The Big Read: As Singapore society ages, who will care for the caregivers?
Saturday, 06 Mar 2021 05:59 PM MYT
In 2018, Mr Tan founded Enable Asia, a platform that focuses on dementia awareness and respite for caregivers. “I controlled myself because I didn’t want to cry in front of my children . I keep telling myself that I am not stupid and useless and that she would not say those words to me if she was well,” said the 57-year-old.
Since she was diagnosed with the illness that causes impaired intellectual functions and personality changes in 2015, his mother, who is now 88, would tiresomely ask him about his father and godmother, both of whom had died, frequently raise her voice at him and accuse their helper of stealing her money.
Alzheimer’s disease is a progressive form of dementia that destroys memory, thinking skills and the ability to carry out simple tasks. “I ended up sleeping from 4pm that day till the next morning,” recalled Mdm Fadilah. “I felt so tired and I was just ‘gone’ all night. My husband thought I had fainted and almost called for an ambulance.”
But the caregivers’ plight has not been forgotten, emerging as a recurring theme during Parliamentary sittings in recent years, including during the Budget debate last week and the Ministry of Health’s Committee of Supply debate on Friday . Earlier last month, Ms Carrie Tan, MP for Nee Soon Group Representation Constituency , also asked in Parliament if the Ministry of Manpower would consider introducing a new financial scheme for full-time caregivers to supplement their income and retirement savings.
Some struggle with the loss of income as they leave their jobs to become full-time caregivers or the pay cut that comes with working fewer hours as they opt for a more flexible work arrangement. Since she quit her job, her five married siblings currently provide financial support for her and their mother.
Ms Belinda Seet, whose 89-year-old mother is afflicted with Alzheimer’s, said even as a part-time early childhood studies lecturer, she could not afford to pay between S$20 and S$40 per hour for someone else to take over her caregiving duties so that she can rest. One such caregiver is Mr Henry Koh, 43, who had taken a significant pay cut when he quit his decade-long job as a behavioural therapist and opted for a flexible work arrangement as a consultant.
There are also other grants available, such as the Home Caregiving Grant , which provides caregivers with a S$200 monthly cash payout to defray caregiving expenses, such as the costs of eldercare services or hiring of a foreign domestic worker. There is also the Community Mental Health Masterplan, introduced by the AIC and MOH, which aims to make it easier for persons with mental health to seek early treatment and to promote early identification of mental health conditions, among others.
For example, at its senior daycare centres in Ghim Moh and Telok Blangah, a client who comes five days a week would get a bill of about S$170 per month after subsidy — which can be fully covered by the S$200 monthly HCG. Touch Community Services actively connects residents with one another, equipping them with skills and giving them the confidence to approach and support a neighbour who might be suffering from caregiver stress or depression.Mr Kavin Seow, senior director of the elderly group at Touch Community Services, said the needs of caregivers have deepened and become more complex.
“For example, people living in private properties may not be eligible for subsidised care but in reality, they may be asset rich but cash poor and could also be requiring long-term care,” he said. Echoing the same sentiments, Ms Tan, the Nee Soon GRC MP, said many stay-home caregivers also do not step out of their homes often, except to do grocery shopping or taking their loved ones for medical appointments.
Mr Lee from Fei Yue said the cost of respite care is similar to the cost of putting dependents in a nursing home. The rate at nursing homes is calculated daily, with the option available for a minimum of seven days per stay, and up to 30 days per year. Those with a household income of less than S$2,600 per capita may qualify for subsidies.
In 2019, Aware released its Make Care Count report which investigated the financial toll that eldercare took on family caregivers. It found that respondents who experienced a change in work situation because of caregiving suffered a 63 per cent loss in income. According to the AIC website, a care recipient who lacks the mental capacity to make decisions can appoint an individual — called the donee — to make decisions on his or her behalf. If the care recipient does not have a donee, the caregiver may make the application on the care recipient’s behalf.
“For a caregiver trying to find the best service for their care recipient, the onus is on them to seek out all available services and try to do a cost-benefit analysis on what works best for their situation — but there is no existing platform that compiles information on all types of services and providers,” said Ms Hingorani. While these gaps in the caregiving ecosystem have been a perennial problem, the pandemic has also brought to fore the issue of availability.
As Singapore ages at a faster pace and people live longer, the Government has over the years strengthened support for caregivers through its policies, tapping technology and beefing up community resources, noted industry players TODAY spoke to. — PhotoTo increase accessibility, more resource centres could be set up islandwide, proposed Ms Ng Ling Ling, an MP for Ang Mo Kio GRC.
To increase the availability of respite care, Ms Chan suggested that neighbours living nearby can volunteer their time to care for individuals at their homes if they are unable to or unwilling to go to another person’s house. This could be implemented in Singapore as a scheme to professionalise caregiving as a career and tackle the manpower challenge that the sector has been battling, he said.
She also welcomed initiatives such as the Matched Retirement Savings Scheme, which can help caregivers attain retirement adequacy. Under the scheme, a contribution must first be made by CPF members or their family members before the Government matches it.
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