Who steps in when parents suddenly fall ill? Discuss caregiving plans early, say experts
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Conversations about caregiving can be sensitive and fraught with tension.
PHOTO: ADOBE STOCK
- Singaporean families avoid discussing future care plans due to cultural taboos, causing stress and conflict during health crises. Many mistakenly assume informal care.
- Despite free Lasting Power of Attorney (LPA) applications, few Singaporeans make one. This leads to costly legal delays if mental capacity is lost, as loved ones cannot automatically decide.
- Social services advise families to discuss care plans early and gently, using open-ended questions in relaxed settings. Focus on stability and quality of care, not just ageing or death.
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SINGAPORE – An elderly woman suffers a sudden stroke and loses the ability to walk. Before she is discharged from the hospital, her children scramble to hire a domestic helper, as tensions rise over who is responsible for her long-term care.
While hypothetical, this scenario may reflect the reality some families face when caregiving plans for their loved ones are not discussed in advance.
Yet detailed conversations about future care arrangements remain uncommon. Several social service organisations told The Straits Times that discussions about death, illness and incapacity are still taboo in many Asian families.
Such conversations include parents discussing with children what to do if they fall seriously ill, or making long-term care plans for a family member with disabilities when the primary caregiver dies.
SPD’s chief executive Abhimanyau Pal said: “In some cases, conversations are only triggered after a health scare, hospitalisation or injury that raises concerns about what would happen if the primary caregiver is suddenly unable to provide care.”
June Sim, who heads TOUCH Community Services’ Caregivers Support Group, said cultural norms around filial piety may make it harder to discuss caregiving plans, because some parents think their children should naturally take on these duties.
Some also think “ignorance is bliss” and avoid having such discussions when family members are still healthy, said Teo Ying Ying, head of the social work department at the Home Nursing Foundation (HNF).
A Singapore Management University Centre for Research on Successful Aging (ROSA) study of 7,910 Singaporeans between 49 and 80 years old found that only around one in three respondents made a lasting power of attorney (LPA), even though nearly seven in 10 knew about it.
This is despite the Government encouraging people to plan early for end-of-life scenarios by making LPA Form 1 applications permanently free for all Singapore citizens from April.
An LPA allows individuals to appoint a trusted person, usually a family member, to take charge of their personal welfare, property and finances if they lose their mental capacity.
“Many Singaporeans assume their loved ones can automatically step in during a crisis to make decisions about medical treatment and financial matters, but without an LPA, the legal process may not be straightforward,” said Paulin Straughan, director of ROSA, in a media release on the study.
Without an LPA, family members may need to apply for deputyship, resulting in higher costs and delays in decision-making, noted the study, which was published in May.
Teo said it is important to prepare for crisis even in normal times. “We never know when a disabling illness might strike us,” she said.
Conversations about caregiving can be sensitive and fraught with tension.
Some parents want to avoid being perceived as having “favourites” among their children when appointing their LPA donee – the person who can make decisions on their behalf, said Adrian Tan, co-founder of SG Assist, a social enterprise which supports caregivers.
HNF has seen siblings squabble over who and how to care for aged parents. Its social workers assess the situation by talking to the different parties and may call for a family conference to guide them towards a resolution, said Teo.
SPD’s Pal said families can start conversations about caregiving gradually, instead of treating it as a one-time discussion.
Some tips include choosing the right time and setting, such as during a relaxed family gathering or over a meal, and ensuring everyone is open to sharing freely, said Sim, from TOUCH’s Caregivers Support Group.
Also ask questions in a gentle way, such as “What would make you feel cared for in the future?”, and sincerely listen to the person without interrupting.
Pal gave other suggestions for open-ended questions: “What are your hopes and concerns for the future?” and “If something unexpected happens, who would be able to help?”
He added: “Framing the discussion around ensuring stability, continuity and quality of care for the person with disabilities, rather than focusing solely on ageing or death, may help make the conversations feel less daunting.”
