Dementia-specific training for maids, stronger financial support and better wages for home care professionals are needed to ensure that dementia patients here are properly cared for, say experts.
Providing their views on the back of a study that puts the cost of dementia care here at $532 million a year - and triple that amount if social factors and accompanying conditions such as depression and hypertension are taken into account - they stressed that dementia patients need better help both at home and in the community.
The Government, recognising the serious and growing problem of dementia in Singapore's ageing population, is tackling it on all fronts - by developing dementia-friendly towns, increasing the number of daycare places and nursing home beds and researching new ways to care for patients.
Nonetheless, researchers from the Institute of Mental Health found that the biggest burden falls squarely on caregivers, who account for over three-quarters of the costs incurred, such as time spent and wages lost.
So help has to start in the home.
Dr Philip Yap, senior consultant and director of Khoo Teck Puat Hospital's geriatric centre, said the burden is especially heavy for adults with children of their own who act as caregivers for their parents.
While applauding the Government's initiatives, he believes Singapore needs to "intensify and fortify support in the form of practical assistance", such as through better financial help for families.
Associate Professor Phua Kai Hong of the Lee Kuan Yew School of Public Policy at the National University of Singapore stressed the need for better training for maids. The Government could license and provide dementia care courses, and make it a requirement for maids caring for such people, he suggested.
"You cannot just throw a young maid into the deep end," he said.
While families can also turn to professional caregivers, there are far too few of them. And this will remain a problem until they are paid better and the profession is seen as more desirable, said Mr Jason Foo, chief executive officer of the Alzheimer's Disease Association of Singapore.
"There is the stigma that it is a dead-end job, that the pay is low and there is no progression. It's a struggle to attract young people," he explained.
This is a far cry from countries like Australia and Canada, where fresh graduates consider a job in the eldercare sector attractive, he added.
Said Ms Yorelle Kalika, chief executive of Active Global Caregivers, which offers professional caregiving help: "People in the service industry earn the least. On top of that, the job can get really messy and frustrating, so it takes a lot for anybody to want to be a caregiver."
Dr Ng Wai Chong, medical director of the Hua Mei Centre for Successful Ageing at Tsao Foundation, said that current community initiatives such as building dementia-friendly communities are a good start. For instance, staff at some McDonald's fast-food outlets have been trained to spot people with dementia and to interact with and help them.
But that is just scratching the surface, said experts.
"You need a proper care system in place. Not just many services," Dr Ng pointed out.
"A structure that allows you to stratify cases, identify the services required and escalate or de-escalate cases such that they get the most appropriate services at the most appropriate cost, in an organised manner."
The primary care sector - general practitioners and polyclinics - would need to take on a bigger role, he added, with support from nurses, social workers and therapists.
This would make care more accessible and reduce the burden on hospitals.
"Constantly referring cases to hospital specialists is a waste of effort, time and money," he said.
