First private firm to join govt care scheme

This post came out from The Straits Times (9 December 2016)

The first private sector firm has come on board a government scheme to help seniors make an easier transition between hospital and home. Active Global Specialised Caregivers, a 31/2-year-old local company, will start caring for people under the Health Ministry's interim caregiver service from next month.

Its rates, said founder Yorelle Kalika, will be comparable to those charged by the existing providers, which are either voluntary welfare organisations or social enterprises. For instance, Ms Kalika said, Active Global will charge subsidised patients $110 per caregiving shift. In comparison, social enterprise NTUC Health is charging $675 per six days, which works out to $112.50 per shift.

Interim caregivers usually work in 12-hour shifts to provide basic care, such as doing simple exercises or helping their clients with eating or bathing. Fees quoted are typically before applying other government subsidises, which can be as much as 80 per cent, depending on a person's income level.

The interim caregiver scheme was set up in 2013 to cater to the growing group of people who were well enough to be discharged from hospital, but were unable to cope on their own at home. This is where caregivers - who are usually not professional nurses but have undergone simple training - step in until more permanent arrangements can be made. People are generally referred to the programme by hospitals, with about six in 10 families eventually hiring a foreign domestic worker to take over the caregiving of the family member.

Three in 10 do not require any additional care, while the remaining one in 10 will either arrange for home care, engage senior daycare services, or move the patient into a nursing home. The interim programme, which is managed by the Agency for Integrated Care, has helped more than 3,000 patients between 2013 and this year.

In addition, Ms Kalika said, her company will be offering subsidised home personal care services at about $22 per hour. These services, which tend to cost between $22 and $30 an hour, are for people who need help with tasks such as eating or bathing - and reduce the need for a live-in maid. Ms Kalika said Active Global, which started out providing permanent live-in caregiver services, is well equipped to fulfil its new responsibilities.

Thoughts anyone?

Yours,

Something Small Thinking Big

'More help needed for dementia caregivers'

This post came out from The Straits Times (2 May 2016)

Dementia-specific training for maids, stronger financial support and better wages for home care professionals are needed to ensure that dementia patients here are properly cared for, say experts.

Providing their views on the back of a study that puts the cost of dementia care here at $532 million a year - and triple that amount if social factors and accompanying conditions such as depression and hypertension are taken into account - they stressed that dementia patients need better help both at home and in the community.

The Government, recognising the serious and growing problem of dementia in Singapore's ageing population, is tackling it on all fronts - by developing dementia-friendly towns, increasing the number of day care places and nursing home beds and researching new ways to care for patients.

Nonetheless, researchers from the Institute of Mental Health found that the biggest burden falls squarely on caregivers, who account for over three-quarters of the costs incurred, such as time spent and wages lost.

Dr Philip Yap, senior consultant and director of Khoo Teck Puat Hospital's geriatric centre, said the burden is especially heavy for adults with children of their own who act as caregivers for their parents. While applauding the Government's initiatives, he believes Singapore needs to "intensify and fortify support in the form of practical assistance," such as through better financial help for families.

Associate Professor Phua Kai Hong of the Lee Kuan Yew School of Public Policy at the National University of Singapore stressed the need for better training for maids. The Government could license and provide dementia care courses, and make it a requirement for maids caring for such people, he suggested. "You cannot just throw a young maid into the deep end," he said.

While families can also turn to professional caregivers, there are far too few of them. And this will remain a problem until they are paid better and the profession is seen as more desirable, said Mr Jason Foo, chief executive officer of the Alzheimer's Disease Association of Singapore. "There is the stigma that it is a dead-end job, that the pay is low and there is no progression. It's a struggle to attract young people," he explained. This is a far cry from countries like Australia and Canada, where fresh graduates consider a job in the eldercare sector attractive, he added.

Said Ms Yorelle Kalika, chief executive of Active Global Caregivers, which offers professional caregiving help: "People in the service industry earn the least. On top of that, the job can really get messy and frustrating, so it takes a lot for anybody to want to be a caregiver."

Dr Ng Wai Chong, medical director of the Hua Mei Centre for Successful Ageing at Tsao Foundation, said that current community initiatives such as building dementia-friendly communities are a good start. For instance, staff at some McDonald's fast-food outlets have been trained to spot people with dementia and to interact with them. But that is just scratching the surface, said experts. "You need a proper care system in place. Not just many services," Dr Ng pointed out.

"A structure that allows you to stratify cases, identify the services required and escalate or de-escalate cases such that they get the most appropriate services at the most appropriate cost, in an organised manner." The primary care sector - general practitioners and polyclinics - would need to take on a bigger role, he added, with support from nurses, social workers and therapists. This would make care more accessible and reduce the burden on hospitals.

Thoughts anyone?

Yours,

Something Small Thinking Big

What each document covers - These forms aim to ensure that your wishes on how to live out your final days are fulfilled

This post came out from The New Paper (10 July 2014)

Advance Care Planning
Made by: Anyone, regardless of age or health
What it is: Enables people to know what your treatment preferences are in a medical crisis, if you cannot speak for yourself. This empowers them to make decisions for you, although it is not a legal document and can be revoked verbally.
Who it involves: Your substitute decision makers, and an ACP facilitator, who is usually a doctor, nurse or medical social worker.

Advance Medical Directive
Made by: Any person aged 21 years and above who is not suffering from a mental disorder.
What it is: A legal document which you sign in advance to inform your doctor that you do not want any life-sustaining treatment used to prolong your life in the event you are terminally ill and unconscious, where death is imminent.
Who it involves: It is activated only when a panel of three doctors certifies that you are terminally ill. It does not have to involve your loved ones, who may not fully understand the reasons for your decision.

Lasting Power of Attorney
Made by: A person who is 21 years old and above
What it is: The appointment of one or more persons, called a donee, to act and make decisions on your behalf should you lose your mental capacity.
Who it involves: Donees are empowered to act in two areas: personal welfare, as well as property and financial affairs. It does not give them the authority to make life-sustaining treatment decisions on your behalf.

Thoughts:

1. Have you start planning yet? Good to know more about these! It can alleviate any stressors that your caregiver might experience too.  

Thoughts anyone?

Yours,

Something Small Thinking Big

Struggles of ageing caregivers

This post came out from The Sunday Times (11 October 2015)

In Singapore's ageing society, caring for an elderly loved one may become a reality for many people. But what happens when the caregivers themselves are getting older and more frail themselves?

Longer lives mean many people have to cope with the problems of ageing not just in their charges, but also in themselves.

Ageing caregivers have their own health concerns, such as chronic conditions like hypertension and diabetes, and worry about their future medical needs, says Ms Wang Jing, senior manager of counselling and coaching at Tsao Foundation's Hua Mei Centre for Successful Ageing.

They may also have little strength to help their charges in daily activities, such as transferring them from beds to wheelchairs. Caregivers may not be aware of the challenges they face.

Their responsibilities are 24/7, says Ms Wang. "They may not get enough rest as they need to be alert all the time, even during the night, if the care recipient needs the washroom or a cup of water."

Mr Kelvin Lim, chief of the social care division at the Agency for Integrated Care, says many caregivers see their duties as "a natural extension of their relationship", such as if they are the wife or the son. "Sometimes they're not aware that their role is quite extensive as a nurse, personal assistant and someone who handles the finances. They tend to focus their energy on their loved one's well being at the expense of themselves," he says, adding that one challenge is that caregivers can become isolated socially.

There are many caregivers who would rather not receive help, eldercare providers say. "We have a certain level of resilience in our community," says Mr Kelvin Lee, manager at Touch Caregivers Support. "People generally want to provide care on their own, sometimes to the point of resisting help or thinking that the assistance can be given to others with more needs."

To lighten the load of caregivers, Touch has asked neighbours to help one another and provides training for more complicated aspects of care, such as changing urine catheters and inserting feeding tubes.

When caregivers are properly trained,they are less stressed and more able to enjoy the presence of their wards. After all, "the quality of care is directly related to the caregiver's health and well being", Mr Lee says.

For information and support relating to caregiving, call:
Singapore Silver Line: 1800 650 6060
Hua Mei Centre for Successful Ageing (Tsao Foundation): 6593 950
CareLine by Touch Caregivers Support: 6804 6555
AWWA Caregiver Service, Caregivers Infoline: 1800 299 2992

Thoughts:

1. I think the post is striking, we have been talking about ageing, but the sick and their caregivers are the unsung group. This post looks at how challenging caregiving for the elderly by the elderly is, and yet people are resilient which can make it difficult to provide further support for them. 

Thoughts anyone?

Yours,

Something Small Thinking Big