It’s no secret that Singapore’s elderly population (65 and above) is projected to grow faster than an Indonesian palm plantation fire, increasing to 19% by 2030, and 38% by 2050. And with the government taking a “your family, your problem” approach, unless you’re destitute, don’t expect any major subsidization of your “golden years.” This leads to the big issue we’ll all have to face – how can we care for ageing parents who don’t want to live in a nursing home?
For some families, nursing homes are an option of last resort due to negative media coverage (see Nightingale Nursing Home). Or maybe your parent(s) aren’t too keen on the idea of living with, or being cared for by “strangers”. With nursing homes out of the picture, what eldercare options are available for your ageing parent(s)?
Here are three alternatives to consider before placing your parent(s) in a nursing home:
1. Have Your Parent(s) Move In
If you distrust caregivers because you’ve seen the movie Misery too many times, or you feel obligated to care for the people who raised you, having your parent(s) move in is a viable option. After all, there’s no higher, or tougher form of filial piety than inviting your aged parent(s) to come live with you.
So whether you decide to free up a room within your own flat (sorry kids, bunk beds for you!), or you and your parent(s) choose to purchase a dual-key EC unit through HDB, some “adjustment” will be needed to make this arrangement work smoothly.
Here are 3 important factors to prepare for when inviting your aged parent(s) to move in:
- Family Synergy: Depending on how well your parent(s) interact with your spouse and children, your environment can range from lovingly imperfect (think Everybody Loves Raymond) to a multigenerational mess that resembles just about every family on Game of Thrones. Family tension usually comes from “power struggles” that arise between you and your parent(s). Hopefully, these are only “growing pains” from everyone experiencing a new environment, otherwise there is counseling that can help resolve family disputes.
- Eldercare Requirements: Hopefully, your parent(s) are still in good physical/mental health when joining your home. However, you may be in a situation where their physical and/or mental condition is deteriorating. In that case, you may need to take a caregiver course to care for your ailing parent(s). This can cause a great deal of stress, so you may want to split the responsibility with the rest of your family, and use caregivers support services when the strain becomes too much.
- Senior-Proofing: Making your home “senior-proof” is all about ensuring your parent(s) can move around your home without risking injury. This means installing rails and grips in areas where your parent(s) will frequently walk to prevent falls (bedroom, shower, and kitchen). Also, you’ll want to make sure your floors are always free of debris that can trip up your parent(s), such as toys if you have young children.
The cost of moving your parent(s) in will vary from family to family. Some families may need to renovate their homes and install rails/grips to make them senior friendly, or perhaps even build a new room. Utilities, food, transportation, and medication need to be factored into your overall budget. Speak to your parent(s) about maybe contributing at least 1/4 to 1/3 of monthly expenses if necessary. If you’re having trouble with expenses, ask your siblings (if any) to contribute to the care of your parent(s).
2. Hire a Caregiver
Some parents are so protective of their independence that they’d rather “age in place,” instead of living with relatives. In that’s the case, your parent(s) will either live in the flat they spent 1/3 of their lives paying off, or sell their flat to purchase a 2-bedroom flat or studio apartment through normal sale or the Multi-Generation Priority Scheme (MGPS), which allows you to live in the same floor or complex as your parent(s).
Depending on how far you live from your “ageing in place” parent(s), and how busy your work/family schedule is, frequent visits may be difficult. If you’re worried about their daily well-being, hiring a full- or part-time caregiver can give you peace of mind. By hiring a caregiver, you ensure your parent(s) daily health/hygiene is monitored, therapy/medical appointments are attended, and social contact is maintained. So how can you find the right caregiver?
Here are several important factors to consider when hiring a caregiver:
- Special Care: If your parent(s) has any special care requirements, such as being wheelchair-bound, diabetic, or suffering from Alzheimer’s disease, you need to hire a caregiver that has the training and experience to care for Mom and/or Dad.
- A Day in the Life: Write a list of activities that your parent(s) do on a daily basis e.g. shower at 7 a.m., breakfast at 7:30 a.m., watch Sun Wukong (Journey to the West) marathon from 8 a.m. – 12 p.m., etc. This will give your prospective caregiver an idea of what his/her daily duties will be and also highlights any training deficiencies on the part of the caregiver.
- Cooking Prowess: Your parent(s) may have strict diet requirements dictated by religion, health condition, or ideology. So your prospective caregiver must be able to cook meals that won’t violate your parent(s) spiritual/physical well-being.
- Background Questions: You’ll want to narrow your caregiver search by coming up with a questionnaire asking about his/her: work history, references, duties, training, cooking experience, ability to administer medications, smoker/non-smoker, past patient emergencies, and personal feelings on being a caregiver.
Charges for hiring a caregiver can vary depending on meals, transportation, duties, etc. So expect to pay between $2.70 – $30+ per hour (excluding meals and transportation). Thankfully, there are numerous government programs that provide subsidies through means testing. Singapore Silver Pages is a useful site for finding caregiver services for a variety of needs. You can even hire a live-in maid with caregiver training as well for about $450 – $500 per month, minus the numerous fees.
3. Day Care
Remember the days when your parents used to drop you off at day care? I recall day care centres being a lot of fun – the food was good, everyone played games, and I even learned the importance of stealth, manipulation, and intelligence to outwit bullies. Now you can do the same for your parent(s) by sending them to an adult day care centre, which pretty much provides the same activities you experienced as a kid (minus the bullying).
Day care is a good option for a number of reasons. It prevents caregiver burnout by providing a welcome break without having to worry about the quality of care your parent(s) receives. Also, day care provides your parent(s) with the social interaction and activities (gossip, mah jong, football discussions) they need to stay lucid. And if your parent(s) suffer from any physical or mental disabilities, some day care centres are staffed and equipped to provide therapy and medical services.
There are three different types of day care for adults:
- Social Day Care: Provides eldercare for seniors focused around social interaction and recreational activities. Depending on the centre, services can also include meals, and health-related services like medication administration. Here’s a link to several social day care providers.
- Medical Day Care: Delivers many of the same services as social day care centres, but with more extensive health-related services, such as physical therapy and rehabilitation. Here’s a link to several medical day care providers.
- Dementia Day Care: Offers seniors suffering from dementia activities and games to exercise their mental abilities and limit the effects of dementia. Therapy can also be provided to Alzheimer’s patients to help them retain their memory. Here’s a link to several dementia day care providers.
Although many day care centres have normal daytime operating hours, some can provide 24-hour supervision for your parent(s). Monthly fees can vary from $70 – $700 per month for social day care, $700 – $1,200 per month for medical day care, and $700 – $900 per month for dementia day care (all excluding transportation). However, you can apply for government subsidies based on means testing.
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