Singapore's caregiver crunch

Services that ease their load must be enhanced as population ages: Experts

Singapore's rapidly ageing population has sparked a race to meet the surge in demand for care services for the elderly and infirm.

Tied closely to this but less visible are the needs of a growing army of caregivers whose lives are disrupted when a family member needs round-the-clock care as a result of old age or illness.

There are children looking after parents, husbands caring for wives, and parents spending their 60s, 70s and later years looking after bed-bound children.

While services catering to such families have risen sharply in recent years, a recent survey by the Duke-NUS Medical School found that fewer than 5 per cent of caregivers interviewed used individual support services such as home nursing, home medical and respite care programmes.

Yet the waiting time for a place at a day-care centre, for instance, can be nearly two months.

"The day-care waiting lists show that people may not be using these services because their capacity is still very limited," said Associate Professor Angelique Chan, who led the study.

There were around 380,000 people aged 65 and above last year, and the number is expected to hit 900,000 by 2030.

An estimated 210,000 people aged 18 to 69 provide regular care to family and friends, and this number too is expected to rise.

The Ministry of Health (MOH) told The Sunday Times that the number of places available at integrated day-care centres for the elderly will double from 230 to 470 over the next six months and by 2020, there will be more than 5,500 places.

These centres offer social support, dementia care, physiotherapy and basic nursing care all under one roof. This will partly offset the rising need for day-care services.

In addition, there are 60 eldercare day centres which can take in 2,800 older folk. These range from centres that offer opportunities for socialisation for relatively fit people to those that cater to people who need more care, such as dementia or stroke patients.

Existing day-care centres have a nationwide occupancy rate of 84 per cent, but the waiting time for a place in some locations can stretch to 50 days.

The Agency for Integrated Care (AIC), set up by the Government in 2009 to coordinate eldercare services, helps connect older folk to support services based on referrals from health-care professionals.

Centre-based services such as day-care centres are most in demand, based on referrals received by AIC between September 2012 and last month, says the Health Ministry. This is followed by home care and finally residential care services, said an MOH spokesman. The ministry declined to give figures on the exact number of referrals for each of the services.

AIC chief executive Jason Cheah said some caregivers may not have sufficient information to help them decide what kind of care is required for their loved ones.

They may also think that they can cope by themselves because of a lack of awareness on caregiving. This may lead to them experiencing "caregiver burnout".

"So there is a need to better equip caregivers with the knowledge, skills and support to care for their loved ones and themselves," he said.

Those working with caregivers, meanwhile, say services need to be beefed up. Insufficient eldercare options within the community are a key challenge, said director Manmohan Singh from the AWWA Centre for Caregivers.

There are more than 99,000 childcare places in Singapore right now, compared to around 3,000 for day-care services for the elderly at present.

"Given the emerging shape of the national population pyramid, eldercare centres should be as accessible as childcare centres," said Mr Singh. "But they're not."

He added that employer support for family caregivers, while important, is also currently "weak, grudgingly granted or quite absent".

"We must do better as a community to support our most vulnerable caregivers," he said.

radhab@sph.com.sg