Forum: Caregiver assessment and support should not be one-off
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I refer to Adrian Tan’s commentary, “The S’pore caregiver who snapped: Abdul Rani’s 14-year burden went unnoticed until it was too late” (July 11). It rightly highlights the need to support caregivers before it is too late.
However, earlier support requires a more basic shift. Caregiver strain should not be treated only as a private family burden.
Many family members do not identify as “caregivers”. They see what they do as love, duty or obligation. These values are meaningful, but can hide the labour, limits and risks involved.
Too often, care planning focuses on the person receiving care: diagnosis, functional needs, medication, appointments and service referrals. The family caregiver is then assumed to carry the daily load.
Care plans must stop treating the patient as the only unit of care. When a care plan depends heavily on a family caregiver, that caregiver’s capacity, strain and limits must be assessed as part of the plan itself.
My research on stroke caregivers in Singapore found that about one in four caregivers who were distressed early in the care journey remained distressed 12 months later.
Caregiver assessment and support cannot be one-off; they must begin early and be sustained.
Caregiver assessment should therefore be routine at hospital discharge, community care referrals, polyclinic follow-ups and social-service touchpoints.
Professionals should not only ask whether the patient is safe. They should also ask whether the caregiver and household are still safe. A simple caregiver strain check could examine whether one person is carrying care alone, whether conflict is escalating at home, whether the caregiver is sleeping, working, financially coping, socially isolated or emotionally exhausted.
Singapore has made progress through national caregiver-support efforts such as the Caregiver Support Action Plan. But support that depends too heavily on caregivers recognising their role and knowing how to ask for help will miss many who are breaking.
Wayne Freeman Chong
Executive Director, GeroPsych Consultants
