“I can pick you up from the MRT station.”

I am supposed to meet Jane Koe at her home in the east because her husband, Alan, is a stroke survivor and homebound most of the time. “We can meet at my downstairs cafe,” she tells me cheerily.

At 69, she is more than 20 years my elder but her energy levels and stamina make me feel like I am the senior in the conversation.

When I finally do meet Jane on Zoom (we decided that it would be better for us to meet online in the current Covid-19 climate), her enthusiasm and force of personality still come across strongly.

She speaks with a firm and confident voice, and her energy is palpable even over the video call. Jane has clearly found her calling – a caregiver to her husband, and a pillar of strength for the several support groups she is part of.

I can’t tell that she is undergoing chemotherapy for breast cancer.

Dealing with breast cancer and stroke

Chemotherapy
Jane undergoing chemotherapy at the National Cancer Centre in 2019. She always puts on a positive attitude while undergoing treatment so as to encourage other patients there. Image source: Jane Koe

Breast cancer is an old foe for Jane. She was first diagnosed in 1999 but beat it the first time. In 2018, it relapsed and has now spread to her spine. Jane is stoic when talking about her condition, but she admits to The Pride that it didn’t come without a struggle.

She says: “I had gone through Stage 2 breast cancer before. When I found out it had relapsed and was now at Stage 4, I cried. I was thinking of my husband and my family. I have so much more to enjoy, why did this have to happen?”

“After crying, I was okay. Sometimes, it’s good to cry and let go. One shouldn’t suppress the feelings.”

It is more of a challenge this second time around because in 2016, Alan, 68, suffered a stroke, which affects his mobility, speech and attention span.

Jane has been caring for him, and despite her own health challenges, she declares that she will continue looking after her husband with the help of their daughter, Michele, 28, who lives with them and their two helpers.

Aside from Michele, Jane and Alan have two other children: Oldest son Sean, 36, is married with a 15-month-old son, Liam, and another baby on the way. Darryl, 32, and his wife are also expecting a baby at the end of the year, and Jane is eagerly looking forward to the new additions to the family.

Asian Family
Caption: Jane’s family in a photo taken in December 2020. (From left) Daughter-in-law Lirong, son Sean, grandson Liam, Jane, Alan, daughter Michele, daughter-in-law Yong Lin and son Darryl. Image source: Jane Koe

When asked who looks after her, Jane declares: “I can take care of myself.”

This means taking her chemotherapy medication and being active in a monthly support group for breast cancer sufferers like herself.

“I still go out and meet friends,” says Jane, emphasising that this is dependent on prevailing Covid safe management guidelines.

So how does she reconcile her role as her husband’s main caregiver while handling her own health issues?

Jane says: “We don’t think of the numbers (referring to her Stage 4 cancer) but we think of it as continuing life as normal. If it is time to go, then we just go. Meanwhile, I am continuing to support my husband.”

Her thoughts rest more on Alan: “I worry about who will look after my husband. My children are there but he may not want to share his thoughts with them.”

She adds: “I hope I can encourage him every day. The important thing for the caregivers is knowing my husband’s thoughts, whether he is sad or wants to have some time alone. We have to be patient.”

Finding strength

Holiday
Caption: Jane and Alan on holiday in Hokkaido, Japan, in 2015, before the stroke. Image source: Jane Koe

Before he retired and before his stroke, Alan was a pilot with Singapore Airlines. He and Jane used to travel to places across the world like San Francisco, London and Hokkaido.

Now that Alan is unable to travel, something which he misses, Jane spends time with him playing boardgames together and chatting about the family. She is his constant encouragement when he feels down.

Deeply religious, Jane often reminds her husband: “You cannot always have these negative thoughts because it is not good for you. You must share your thoughts with God and also pray for other people.”

Cancer Relapsed
Caption: Jane and Alan in 2019. She had shaved her head when her cancer relapsed, anticipating hair loss from the chemotherapy. Image source: Jane Koe

Such is the couple’s devotion to their faith and to each other that when she goes out in the evenings, he will wait for her to return home to pray with him, so that he can sleep well.

Jane accepts her illness and her concern for Alan’s well-being with equanimity. She is clear about what keeps her going.

She says: “It’s the love for my husband. I believe you should not put yourself first. I put my husband and my family first. Even if I need someone to look after me, my caregivers can help me with simple chores. Social activities motivate me and make me happy. I like meeting up with my friends.”

“Of course, we have private moments that we share with God. You must believe that every day is better than the previous day. I believe that if you are a happy person, you want to bring smiles to everybody. This might help my cancer cells also,” she laughs.

Prudent in treatment

Asian Couple
Jane and Alan on a trip to Japan. Image source: Jane Koe

With their multiple health challenges, Jane and Alan require medical care and support for their daily activities. They rely on their savings from Alan’s job as an airline pilot to cover their medical and household expenses. Prudently, they also took the step to move from private medical care to subsidised care.

Jane used to receive cancer treatment from a private hospital. She chose to receive treatment from the National Cancer Centre instead and says: “I am very happy with the care I receive there. The doctors and the staff there are very good to me and they take the time to answer my questions and explain things to me.”

Alan was a private patient at NUH for his stroke, heart, vascular and urology issues. He transferred to subsidised care this year because he and Jane feel that they receive a similar level of care at a lower cost.

Additionally, Alan receives monthly payouts from his insurance policy, due to the disabilities arising from his stroke. Unfortunately, Jane’s medical expenses are not covered by private health insurance and she rues allowing her policies to lapse.

“It didn’t occur to me when I was younger that I would need health insurance now,” she says, adding cheerfully that her cancer treatment expenses are now paid for by Medisave. Jane used to work at a private school before she quit to look after her young children.

Both Jane and Alan do not want to accept financial help from their children because they understand that their children have their own families and financial commitments. They do let their children contribute by paying for family gatherings and meals, however.

In Jane’s words, they manage financially because they were careful with their savings from when Alan was working. She laughs: “Alan is a thrifty person, just what you would expect from someone from Penang!”

Support groups

Speech from Caregiver
Caption: Jane sharing her journey as a caregiver at a public talk organised by SNSA in October 2018. Image source: Jane Koe

With so much on her plate, Jane is pragmatic when it comes to getting and offering help. She recognises that a caregiver’s job can be a lonely experience and she is a firm believer in support groups.

“I always encourage people to join support groups. We support one another and share our experiences.”

“Don’t journey alone. You must reach out. If you want to improve on your caregiving, you need to ask for help. It lessens your burden.”

After Alan was discharged from hospital in April 2017, five months after his stroke, Jane contacted the Singapore National Stroke Association (SNSA) for help. There, the couple started participating in activities such as Seated Tai Chi and the Stroke Self-Management Programme, for stroke survivors and their caregivers.

Jane was so moved by what the charity was doing that she volunteered for a more active role. She was recently elected as a member of the management committee at the SNSA.

Jane and Alan also attend ABLE’s Respite Centre, which offers support for people with physical disabilities and their caregivers, every Thursday. Before Covid, Alan attended swimming classes organised by ABLE as a form of therapy while Jane joined the caregiver’s support group. She says: “We support one another and share our experiences. I am not an expert and am still learning. Someone else may be able to help me by sharing about their experience.”

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Jane herself attends a support group for Stage 4 cancer patients. This is where she gets support and shares coping tips with others.

Jane enjoys meeting her support group for cancer patients at the Breast Cancer Foundation over Zoom one Saturday a month.

“We are all in the same stage of cancer – stage 4 – so we can understand what each of us is going through. We exchange information on the types of drugs we are on, how to cope with the side effects and any worries that we have. We are a small, close-knit group.”

Even more volunteer work

In addition to looking after her husband and volunteering at SNSA, Jane helps out at two other organisations.

Even though her own children have long graduated from their schools, she is still part of the parent support groups there. Jane still volunteers at Ngee Ann Primary School where she is a member of the executive committee, and at Temasek Secondary School, where she serves as a mentor for the parent support group.

You would think that all this activity, between caring for her husband, managing her own illness and volunteering to help others, would be a chore for Jane. But the indefatigable woman says: “I enjoy working with the parents in the support groups. My role at the SNSA is different as I can reach out to stroke survivors and caregivers to let them know that they are not alone in their journey.”

And her efforts have not gone unnoticed. Catherine Yeow, a fellow SNSA member, says: “Jane is very helpful and genuine. Always putting others before herself. Whenever she can do something for somebody, she’ll do it.”

Talking to Jane, I get the impression that she is a woman on a mission. She is a catalyst and a cheerleader. But most of all, I can see how she carries herself as a woman and as a wife.

Asian Couple
Caption: Jane and Alan in a photograph taken in December 2020. Image source: Jane Koe

She and Alan recently celebrated 37 years of marriage. She tells me happily that Alan used to be reticent about expressing his feelings for her. Now he often tells her “I love you”, and that he would tell his friends “I have the best wife”.

And that is part of what keeps her going. That, and her belief that she wants to make full use of what she has, in the time that she has.

“You must make the most of the talents that you are born with. It is better than waiting for an end to a death sentence. Life is a journey and we have support from family, friends and support groups. I am very grateful for all this.”

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Top Image: Jane Koe