Nurse rebuilds family as Kinmen’s first home care nurse
Nurse rebuilds family as Kinmen’s first home care nurse
2024-12-08
Today we’re visiting a very special and resilient family in Kinmen that is headed by 40-year-old nurse Chou Ya-hui. Both Chou and her husband worked at the same hospital in Northern Taiwan at one time: she as a nurse anesthetist and he as a surgeon. In 2012, the husband had a stroke after being on duty for 32 hours, and the responsibility of the family fell on Chou’s shoulders. By chance, the family of four relocated to Kinmen, and eventually Chou became the first home care nurse on the outlying island. Here’s her story, in our Sunday special report.
In Jinhu Village in Kinmen, Chou Ya-hui, a home care nurse travels from one door to another.
Carrying a nursing kit, she’s on her way to the home of a 99-year old patient surnamed Kuo.
To the patient’s family, Chou is their savior.
They have high regards for Nurse Chou, who’s taken care of their grandma for almost two years now. Once the old lady injured her toes, and it was Chou who helped tending to her wounds.
Ms. Wu
Family member of patient
Grandma’s toes had a fungal nail infection. She said they need to be cleaned and disinfected, then carefully trimmed. She sat here on this tiny stool for two hours trimming grandma’s toenails, and she helps us with that every couple of days. She’s really kind and patient. She’s someone who’s changed our life for the better.
Chou usually treats patients who have just been discharged from inpatient care but still have various catheters inserted, or score lower than 60 for their ADLs, abilities of daily living. Conventionally speaking, Chou would only be required to visit each patient at their home 1 to 3 times per month. But she goes above and beyond that, trying her best to show up whenever she’s called on.
She’s known across the Kinmen archipelagos. For a time locals thought she had to be born and raised in Kinmen, being so dedicated to the elderly patients.
But Chou is in fact from Taipei, and only moved across the Taiwan Strait to Kinmen eight years ago, due to a family tragedy.
Chou’s husband Chang Hao-cheng’s right side is completely paralyzed. He can only walk with a four-legged crutch. Now 45 years old, Chang had a stroke 12 years ago, at the age of 33. Through all these years, Chou was by his side for rehabilation.
Chou ya-hui
Home care nurse
He has hypertonia from the stroke, so he has to have something to hold, otherwise he’ll get spasms.
Apart from training motor skills, Chang is also in speech therapy.
Chou ya-hui
Home care nurse
We did a follow up IQ test. His cognition wasn’t compromised.
Before he got a stroke, Chang was a colorectal surgeon at a well-known hospital in Northern Taiwan. Chou was an anesthetic nurse at the same hospital. There is great affection between the couple.
Chou I-chu
Chou Ya-hui’s brother
Hao-cheng really cared for her. Even in the middle of the night when she really needed to go he’ll carry her to the bathroom. Can you say the same for most other men?
The couple lived comfortably as medical professionals, until 2012. Chou was pregnant with their second child when tragedy fell on the young family.
In July that year, Chang had just gone off duty at noon before rushing to ER, not to see a patient, but for a searing headache.
Chou ya-hui
Home care nurse
He collapsed right there then, and was rushed to the surgery room. I made a quick change into surgical scrubs. My hands were shaking while I was about to inject him with anesthesia. I remember it was Dr. Lin, the anesthesiologist, who held my hand to stop me, and said he’ll take over for that instance. So I retreated to the room next door, I couldn’t stop vomiting while there.
Chang survived after two craniectomies, but he was in coma after the surgeries and was in intensive care for two whole weeks.
Chang Wen-hsin
Chang Hao-cheng’s father
When we found out, it was the day after, we immediately went to see him. He was already in the ward, and seemed to be almost gone, not making any sound. His mother and I were absolutely devastated.
Chang miraculously awakened, but in a vegetative state.
Chou ya-hui
Home care nurse
The doctor told us it was no longer worth putting in more resources or undergoing more treatment, because it’s likely he’ll remain in that state. But one day, I asked him if he could hear me, and to blink if he could. And he did blink.
Under Chou’s meticulous care, Chang went from being able to blink, to regaining movement in the fingers, and gradually his memory. The recovery was clear by the day, but by then Chou was on the verge of a breakdown, and even thought of giving up their unborn second child.
Li-chiu
Chou ya-hui’s colleague
I asked her why she didn’t get an abortion, and she said she was actually already going to. She’s already gone to the doctor. The doctor did an ultrasound and it was probably at that moment that she reconnected with the baby, and regained her courage to go on.
Chou decided to continue keep fighting because she wanted to hold the hospital accountable for her husband.
Why would an otherwise healthy individual at the youthful age of 33, suddenly get a stroke?
Chou ya-hui
Home care nurse
The day before the incident, he’s been on duty for 32 hours. Once I got the record, I passed it on to a senior colleague in occupational medicine, and she showed it to the physician, who took a look and said the hours isn’t normal at all.
It turned our Chang had collapsed under an immense workload. Chou then filed a lawsuit against the hospital. She won on the first ruling, but during the appeal, the hospital settled with Chou. They were compensated, but lost their jobs at the hospital.
Chou ya-hui
Home care nurse
I got a fraudulent call, they told me that I owe money to Chunghwa Telecom, and that I’m going to be sued. I looked at the bank account balance, and said, I had no money, my husband had a stroke, and now this? I broke down in tears, even the fraudster ended up consoling me. So then I thought, I couldn’t carry on like that. My life, my children’s future will be ruined. I had to go back to work.
A new opportunity came. A medical lab scientist who’s about to set up a health check clinic in Kinmen learned what the couple had gone through, and invited them to join the team.
Chou ya-hui
Home care nurse
I looked up how things are in Kinmen, and found that you don’t have to pay tuition in public schools, at most NT$200 per semester. What’s more, healthcare is also free of charge, including registration fee. So I thought Kinmen was a good place for us to make a living at the time.
Even though they’d never been to Kinmen, Chou believed it was the opportunity of a lifetime, so she decided to uproot the family and move there.
But the great start to her new life did not last long. After several months at the clinic, the owner could not afford to pay her, so she had no choice but to quit. Her husband still had to do ER runs every so often, and the kids had not yet reached school age. Family obligations meant she couldn’t work full-time, so she made do with various odd jobs.
Chou I-chu
Chou Ya-hui’s brother
When she first got here she was really lost. She’s done insurance sales, and part-time minimum wage work, as long as there’s money to be made she’ll do it.
One day, a friend working at the county health department told her about a new way to really settle down.
To meet demands due to the rollout of the long-term care 2.0 policy and community care, in 2016 the Ministry of Health and Welfare introduced two in-home care initiatives. With encouragement from the health department, Chou began her practice as the very first home care nurse in Kinmen. Coordinating with the health department and local clinics, she began providing nursing services at patients home.
Yang Ta-wei
Lieyu Township Health Center
In the past it was difficult to travel to Lieyu, so health practitioners are less willing to practice here, so we need more in-home care. In the beginning Chou had to take the ferry here when she worked with me. Sometimes the patient’s catheter will fall out, and with a phone call, she has to take the ferry here immediately after.
The greatest advantage of Chou’s new work is the flexibility. When there’s no one to take care of her husband or the kids, she can take them along.
Chou ya-hui
Home care nurse
I think people here are all so kind. I’m supposed to be the service provider, but often it’s the patients’ family that ends up helping my husband and encouraging us, saying he’ll eventually recover.
Mr. Huang
Family member of patient
Whenever I need medical advice, I think of her first. I think she’s even more capable that a doctor. It’s really great that someone from Taiwan is willing to come to Kinmen.
Being a family member of a long-term patient herself, Chou easily gained the locals’ trust.
Chou ya-hui
Home care nurse
I’ve met a grandma, her husband also had a stroke, a year or two later than my husband. She would sometime say, “why wouldn’t my husband die already? There are so many bills to pay: the migrant worker’s salary and the baby formula.” I’d tell her about what I’ve gone through, to let her know that my husband also had a stroke, and she’s not alone.
With her words of encouragement, the patient’s family pulled through. Chou had rebuilt her life. Her parents-in-law had also moved to Kinmen to help care for her husband and two daughters. The family is now doing much better.
Although the tragedy that had befallen her husband was once a great trial, with perseverance she’s changed the fortune of her family, and touched the hearts of elderly patients in Kinmen, too.
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丈夫病倒 護理師舉家搬遷金門 提供「到宅醫療照護」
2024-12-08
帶您看一個令人動容的故事。主角是40多歲的周雅慧，她原本是一名麻醉科護理師，跟擔任外科醫師的先生在北部同一家大醫院工作，沒想到，2012年的某一天，先生因為工作過勞、病倒，中風。周雅慧得要一肩扛起照顧先生跟兩個孩子的責任。在一個因緣際會下，他們一家四口搬到了金門，周雅慧除了照顧先生之外，還開設了全金門第一間「居家護理所」，照顧需要「到宅醫療照護」的民眾。
金門金湖鎮這小村莊裡，經常能看見居家護理師周雅慧到訪的身影。
帶著訪視包，她準備前往高齡99歲的郭姓阿嬤家。
家屬看到周雅慧，宛如救星現身。
家屬滔滔不絕的讚賞。周雅慧照顧阿嬤近兩年，有一回老人家的腳趾受傷，她細心照料。
[[居護所個案家屬 吳女士]]
“阿嬤灰趾甲，她說有黴菌，她說要洗、要消毒，再慢慢剪。她坐在這邊用小板凳，坐兩個小時，一直剪一直剪，幾天就來幫我們剪一次。她真的很有愛心、耐心，我們碰到貴人。”
周雅慧居家護理的對象多半屬於出院後，仍留置鼻胃管、尿管，或ADL日常生活活動功能小於60分的病人。按一般程序，她只需一個月到府訪視一到三次即可，但她彷彿把自己當成外送員，家屬打一通電話就到。
周雅慧的足跡踏遍大小金門，當地居民一度以為她是土生土長的金門人，才會對家鄉長輩如此疼惜。
但其實她是來自台北的護理師，八年前會從台灣跨海來到這裡，從醫院開刀房走進居家醫療，全因為深愛的另一半歷經生命驟變。
周雅慧的先生張皓程右半邊肢體無力，不良於行，平日靠助行器輔助。45歲的他，從33歲中風至今已經12年，太太也一路陪伴，走過復健的漫漫長路。
[[居家護理師 周雅慧]]
“因為他是張力型的中風，所以他必須要有東西去握住，不然他就會呈攣縮。”
除了訓練握力，還有語言治療。
[[居家護理師 周雅慧]]
“他的智商我們後來有再去追蹤，其實他智力是沒有受損。”
事實上張皓程在中風之前，是北部知名大醫院的直腸外科醫生，周雅慧在同間醫院工作，擔任麻醉科護理師，夫妻倆鶼鰈情深。
[[周雅慧哥哥 周易助]]
“最主要是皓程很疼她，他甚至半夜雅慧要尿尿，他甚至可以抱著她去上廁所，你看幾個男人能夠做得到？”
周雅慧原本過著人人稱羨的醫生娘生活，但當2012年雅慧懷上第二胎時，美好的生活，一夕間變了調。
七月的某天午後，剛離開工作崗位的張皓程，又回到急診，不是替人看病，而是自己頭痛欲裂。
[[居家護理師 周雅慧]]
“那一天就在急診當場倒下去，就送到開刀房，我就趕快去換開刀房衣服，我還手發抖，要幫他打麻藥，我記得應該是林醫師吧，麻醉科的醫師，他握著我的手，他就說，這個我來。我就撤到隔壁房間，結果我到隔壁房間的時候，我是一直吐。”
經過兩次的開顱手術，張皓程撿回一命，然而術後的他並未甦醒，整整兩個禮拜，躺在加護病房觀察。
[[周雅慧公公 張聞信]]
“我們知道的時候，第二天，趕快去找他，他已經在病房了，都奄奄一息，沒聲音了，我跟他媽媽是真的痛苦萬分。”
幸好張皓程奇蹟似的甦醒，只是醒來後卻呈現植物人狀態。
[[居家護理師 周雅慧]]
“因為醫師已經告訴我們，不用花太多的資源，或是太多任何的(治療)，可能他大概就是這個樣子。一直到有一天，我說，你知道我叫你嗎？眼睛眨一下，他會眼睛眨一下。”
在她細心照料下，張皓程從可以眨眼睛，到手指有動作反應，記憶力也慢慢恢復，病況逐漸好轉，但周雅慧自己卻快撐不下去，一度想放棄腹中的胎兒。
[[周雅慧同事 麗秋]]
“我就說，為什麼妳那時候沒有把她拿掉？可是她說其實已經有動作，要去找醫生了，醫生照超音波給她看，有可能當下她是跟著她的BABY對話，我覺得那時候她的勇氣應該就出現了吧。”
周雅慧決定繼續勇敢面對，因為她想究責，替先生對醫院究責。
好端端的一個人，才33歲，怎麼會突然倒下？
[[居家護理師 周雅慧]]
“發生事情的前一天，上班上32小時。那個時數拿來之後，我就送給職災科的學姐，職災科學姐就幫我給醫生看，那時候他一看就覺得，這(上班)時數是異常的。”
原來張皓程是被龐大的工作量壓垮了，太太憤而向醫院提告。雖然一審勝訴，二審前院方與周雅慧和解，看似圓滿落幕，但他們夫妻倆都回不去醫院上班了，未來的生計該怎麼辦？
[[居家護理師 周雅慧]]
“收到詐騙集團的電話，詐騙集團就跟我講說，你欠我們欠中華電信，你要被告，我就去拿存摺一看，後來我就說，我身上沒有錢，我先生又中風，又遇到這個事情，我就哭了，後來那個詐騙集團安慰我，但是我那時候是，我那時候是想，如果我再這樣下去，賠下去的是我的人生、是小孩的未來，所以我覺得，我還是必須要出來工作。”
就在這個時候，機會悄悄來臨，一位準備到金門開設健診診所的醫檢師，得知他們的處境，找夫妻倆一同到金門發展。
[[居家護理師 周雅慧]]
“我有去查詢金門這邊，他的學費是不用付費，每學期頂多只要繳200元，再來醫療部分是不用付費的，也不用掛號費，讓我覺得其實金門是一個很適合當下的我們來這裡生存。”
儘管從沒到過金門，但周雅慧堅信是上天替她開了另一扇窗，她毅然決然帶著一家四口舉家搬遷。
沒想到老天爺又跟她開了個玩笑，她到金門工作幾個月後，診所老闆竟發不出薪水，她無奈離職。由於當時先生經常進出急診，學齡前的小孩也常需要人顧，她無法找一份正職工作，只能四處兼差。
[[周雅慧哥哥 周易助]]
“雅慧剛開始來的時候很迷茫，也賣過保險，也打過工，只要有錢賺她就去。”
直到某一天，在縣府衛生局工作的友人，告訴她一個能安定下來的選擇。
為了因應長照2.0與社區照護需求，2016年起衛福部陸續推動「健保居家醫療整合」與「居家護理所整備計畫」，因此周雅慧在衛生局人員鼓勵下，開立全金門第一間居家護理所，與衛生所、診所醫生配合，進行到宅醫療服務。
[[金門縣烈嶼鄉衛生所主任 楊大威]]
“(金門)烈嶼鄉這邊因為早年交通非常不方便，醫事人員來服務的比例意願也比較低，所以這個地方更需要居家醫療的關注。早期她(周雅慧)也是常常要搭船過來這邊跟我配合，有時候鼻胃管掉或是尿管滑脫，病人一通電話，她幾乎馬上要搭船過來。”
這份工作帶給雅慧最大的好處就是彈性，當先生或小孩沒人照顧時，她能帶著他們一起同行。
[[居家護理師 周雅慧]]
“我覺得這邊的人都很有憐憫心，本來是我要去提供服務，後來別人服務我先生，講說「你這一定會好」，「放心 他一定會好起來。」”
[[居護所個案家屬 黃先生]]
“我如果有什麼事情，我第一時間問她，我覺得她比醫生厲害。台灣人有辦法來金門這個區塊真的不簡單。”
一個外地人之所以能成功打進金門，是因為周雅慧同為長照患者家屬，多了一份同理與體諒。
[[居家護理師 周雅慧]]
“我遇過一個阿嬤，因為她老公中風的時間，比我老公短一、兩年，阿嬤就會說「我先生怎麼還不死」你看，外勞的錢還有奶粉錢，我會把我的案例告訴她，說我老公也是中風「我們是一樣的」。”
以自身案例鼓勵家屬，攔阻可能發生的長照悲歌，周雅慧找到人生的新方向，她的公婆也從台灣搬到金門，幫忙照顧先生與兩個女兒，生活日漸步上軌道。
曾經，先生的倒下，讓她從天堂掉到地獄，但她不離不棄，讓烏雲散去，不僅讓家重見光明，也把愛照進每位長者心中。
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