
助，他们相信自己的强迫思维和行为是不受控制的并且尝试单凭自己的力量来应付病症。所幸有治疗方案可帮助患者应对此病的症状。综合性治疗法往往最有效，这包括了服用药物、行为疗法及认知疗法。
药物由于强迫症的其中一个导因是脑部里一种叫5-
羟色胺的神经递质失调，因此服用选择性血清素再吸收抑制剂，如百忧解（Prozac）、舍曲林（Setraline）和马来酸氟伏沙明片（Faverin）或抗抑郁药，如氯米帕明（Clomipramine）可有效缓解和控制强迫症的症状。通常如果临床治疗的疗效欠佳，服用一种或多种药物可有效改善病情。有必要时或许还得增加药物的剂量。这些药物一般来说相当安全并且不会使人上瘾。但是某些患者可能会在服用药物的初期出现副作用的症状，如头痛、作呕或口干舌燥。
暴露和反应预防（Exposure and Response Prevention）
“暴露”指的是让强迫症患者直接面对使他感到焦虑的观念、影像、物件或状况,，而"反应预防"指的则是压制患者在感到焦虑时做出强迫行为。
此疗法的核心理念是当患者被暴露在使他焦虑的状况时，他的焦虑感会在刚开始时上升然后逐渐消退。
认知疗法以理性的方式让患者直接面
对他不符逻辑的思维。此疗法使用多种手法，如让他们正视自己功能失调的
思维和让患者转换思维方式并且付诸于行动。通常强迫症患者能够意识到自己的思维其
实并不理性但他未必能够控制它。
如果您身边有人患有强迫症、又或者您本身正与此病搏斗，请切记：只要获得适当的治疗，强迫症患者是可以从功能失调的思维里挣脱出来的，并且重新过上一个正常、积极及丰富的人生。
功能失调的思维和行为强迫症其实比我们想像的还要普遍。有一项近期的全国调查显示在新加坡每100个人当中便有3个人在其某个人生阶段里患有强迫症。在新加坡，它是第三种最常见的精神病，仅次于抑郁症和酗酒。强迫症是焦虑症的其中一种并且有以下几种特征：
使人感到焦虑的念头（强迫思维） 由于强迫思维而引起的焦虑感 患者为了缓解焦虑的情绪而做出一些固定动（强迫行为）
强迫思维可以是观念，影像或疑虑。一些常见的强迫思维包括:
害怕受感染 疑虑电器开关没关好或门窗没关紧 表现出性爱或暴力的主题，这和患者的个性有很大的反差 即使是做些简单的决定也反复琢磨并且内心十分挣扎
虽然这些思绪并非其所愿，但它们还是无法抑制地反复出现在患者的脑海里。正是由于这些强迫思维，患有强迫症的人会感到焦
虑、害怕、愧疚或综合这几种情绪。为了减低这些使人极度不安的情绪和预防一个可怕的结果，患者于是无法自制地做出一些举动或固定动作，如反复检查或清洗以便把这些情绪抵消掉。刚开始时患者的焦虑和愧疚会由于做出这些强迫
行为而减轻。但时间长了，这些强迫行为只会强化患者这些不理性的行为。结果是这些错误的“应对策略”将加深强迫症并且进一步影响到患者的日常生活。
挣脱吧! 虽然目前还未能明确指出强迫症的导因，但有以下几种可能性，如遗传、脑部的化学成分失调、追求完美、
强迫症是一种焦虑症，它令患者感到焦虑，患者为了缓解焦虑的情绪而做出强迫行为
3 6 J U L– A U G 2 01 5 C A R I N G
立一份持久授权书，以为将来做好打算
未雨绸缪原文 欧阳莉娜
3 6 J U L– A U G 2 01 5 C A R I N G
FEATURE特写
詹姆斯是一名55岁的中学老师。他任教已将近30年并且非常热爱他的工作。在业余时间里，他喜欢和家人欢聚一堂，尤其是他刚
大学毕业的儿子。以他的年龄来说，詹姆斯在他的众多朋友当中算是
相当健康的。虽然他和自己的父亲和兄弟一样都患有高血压和高胆固醇，但他避免吃煎炸的食物并且在工作没有那么繁忙时会尽量腾出时间来做运动。可是有一天，詹姆斯突然严重中风。几个星期后他
再次中风。连续两次中风严重地影响了詹姆斯所有的生理功能。他无法行走、自己进食或穿衣服。更糟的是，他的心智能力被严重削弱并且无法为自己做任何决定。
他的妻子琳达和儿子瑞安感到十分震惊并且从此接手管理有关他的所有事宜。但是母子二人在某些事宜上意见分歧，如詹姆斯是否应该入住疗养院或请一个私人看护在家里照料他、他的多个银行户口和投资应该如何处理等。这些复杂的决择让仍处于震惊中的琳达和瑞安招
架不住。
为将来做好打算这样的情况其实并不少见。看似健康状况良好的人也可能由于某些疾病而处于完全衰弱的状态，如中风、老人痴呆症或由于发生意外使得脑部受到创伤。这些都能使他们失去心智能力。
3 8 J U L– A U G 2 01 5 C A R I N G
正所谓“未雨稠缪”，为无法预知的未来做好安排是非常重要的。当以上状况发生时，其中一个保护您自身和亲人利益的最佳方式便是立下一份持久授权书。什么是持久授权书？简单的来讲，它是一份法
律文件，它能够让您授权予一个您信任的人，让他在您失去心智能力时为您做决定。授权的范围分为2大项： 个人利益，如您的保健护理、住所的选择及您的社交活动 财产和财政事务，如钱财、买卖房子或车子、税务
法定性地任命一位代理决策者（受赠人）除了能够保障您自身的利益，持久授权书也能够让您的亲人免去不确定性所带来的压力，因为授权书让您明确地列名授权者所享有的权利。
立一份持久授权书 如果您想要立一份持久授权书，您必须到公共监护人办公室办理申请。有关申请的相关表格可从他们的网页www.publicguardian.gov.sg下载。
在填写表格时，您可以根据自己的要求赠予您的受赠人普通权利或特定权利。受赠人必须是：
年龄在21岁及以上 不可以是破产者（如果受赠人被赠予处理财产和财政事务的权利）
您可以任命超过一个受赠人。但是如果受赠人太多的话可能会节外生枝，以及他们可能会在某些事宜上意见分歧。您所
任命的受赠人应该是能够有商有量地一起解决问题的，这样才不会出现任何僵局。持久授权书的表格必须由一
名受认证签发人签字及认证。他可以是执业律师、注册精神病医生或合格的医护人员。公共监护人办公室的网站上有一个受认证签发人的目录供您参考。
表格呈上后必须等上6个星期，在这期间如果没有人提出任何异议那么您的持久授权书便正式被登记。
持久授权书能够让您的亲人免去不确定性所带
来的压力，因为授权书让您明确地列名授权者所享有的权利
FEATURE特写
然而，这并不代表有关您的所有事宜便从此由您的受赠人代办。持久授权书只有在您失去心智能力时才会被启动。只要您心智仍然清晰，即使您的授权书已经被登记，您的受赠人也不应该介入为您做决定。一直到2016年8月为止，所有使用持久授权书表格
1（LPAForm1）的新加坡公民可免付申请费。表格1适合那些要赠予受赠人普通权利的人士。新加坡公民申请者只须要交付受认证签发人所收取的专业费用。永久居民和外国人则须交付$50的申请费.
若想了解更多有关持久授权书的信息或涵盖持久授权书的心智能力法，可联络公共监护人办公室。
上述资料由公共监护人办公室提供。欲知详情，敬请致电：18002266222或发电邮查询：[email protected]，也可浏览www.publicguardian.gov.sg
1 没有立下持久授权书有大碍吗？没有持久授权书意味着您没有一个受赠人来为您做重要的决定。因此，如果您不幸失去心智能
力，您的家人或亲友便必须向法庭申请成为您的代理人。
2 智障人士可以立持久授权书吗？只有心智能力正常的人才可以立持久授权书。患有智障的儿童如果在年满21岁后有很大可能
性仍然缺乏心智能力的话，他们的父母便可以向法庭申请成为孩子的代理人。
家长也可以向法庭申请委任代理人的接棒者，在他们过世后或由于某些原因无法为孩子做决定时成为孩子的代理人。
3 我可以撤销我的持久授 权书吗？可以的。只要您在撤销授权书时心智能力是正
常的，您便可以这么做。您必须签下一份撤销表格，并且通知所有的受赠人及公共监护人办公室。您也必须支付$25的撤销费用。
常见询问
4 还有其它的情况会使得我的持久授权书或受赠人的权利被撤销吗？除了您自己申请撤销您的持久授权书以外，还有以下几
种情况会使得您的授权书或受赠人的委任被撤销：
s您或您的受赠人过世了
s您的受赠人失去心智能力，因此无法担任受赠人
s您的受赠人拒绝接受任命
s您的受赠人是您的配偶而你们离婚
s您或您的受赠人是破产者或您的受赠人是一个持有执照的信托公司而公司破产清算、结业、解散或正接受审判管理
s法庭出示庭谕撤销您的持久授权书或受赠人的权利——如果您的受赠人并没有以您的最大利益来为您做决定
5 如果我有超过一位受赠人，他们应该如何
为我做决定？
如果您委任超过1位受赠人为同类的事宜做决定可以选择做出以下安排：
s联合做决定：受赠人必须一起行动，不可以单独行事，又或者
s联合及单独做决定：受赠人可以选择一起或单独做决定。两者决定方式的结果都是有效的。
如果没有具体说明，依法将假定受赠人会联合做决定。
4 0 J U L– A U G 2 01 5 C A R I N G
吃出健康
这道菜烹调简单，并且卡路里和脂肪含量低，纤维含量高
鸡肉馅芥菜小舟准备时间45分钟
供人份
所需材料 芥菜，把叶片拨开，洗干净后滤干（400克）
馅料
鸡腿或小鸡腿，去骨，切粒状（200克）
马蹄，去皮，切粒状（100克）
虾仁，去壳，剁碎（150克）
青葱，切碎（1棵）
小葱头，去皮，切碎（2粒）
新鲜面包屑（2汤匙）
盐（少许）
白胡椒粉（少许）
水（3汤匙）
鸡蛋，打烂（1粒）
做法 去掉芥菜的叶子部分。把菜茎部分朝下，用利刀把茎切成小舟状，备用。
准备馅料。用一个搅拌碗，把所有的馅料材料加入后搅拌均匀，然后盛入切好的芥菜茎里。
将塞满馅料的芥菜茎放入蒸锅里，用大火蒸5到7分钟，或至馅料熟透为止。
随意点缀，立即上桌。
该食谱首次出版于《ACookbookforDiabeticsbyaDietitianandaChef》。
营养成分（每份）卡路里 146大卡碳水化合物 12.4克脂肪 3.4克胆固醇 139.2毫克纤维 4.5克
4 0 J U L– A U G 2 01 5 C A R I N G
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