Home-based Care for the Aged

Mr David Ong asked the Acting Minister for Community Development, Youth and Sports (a) whether there is sufficient support for home-based care of the aged, chronically ill or disabled elderly; and (b) what are the Ministry's plans to ensure that domestic help receive the right level of care-giver training and support to look after the elderly at home.

The Minister of State for Community Development, Youth and Sports (Mdm Halimah Yacob) (for the Acting Minister for Community Development, Youth and Sports): Sir, MCYS understands and supports older Singaporeans' wish to age in place in their own homes among their loved ones, rather than in an institution among strangers and unfamiliar surroundings. We recognise the fact that our population is ageing rapidly and we need to prepare for this silver tsunami. Over the last few months, I have been visiting many eldercare facilities, including the frail elderly at home using home-based care services, to understand their needs and concerns. I agree that we need to do more.

Currently, MCYS and the Centre for Enabled Living (CEL) work with nine VWO service providers to offer home care to some 2,000 seniors. MCYS and CEL will nurture our VWOs so that they can expand and scale up their services in tandem with our rapidly ageing population. CEL will work with them on their manpower needs, and also to recruit and train the staff that they need. CEL will also continue to encourage and seed fund the use of technology and innovative care solutions to enhance the efficiency and quality of home care. The SEED Fund or Sustainable Enhancement for Eldercare and Disability Care Services Fund has, to date, supported 23 projects, granting a total of $2.4 million for initiatives benefiting our frail elderly and their caregivers.

One such initiative is the one that CEL is currently partnering with NTUC Eldercare and Thye Hua Kwan Moral Society, to pilot an integrated home care model. The pilots currently serve 184 elderly with multiple care needs. The staff takes care of the elderly's basic needs such as basic maintenance exercises, the provision of emotional support, personal hygiene, meals preparation and household tasks, in an ensuite elderly client-centric fashion.

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Currently, home healthcare forms a small part of MOH's healthcare system. In 2010, there were 10 subvented home medical/nursing providers serving 4,000 unique patients. This includes a provider that has since ceased operations. MOH will of course continue to scale up the capacity and capability of this sector to meet the rising demand.

MOH has also started on several pilots to enhance home healthcare services. One such pilot is with the Home Nursing Foundation (HNF). HNF works with the hospital team to facilitate a smooth transition for patients newly discharged from the hospital to home. Once the patient is at home, HNF will coordinate with other service providers to provide for the patient's care needs in the community. HNF has served over 300 patients since its inception in August 2010.

MCYS and MOH are currently studying the provision of home based social and health care needs for our frail elderly, with a view to promoting ageing in place, right siting of care and a more seamless transition from hospitals to the community and the home.

On the issue of training for foreign domestic workers, MCYS recognises that they play an important role in supporting families to cope with the demands of caregiving. We introduced the Caregiver Training Grant in 2007. Families may use the grant to train their Foreign Domestic Workers (FDWs) to acquire core care skills. Between January 2010 and September 2011, 2,311 informal caregivers of our frail elderly had benefited from the grant, almost half of whom are FDWs.

CEL has partnered NTUC Eldercare to offer structured hands-on training for FDWs, including training on communication skills with the elderly, given the potential language barrier between our elderly and the FDWs. CEL is also partnering TOUCH to implement in-home training of FDWs which allows for customisation based on individual household needs. Since the start of the pilot training programmes in April 2010, 300 FDWs have been trained by NTUC Eldercare and TOUCH.

MCYS would like to encourage more employers to send their FDWs for training which will benefit both the frail elderly and the caregiver, as the numbers that have attended are still small. Caregivers need to have some basic skills so that they can provide better care to the elderly, as well as minimise physical and emotional stress and strains on themselves.

We believe that everyone can do their part to make ageing in place, meaning in the community and at home, a reality for our elderly. And MCYS will do our best to initiate and support these initiatives so that our frail elderly too can live in peace and with dignity in the twilight years of their lives.

Mr David Ong (Jurong): On the training programme for caregivers including domestic help, the take-up rate as the Minister of State mentioned earlier is low. This could also mean that they are not aware or they have no time. Sir, I would like to see whether MCYS could work with MOM to look at accessibility of maids, and to see if we can have a training programme for them even before they are deployed to the homes. If the maids are not physically and mentally able to take care of the elderly, transitional care and other costs can be high.

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Mdm Halimah Yacob: I want to thank Mr David Ong for the suggestion. It is a very useful suggestion and we would certainly look into it and work with Ministry of Manpower to see how we could do that. I agree entirely with Mr Ong that it would be better for us to prepare a FDW who is coming in for the specific purpose of taking take care of a frail elderly beforehand rather than after the person has already been employed and then gets caught up with her work, household chores as well as other care-giving responsibilities. It is a lot harder to pull the FDW out to go for training. We will look into his proposal and work to see how we could achieve that.