SINGAPORE - Imagine you are an elderly resident who is overdue for cataract surgery on your eye.
You want to undergo the procedure, but you have a problem: If it requires anaesthesia or sedation, how will you get home if your family members are busy at work?
Here is where medical escorts such as Madam Maria Mohamed come in.
They pick up the elderly right at their doorstep, stay with them throughout their appointments and take them back home safely.
Demand for their service has soared, say service providers.
Madam Maria, 56, who works at the Handicaps Welfare Association (HWA), said: “I always regard my clients as my own folks or next of kin.
“Sometimes they can be difficult, but we’ll all grow old one day, and we might be the same.”
Medical escorts like her are increasingly important in Singapore’s greying society.
They are provided by voluntary welfare organisations, social enterprises and private companies.
Madam Maria has seen a surge in demand since Covid-19 restrictions were lifted.
“It was quieter during the pandemic as the seniors were staying at home,” she said.
“Now, many are seeing doctors again and need our help.”
Currently, there are 13 medical escort and transport (MET) service providers that receive subvention from the Ministry of Health (MOH), said its spokesman.
These service providers are subject to service requirements, such as those pertaining to safety and training for their staff and volunteers.
MOH added that the use of MET services has increased gradually over the years.
An average of about 2,800 trips were made a month in 2022.
In 2018, there were nine community care providers of MET services and they made about 2,000 trips monthly.
“This is likely due to an ageing population, and the associated increase in the number of seniors with health conditions who require regular medical follow-ups,” the MOH spokesman said.
“To provide more convenience to patients, public healthcare institutions are expanding the use of telehealth where appropriate, and bringing healthcare services to the community, closer to where patients reside,” added the spokesman.
HWA senior manager Simon Ching said there has been an increase in referrals from the Agency for Integrated Care over the years due to Singapore’s ageing population. The agency was set up by the Government to coordinate eldercare services.
By 2030, one in four citizens here will be aged 65 and above, up from one in six currently.
“Unfortunately, we sometimes have to turn down referrals due to our limited assets and manpower,” he said.
HWA’s MET service, started in November 2014, supports frail or home-bound seniors so that they can continue to live in the community.
It serves the central region of Singapore with six vans and 10 medical escorts.
The rates depend on subsidy guidelines, and can range from $9.20 (two-way transport only) to $22.80 (transport and escort), said Mr Ching.
Some clients live alone.
Others have family or primary caregivers who are not available, or are unable to accompany and care for them throughout the trip.
A former airport passenger service officer, Madam Maria started working as a medical escort in 2016. She handles one or two assignments daily on weekdays and earns about $1,700 a month.
The first impression is most important, said Madam Maria, who always greets her clients with a smile.
For those who are fussy, complain a lot or lose their patience while waiting to see the doctor, she chats with them or offers a drink.
“They are sick, they may be in pain, or they are feeling stressed about their medical condition,” the grandmother of five said.
HWA’s medical escorts are full-time employees and mostly women between 38 and 60 years old.
No special medical knowledge is required, as training is provided in areas like basic wheelchair transfer, securing of wheelchairs when on board a bus, and operating the hydraulic lift to transfer patients from bed to wheelchair.
There are also freelancers who advertise their services on sites such as Caregiver Asia, charging from $16 to $25 an hour, excluding transport.
Many do not have prior experience, and provide other services such as babysitting, pet-sitting and home cooking for the elderly.
Like HWA, other service providers have seen a spike in demand for medical escorts.
Ms Wong Li Peng, deputy group head of Touch Elderly Group of Touch Community Services, said its MET trips rose from 6,933 in 2021 to 8,004 in 2022, an increase of 15 per cent. She expects the demand to further increase with the rapidly ageing population.
The not-for-profit organisation has a team of eight medical escorts comprising three men and five women, serving clients in the central and western regions.
They are all full-time staff aged 42 to 65. Fees are subsidised and subject to means testing.
Ms Wong said: “We are currently operating at full capacity. We are utilising resources other than our own vans, such as taxis and private-hire cars.
“We are also tapping our pool of volunteer befrienders to help meet these escort needs.”
Ms Gillian Tee, chief executive and co-founder of care services provider Homage, has also seen a rising need for medical escorts.
Homage’s medical escort service rates start from $21 an hour.
It employs more than 10,000 “Care Pros” on freelance and full-time basis.
Currently, 70 per cent of its medical escorts are women. They range in age from 18 to more than 60 years.
Many used to work, or are working, in sectors such as finance, hospitality, food and beverage, and human resources, besides healthcare.
They are locals who understand the cultural norms here, and speak a common language or dialect with care recipients and their families, Ms Tee said.
“We actively employ mid-career people who are keen to be part of the eldercare community.
“By providing flexible work arrangements, we cater to individuals who may not be able to commit to full-time roles,” she added.
Part-time nurse Natasha Said, 31, joined Homage as a freelancer in 2016. She has seen not just a growing need for medical escorts, but also rising awareness of such a service.
“While some may think that this is a quick job, it can take the whole day as the journey from home to the medical facility takes time.
“In addition, waiting at the clinic can drag on for a few hours on busy days even if an appointment has been booked,” she said.
Ms Foo Fang Fang, 32, has been using Homage’s medical escort service since 2021 for her elderly mother, who has a number of medical appointments and needs monthly injections at hospitals.
Due to the frequency of the visits, the school teacher is unable to take time off work to accompany her mother.
“For my mum, the most challenging part would be travelling to and navigating around the hospital,” she said.
Homage also provides other services, such as home nursing, home rehabilitation and assistance with daily living, including eating, bathing, getting dressed and toileting.
Said Ms Tee: “With new policies such as Healthier SG and more conversations around preventive care for our ageing population, we expect to continue to see growing demand across all our home- and community-based care services.”