Who is looking after the elderly?

'I'd rather die than go to a home'

Mr Goh appreciates the help he gets from occupational therapist Doreen Ang, saying she is like family to him.
Mr Goh appreciates the help he gets from occupational therapist Doreen Ang, saying she is like family to him. ST PHOTO: ONG WEE JIN

A stroke in May last year did not kill Mr Goh Keng Char, but the depression that followed almost did.

Before the stroke, Mr Goh, then 77, lived alone in a one-bedroom Housing Board rental flat in Toa Payoh. His flat-mate of over 10 years had died a year earlier.

When he was discharged from Tan Tock Seng Hospital after a seven-week stay, Mr Goh, a bachelor, felt lonely and helpless, having to use a wheelchair to move around.

"I cannot walk... I felt I had nothing to live for," says the former water tank maintenance worker.

"I took the lift to the 12th floor of the block in my wheelchair and wanted to jump down.

"A Malay neighbour saw me in a daze and stopped me. He saved my life."

Today, Mr Goh still cannot walk and he continues to live alone at the rental flat, but he no longer thinks about taking his life. "I have many new friends in the neighbourhood, especially the hawkers," he says. "They do not charge me."

He relies on voluntary welfare organisation (VWO) Touch Home Care for food, medical care and housekeeping. Twice a day, seven days a week, volunteers from Touch deliver lunch and dinner to his flat. "The food is still warm when they arrive," says Mr Goh.

A nurse visits weekly to check on his health, and staff from the VWO clean his flat. The services are free because Mr Goh is on long-term public assistance, getting $500 a month from the Government.

Last December, Touch helped Mr Goh apply for government funding to buy a motorised scooter, and sent two occupational therapists to teach him how to use it this year.

Touch Home Care director Kavin Seow says it provides these services to seniors like Mr Goh as part of a larger government drive to help the elderly grow old where they live, instead of in nursing homes. "We recognise that the elderly want to be independent and many prefer to age at home."

Volunteers from the VWO deliver daily meals to about 400 seniors living alone. Each month, its nurses make housecalls to about 340 seniors. It also runs a daily ambulance service ferrying the elderly to hospitals for check-ups.

Touch operates in Ang Mo Kio, Jurong and Toa Payoh. It plans to expand to Bukit Batok and Yishun next year, but it is feeling the heat from the manpower crunch in the sector.

"Manpower challenges continue to be a concern for us, as it is important to recruit people with the right skills and heart for the work," says Mr Seow.

Mr Goh appreciates the help. "I have no relatives, so she is like family to me," he says, pointing to occupational therapist Doreen Ang, who accompanied Insight to visit him last week. Mr Goh had five siblings but they have died and their children do not visit him.

Ms Ang, who taught Mr Goh how to use the motorised scooter, downplays her role, saying: "Mobility is important for seniors socially, so I helped him get around the neighbourhood safely."

The 24-year-old graduated with a degree in occupational therapy last year and could have easily found work in hospitals, but she opted to work at Touch. She says: "I can make a direct impact on the seniors in a community setting."

Mr Goh is thankful for the motorised scooter, saying he is no longer confined to the flat.

When Insight asked if he would consider moving to a nursing home should his health deteriorate, he retorts: "No. I'd rather die than go to a nursing home... I have lived in Toa Payoh for more than 40 years and in this flat for more than 20. I want to die here."

Ageing in place: More support for seniors living at home

The key thrust of Singapore's ageing policy is based on the view that most people want to be cared for at home or in the community. That's because they feel more comfortable in familiar settings and around people they know.

And that is why the Ministry of Health (MOH) has ramped up aged care services significantly of late. Over the past five years, centre-based daycare places rose by 67 per cent, and seniors receiving care services in their homes increased by 82 per cent, says the MOH.

The ministry intends to keep up this momentum. The number of daycare places, where older people go for rehabilitative and social activities, will jump from 3,500 last year to 6,200 in 2020. Likewise, the capacity to care for seniors in their homes is expected to rise by 45 per cent from the 6,900 available last year to 10,000 by 2020.

Daycare centres and home- based care services - such as meal delivery, medical escorts, personal and nursing care, rehabilitation and "elder-sitting" for those with dementia - allow seniors with mild or moderate disability to still be able to age well at home.

For those with more complex needs, the MOH has started piloting integrated care packages this year that bundle both home- based and centre-based care to serve needs of seniors holistically.

However, the capacity to provide daycare and home-based care services remains minuscule compared with the vast, growing ranks of people turning grey.

The number of elderly living alone increased from 6,000 in 1990 to 29,000 in 2011 and is estimated to reach 92,000 by 2030. Disability rates among the elderly are expected to rise, even as the number of family caregivers shrinks.

To cope with heavy caregiving work, Singaporeans have been accustomed to outsourcing care to foreign domestic workers.

The MOH piloted a programme last year to train domestic helpers - both in the classroom and on the job - so that they can look after seniors better. But that pool of labour is dwindling, with source countries limiting supply and maids less keen to work here.

To have enough manpower, the rest of the community will need to fill the gap, experts say - pointing to volunteers. Tsao Foundation, a non-profit group that specialises in ageing issues, has more than 120 trained volunteers who help regularly in counselling and organising activities.

"Volunteers make a critical contribution to the care of our elderly clients," says Ms Doris Low, director of community relations at Tsao Foundation. "(Volunteering) is also one way in which we can support one another in an ageing society instead of seeing older people as 'others'."

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A version of this article appeared in the print edition of The Sunday Times on November 06, 2016, with the headline 'I'd rather die than go to a home'. Subscribe