Read the full transcript of Grace Cheng’s talk titled “Caregiving For Family Is Hard—Here’s How You Can Prepare” at TEDxTinHauWomen 2025 conference.
Listen to the audio version here:
TRANSCRIPT:
The Unexpected Journey of Caregiving
GRACE CHENG: I graduated in 2020, but I’m not talking about my degree in social sciences. I didn’t graduate from any schools or courses. I have no diploma. It was not even an education I voluntarily signed up for.
But this experience has been my life’s greatest lesson. It changed how I see my future, my career path, and my family relationships. When my grandmother passed away in 2020, I became a graduate caregiver, or as we say in Cantonese, “some of you in the audience may be graduate caregivers like me, or freshman caregivers at the beginning of your journey.” Others of you may not be thinking about it at all, because the situation hasn’t happened to you yet.
Let me share what caregiving was for me, what it could be for you, and what it has the potential to be for all of us. There are an estimated 1.3 million family caregivers in Hong Kong now, and the number will only grow due to the aging population. In just 13 years, 30% of our population will be 65 years old or older. That means there will be 2.4 million older people in Hong Kong.
Even if you are not taking care of someone today, chances are you will need to care for your aging parents or relatives one day. I used to think being a family caregiver was just doing the day-to-day tasks, like feeding, changing the diapers, or helping with medication. But it’s so much more than that. Not only are you the nurse, you also become the counselor, legal advisor, accountant, and around-the-clock assistant.
The Hidden Toll of Caregiving
Caregivers do so much to care for their loved ones, but who cares for them?
Studies have found that caregivers under stress have a much higher risk of early death, 63% higher, to be exact. That’s why caregivers are sometimes called the invisible second patients. There is so much information out there for expectant parents, but not nearly enough for those expecting to care for their aging relatives.
I did not expect to become a caregiver at 26 years old. I had a promotion coming up at work, and after six years of dating, I was ready to move out with my boyfriend, who is now my husband. I was excited about this upcoming chapter of my life. Then everything changed when grandma’s health started to get worse.
I was the first grandchild of my family, and I was really close with my grandparents. They were my primary caregivers because my parents both worked full-time and traveled a lot for work. For many years, when I was little, I actually lived with my grandparents. When the roles reversed and I became the one to care for grandma, I was not prepared for how demanding it would be, especially while still juggling a full-time job.
I remember finally finding the time to watch a movie once and turned off my phone. Two hours later, I saw a ten-minute call from grandpa. Grandma had had a fall at home. Ever since, my phone was always on.
The Challenges of Hospital Care
That was in early 2019. After that, grandma was in and out of the hospital every few months. At the end of December 2019, grandma was hospitalized again for another fall. But what’s different this time is that a few weeks later, COVID hit, and the government shut down all visits to the public hospital.
Grandma was actually fit for discharge two weeks later, and she repeatedly asked us to take her home. To me, it was so clear that we should respect her wishes. But to the rest of the family, they were really worried that grandma would not receive the care she needed at home. What I know now, but didn’t know back then, was that the government actually has a support scheme.
It provides transitional care to patients discharged from the hospital. If only I had known about these services earlier, I might have been able to convince my family to bring grandma home sooner. Grandma was miserable in the hospital. Over the course of two months, she lost her appetite, and she kept growing thinner and weaker.
She even contracted pneumonia. On her last day, she lost consciousness, so we all rushed to the hospital immediately. The doctor said they couldn’t find any advance directive on file and asked if we would like them to continue CPR. In a panic, we just told him to keep going, not really understanding what that meant.
Later, I learned that the survival rate of resuscitation is only around 10% for older patients in hospital. The pounding can cause serious physical trauma, like broken ribs or damage to the internal organs. I would never know for sure if our decision to continue CPR was what grandma would have wanted. We had never talked about it.
In February 2020, grandma died alone in the public hospital. The biggest regret of my caregiving journey and of my life was not being able to bring grandma home from the hospital.
The Rewards of Caregiving
By now, you may be thinking, “Why would anyone want to be a family caregiver when it’s so stressful and so challenging?” Caregiving is the hardest thing I’ve ever done, but it’s also my most fulfilling experience.
And I’m not alone. In multiple studies, caregivers reported positive benefits of caregiving. They experienced personal growth, impatience, and resilience. They learned to appreciate life more.
They built meaningful relationships with their loved ones. So how can we enjoy the good parts of caregiving more and better handle the tough parts? Here are four things you can do to care for yourself and for your loved ones.
Four Tips for Effective Caregiving
Create memories. Yes, you are the caregiver, but don’t forget that you are always the family first. What I remember most from my childhood was going to the theme park, playing at the arcade, and family holiday trips. I wanted to create the same happy memories for my grandparents. When grandma’s heart was too weak to travel by plane, I organized a cruise trip to Taiwan with my whole family.
Back then, I didn’t know it would be our last time to travel together, but I’m so grateful to have this memory to look back on now.
Advance care planning with your loved ones. Don’t wait until it’s too late. Ask them about their care preferences and make sure the whole family is on the same page to honor those wishes.
I know talking about end-of-life care is uncomfortable, especially in Asia. Maybe start by sharing your own care preferences or even tell my grandma’s story to start a conversation. I wish no one ever had to feel the panic and anxiety I felt in the hospital room.
Resources. Remember, you can’t possibly do everything by yourself. If it takes a village to raise a child, it’s the same to care for older people. Delegate tasks to others, learn about community resources, and find a backup caregiver. Let’s normalize elder sitting and check on friends who are caring for sick or older relatives, just like how you would check on new parents.
Expect caregiving. All of us could become a caregiver one day. The more prepared you are, the less overwhelmed you will be. Be proactive in planning for your future caregiving journey.
In this final chapter with our loved ones, try to create moments of joy whenever you can. Looking good was important to grandma. When I was a little girl, I loved digging through her jewelry box and playing dress-up. In fact, I’m wearing her earrings today.
When she was in the hospital, she hated how she looked in the gray hospital clothes, so I brought her a colorful scarf to try to lift her spirits. My whole family took the learnings from caring for grandma to heart. Grandpa was not confined to the hospital bed in his last days. Instead, we were able to celebrate our last Chinese New Year together at home, eating sweet dumplings I made with grandma’s recipe.
Last year, he passed away peacefully in his favorite massage chair with my father by his side. While I have graduated from caring for my grandparents, I know it’s not the end of my caregiving journey. My parents are in their 60s now, so I found myself in the role of an expectant caregiver again. And for my own aging journey, I don’t have children, so my husband and I will most likely have to count on each other.
You can bet that I already put my wishes in writing and made him do the same. Whoever my future caregiver is, I would like to spare them from making difficult decisions for me. My caregiving experience also inspired me to found my own social enterprise. I want other caregivers to receive the support and guidance I wish I had, so they have more time for joy and connections with their loved ones.
No one is exempt from giving and receiving care throughout their lives. How do you envision your caregiving journey? Thank you.
