SINGAPORE - Caregivers spend nearly seven hours a day taking care of their wards, and over four in 10 of them are at risk of depression after being confronted with multiple challenges such as inflation and Covid-19 in recent times, a survey has found.

The in-person survey of 200 family caregivers of Dover Park Hospice home and day care patients was conducted between October 2022 and January 2023.

It was commissioned by the Palliative Care Centre for Excellence in Research and Education, which was set up by the hospice, Nanyang Technological University’s Lee Kong Chian School of Medicine and National Healthcare Group.

To better support caregivers, the study recommended that the Government continually review the financial support given to caregivers, and also to consider introducing caregiving leave.

The results of the study were shared by Dr Mervyn Koh, medical director of Dover Park Hospice, at a one-day caregiver symposium at Furama Riverfront hotel on Thursday.

The survey was done as family caregivers caring for a loved one with a life-limiting disease are a particularly vulnerable population, especially given the recent challenging global environment, said the Palliative Care Centre for Excellence in Research and Education in a press statement.

Caregivers were asked to rank on a scale of zero to four, with zero being “never” and four being “nearly always”, how they felt about a particular statement. Questions asked included if they have felt they lost control of their life since their relative’s illness, and whether they felt stressed between caring for their relative and trying to meet other responsibilities for family or work.

From their responses, scores were tabulated, and those who scored more than eight points on a scale were deemed to be at risk of depression. A total of 52 questions were asked.

Dr Koh told The Straits Times that the survey found that the average caregiver is between the ages of 45 and 60, female, married and holding down a full-time job, but spends another 6.7 hours on caregiving per day.

Another group of concern is singles taking care of their loved ones at home, as they lack the support from a partner.

The depression risk for caregivers increased when there was a lack of practical assistance and emotional support from family and friends, and when the caregiver’s spiritual or religious needs were unmet if they were unable to take time out to attend places of worship.

Dr Koh said there is a need to expand ad hoc in-home respite services, which will go a long way in returning caregivers some personal time and space. This will help them better manage their multiple caregiving and life commitments.

There is also a need for friends and family members to show care and concern for caregivers, as well as wider social recognition for the informal, unpaid role that caregivers play, he said.

“As a start, we can look at constructing caregivers as a social identity to formally recognise their efforts and contributions, and optimise allocation of resources and assistance for them. Beyond the practicalities, formalising their identities could also uplift them and boost their morale with the hope of reducing depression risks.”

Dr Koh added: “Caregivers are an important part of Singapore’s social fabric, and we cannot let them remain invisible. We need to take care of them.”

Another suggestion was to implement caregiving leave as part of family care leave, so caregivers would not have to use up their own annual leave to take their loved ones to medical appointments.

Another key finding from the survey was that those who were concerned about the rising cost of care had a 10 times higher risk of depression, compared with those who were not. Over 91 per cent of respondents felt that costs had increased somewhat, and 82 per cent were worried about not being able to afford the cost of care.

Respondents said they hope for more financial assistance and subsidies for home-based care and social services, financial incentives for family caregivers providing care at home, and increased use of MediSave or SkillsFuture credits for caregiving-related expenses and courses.

Dr Koh pointed out that the Government has made some moves to defray the cost of community caregiving. He highlighted the enhanced Home Caregiving Grant, which was raised from $200 per month to up to $400 per month from March 2023. But whether the amount would need to be increased in the future if costs continue to rise should be monitored, he said.

In his opening remarks at the symposium, Professor Kenneth Mak, Singapore’s director of medical services, detailed several areas where the Government is supporting caregivers.

These include equipping the caregiver with the skills and resources needed to better anticipate and support their loved ones when they experience end-of-life symptoms, making it easier for caregivers to arrange for respite care, and empowering more to make end-of-life care plans.

“We should always remember that caregivers are those who play the most important role on a day-to-day basis, in supporting and meeting the needs of our patients and clients, in their homes and in the community,” said Prof Mak.

Correction note: An earlier version of this article said the Home Caregiving Grant was raised from $200 to $400. It was raised to up to $400. This has been corrected. We are sorry for the error.