Of all the issues facing Singapore, the biggest elephant in the room is the rapidly ageing population. Almost 20% of the populace will be 65 and over by 2030, with that number doubling to nearly 40% by 2050. At the national level, it’s a concern that will gradually reduce economic output and raise eldercare costs.
At the individual level, however, this issue brings up another tough question – how will you care for your ageing parent(s) once they need living assistance? Depending on your situation, a nursing home may be the only way to ensure your parent(s) receive the attention and care they need. Unfortunately, bad headlines and abuse cases have tarnished their image.
So how can you be sure you’re sending your parent(s) to a good nursing home and not a “quilting sweatshop” like the one from the movie Happy Gilmore? You just need to evaluate the following factors:
Accessibility means choosing a nursing home that’s conveniently located close to where you live so you can visit your parent(s) quickly and easily. Just imagine how difficult visiting would be if you lived in Bedok while your parent(s) stayed at a nursing home in Woodlands or Johor Bahru.
Accessibility is also about selecting a place with longer visiting hours, allowing you the flexibility to visit in the early hours of the morning or late at night. But there’s another reason why accessibility is so important – visiting regularly (especially unannounced) can impact on the quality of care your parents receive. Why? For two reasons:
- Staff notice that you visit frequently and are more conscious of the care given to your parent(s)
- You can directly observe your parent(s) treatment and point out any shortfalls in care provided by staff (ex. calls for assistance go unanswered)
*Note: If your parent(s) have special conditions like Alzheimer’s disease, there are nursing homes to meet their needs, but these specialized homes may not be close to where you live.
You’ll need to prepare your senses before visiting each of your choices. That’s because the first visit is all about finding clues to the real condition of each nursing home. So do your best Sherlock Holmes impersonation and pay close attention to these key areas:
Are you greeted with smiles from staff and residents throughout your visit, or are you met with hollow stares from people who look like they’ve served a few tours in Afghanistan? What kinds of recreational activities does the facility provide to enhance their quality of life? An atmosphere that is warm, social, and welcoming will help your parent(s) adjust to their new home.
Richard L. Peck, former editor with Long-Term Living Magazine said it best: “If it smells like urine, that’s obviously a bad sign. But if all you smell is pine cleaner, I’d be a little suspicious about that too, wondering what odors it’s covering.” A place that smells like a normal home instead of a public bathroom would definitely put your parent(s) at ease.
Does the place look like a clean and tidy home, or a hospital? Are there well-lit corridors with clear signage to direct residents/visitors to where they want to go? Are there handrails/wheelchair ramps to aid accessibility? Is there frayed carpeting, broken tiles, or other hazards that can trip up residents? Are the facilities secure enough to prevent residents from walking off or break-ins? These are some of the things you need to keep in mind while doing your walk-through.
Is the nursing home quiet and peaceful, or are you bombarded with noise from loud televisions, radios, or residents constantly crying out for staff assistance*? Do you hear staff regularly interacting with patients, or gossiping loudly with each other? If your parent(s) are social, selecting a nursing home with more engaging staff is preferable. If your parent(s), favor peace and quiet, a more tranquil place (or a private room) would be better.
Make sure you don’t leave without viewing the rooms! Are the rooms tidy and well-maintained, with elderly-proof features like handrails? Some facilities may have different rooms available ranging from private rooms to rooms housing 2, 4, or 8 residents. Observe if there’s enough space for each person in shared rooms, or if they’re overcrowded and unclean.
Take time to eat lunch/dinner at the nursing home to see what mealtimes are like. Does everyone eat together at the same time, or at their leisure? Do people eat in peace, talk with other residents, or argue with each other? Is the food comparable to something you’d eat at home, or is it something a prisoner locked in solitary confinement at Changi Prison wouldn’t touch? Also, ask whether they can provide for special diets based on religious, health, or ideological preferences.
*Note: Don’t let the sound of patients crying out disturb you too much, as some patients with severe dementia will do that, so don’t let it freak you out too much.
On your first visit someone in admissions will probably give you the tour of the grounds, so there’s a good chance that any questions you ask will have a rehearsed answer (every good salesman has answers/rebuttals). The people you really want to talk to are the staff (nursing, administrative, caretakers, etc.) who deal with residents on a daily basis.
You can ask the admissions/marketing representative if it’s ok to speak to staff about anything. If there’s some hesitancy on their part, it’s probably a warning sign that they’re hiding something. Once you manage to speak to a staff member, ask about the following:
As you walk through the facility, don’t be afraid to ask the staff, especially nurses and caretakers, about their experience working there. Don’t be afraid to ask them the same questions that you’d ask of any anyone you want to hire to care for your parent(s), such as:
- How long have you worked here?
- What credentials or training do you have?
- Do you take time to get to know each resident personally?
- Can you tell me a little bit about some of the residents?
- How do you handle medical emergencies?
- How do you handle residents with special conditions like dementia?
During the tour, observe if there are enough staff members to manage the residents living there. A horrible staff-to-patient ratio will be pretty obvious if there are multiple residents asking for assistance but not enough caretakers/nurses to help. Even if the place looks well-staffed, ask if the staffing levels are always constant or change during the evenings and weekends.
While nursing homes generally have a high turnover rate (hey, it’s a tough job), a turnover rate that’s too high (50% and above) almost always means that residents will suffer as a result. Because no matter how dedicated the experienced staff are, there’s not enough of them to care for everyone. And inexperienced staff are more prone to making harmful mistakes (i.e. giving the wrong medication, not recognizing illness symptoms, etc.).
The cost of sending your parent(s) to a nursing home can be steep, ranging from $1,200 – $3,500 per month without government subsidies. Many factors such as room type (private room vs. 4-person room, etc.) and special medical needs (dementia, Alzheimer’s disease, etc.) contribute to the cost.
Depending on your income, you can apply for and receive subsidies under Medifund and Eldershield that will cover 10% – 75% of nursing home fees. For more information, you can visit the Silver Pages website to speak with a client relations associate on their Online Helpdesk.
Making the choice to place your parent(s) in a nursing home is never an easy decision. But if you’re looking for another alternative, you can read my previous article here. Follow us on Facebook as we keep you up to date with the proposed changes to our healthcare system.
How do you plan on caring for your ageing parent(s)? Share your thoughts with us on here!
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