INTRODUCTION
Selecting a suitable care arrangement for an elderly loved one with long-term care requirements can be a challenging decision for many Singaporean families. You will want to strike a balance between cost of care, health needs, and personal living preferences. Moreover, there are various elderly care options available, each with its implications involving seniors and their families.
To help you make an informed decision for you and your loved one, let us examine the various elderly care arrangements available in Singapore, with a focus on home care and nursing care. We hope what we shared can aid you in carefully weighing your options and making the ideal choice for you and your loved one.
UNDERSTANDING THE ELDERLY CARE SERVICES AVAILABLE IN SINGAPORE
2.1. Types Of Elderly Care Services In Singapore
Generally, there are five main categories of care arrangements for seniors in Singapore:
1. Home Care
The preferred option for individuals who want to age in place, home care services offer a range of medical care in the comfort of the elderly’s home, assisting with companionship, respite care, meal preparation, and basic housekeeping.
2. Nursing Homes
These facilities are equipped to provide elderly care 24/7, with trained professionals and medical equipment available to provide living and medical assistance. This option works best for those who require daily and long-term medical care.
3. Assisted Living
Assisted living, otherwise known as community living, is typically for seniors who may not be able to live independently but do not require a high level of care. The focus is on creating a comfortable living environment and promoting community activities for residents. Nursing and medical care are available but may be more limited than at nursing homes.
4. Elderly Care Centres
Unlike nursing homes, seniors do not reside in elderly care centres. Instead, they come here to be cared for during the day before returning home in the evening. The aim is to provide them with social and recreational activities, rehabilitation and therapy, or specialised care, such as dementia care, hospice care, or palliative care.
5. Short-Term Residential Care
Short-term residential care facilities, as their name implies, only offer care for a specific period of time, after which seniors will return to their primary residence. Those who turn to short-term residential care often do so when the caregiver requires a break or in unexpected circumstances where they are ill or not well enough to care for the care recipient.
Please note that what we have shared is a brief summary of the care provided by these elderly care services. However, for the purpose of this guide, we will primarily focus on comparing home care and nursing homes to help those whose loved ones require significant assistance with activities of daily living decide the best care option for their family member.
2.2. Home Care Services For The Elderly: What Is It?
Home care, or in-home care, refers to the arrangement where a person receives support for activities of daily living (ADLs), such as grooming, mobility, administering medication, and other personal needs, in the comfort of their home. This day-to-day physical care may be provided by a family member, a domestic helper, a professional caregiver, or a combination of the three.
Depending on the level of support needed, a professional caregiver may be required to live in or come over for a set amount of hours daily. It is crucial to note that while professional caregivers are trained to provide basic medical assistance, home care does not eliminate the need to visit a clinic or hospital when necessary or during emergencies.
Understanding the need to support home caregivers, the Ministry of Health (MOH) has enhanced the Home Caregiving Grant (HCG) in 2023, increasing the monthly cash payout from S$200 to S$400 to help defray caregiving costs for eligible individuals with permanent moderate disability living in the community, with more help provided to lower-income households.
In addition to HCG, MOH also has various existing subsidies, including the Seniors’ Mobility And Enhancing Fund (SMF) and Migrant Domestic Worker (MDW) Levy Concession, to help offset the cost of assistive devices and home healthcare items and MDW levy for households who need to hire a domestic helper to care for an elderly or disabled loved one, respectively.
Singaporeans can also tap on the Caregivers Training Grant (CTG) to enrol themselves or their domestic helper in caregiving training courses so that they can equip themselves with the relevant skills to care for their loved ones. For more information on the subsidies, please visit https://www.moh.gov.sg/healthcare-schemes-subsidies/caregiver-grants-subsidies.
2.3. Nursing Home In Singapore: What Is It?
Alternatively, Singaporeans juggling work and family commitments and are unable to commit to the long-term care of their loved ones may often consider placing them in a nursing home to ensure their needs are taken care of, as the establishment is well-equipped to care for those with long-term complex care needs.
Besides daily caregiving, such as providing support for activities of daily living, the trained professionals at a nursing home are also able to administer basic medical care when necessary and attend to the needs of residents with severe illness, disability, advanced dementia, or other types of cognitive impairment.
Nursing Homes Vs. Other Long-Term Elderly Care Facilities
Despite the prevalence of nursing homes in Singapore, there remains a misconception that the term ‘nursing home’ is a catch-all for any facility providing long-term elderly care. However, that is not the case.
Nursing Homes Vs. Care Homes
While nursing homes also provide residential care services, they are not the same as a care home. The latter only offers support for activities of daily living, whereas the staff at a nursing home is also expected to attend to residents’ basic medical care and needs.
Nursing Homes Vs. Old Folks Homes
At an old folks home, the focus is on maintaining freedom for residents and offering organised communal and social activities to foster a sense of community among the seniors. While daily support and medical care are available, they are more limited as the elderly residents are usually relatively healthy and self-sufficient. That contrasts with the level of care provided at a nursing home.
Nursing Homes Vs. Assisted Living
Assisted living aims to meet the needs of the ‘missing middle’ – seniors who encounter difficulty with fewer than three activities of daily living. While they may not be able to live independently, they are still well enough to be in the community and do not require the extensive care provided by nursing homes.
Nevertheless, these facilities still maintain trained caregivers on roster duty, offering residents meals and other professional assistance services. Examples of public assisted living facilities in Singapore include the Housing and Development Board’s (HDB’s) community care apartments.
HOME CARE OR NURSING HOME: DECIDING ON THE MOST SUITABLE OPTION
There is no right or wrong option when deciding between providing home care to your elderly loved ones or sending them to a nursing home. The decision ultimately depends on your family’s best interest, including your loved ones’ well-being and your capability to provide adequate care. Nevertheless, it is essential to consider the pros and cons of both services to ensure you make a more informed decision.
3.1. Understanding The Pros & Cons Of Home Care
Home care can offer various essential benefits:
Pro #1: Familiar Living Environment
There is no place like home, and the comfort, cosiness, and familiarity that home care provides can significantly contribute to your loved ones’ overall well-being. With the assistance of a trained caregiver, you can ensure your loved ones receive professional attention while enjoying the ease of recovering in familiar surroundings, thus lessening the stress of adapting to a new situation and environment.
Pro #2: Maintain A Sense Of Independence
With home care, your elderly loved ones do not have to trade their independence for the safety of medical care. This semblance of autonomy is not only vital for many seniors but can also empower them to navigate their daily lives on their terms, reinforcing their sense of self-worth and purpose.
Pro #3: Personalised Care
Whether you opt to care for your loved ones yourself or hire a domestic helper or professional caregiver, you can ensure they receive personalised elderly care tailored to their specific needs and preferences. As the caregiver will only be attending to the needs of your loved ones, they can commit the time and effort to fully understand their requirements and cater accordingly instead of adopting a homogeneous approach.
Pro #4: Family Involvement
Home care allows you and other family members to actively participate in caring for your loved ones, fostering a profound sense of connection and emotional fulfilment for all parties involved. This close-knit dynamic can help strengthen familial bonds and cultivate a nurturing environment where your elderly loved ones feel valued and cherished.
Pro #5: More Affordable In The Long Term
Depending on your loved ones’ condition and the level of care they require, the costs associated with engaging a domestic helper or a professional caregiver may work out to be lower than other available long-term care arrangements in Singapore.
However, there are also several limitations that you must take into account when considering in-home care:
Con #1: Care Disruptions
While home care undoubtedly offers a comforting and familiar environment for your loved ones, the potential disruption that occurs when the primary caregiver is not available can create moments of uncertainty. For example, when they are ill, unavailable, or have other duties to prioritise.
Moreover, there are instances where the care receiver is suffering from specific conditions and requires medical attention that goes beyond the scope and training of the caregiver’s expertise. If the medical professional is unavailable after office hours, it can be potentially disruptive to the patient and their family, as they must seek treatment at a hospital.
Con #2: Limited Medical Support
Depending on your elderly loved ones’ needs, the home environment might not be adequate for long-term medical care. The lack of proper medical infrastructure and equipment may cause their condition to deteriorate and compromise their health and safety.
Con #3: Home Modifications May Be Required
In addition to catering to your loved ones’ medical needs, you may also have to outfit your home with additional elderly-friendly facilities to combat fall risks. These changes are additional monetary and spatial costs you have to consider to accommodate their safety and convenience.
Con #4: Additional Space For A Live-In Carer
Likewise, if your loved ones require 24/7 attention, which you may not always be able to provide, you may need to consider hiring a live-in caregiver or helper. That means providing additional room for them, which may be a challenge for a compact home.
Con #5: Potential Caregiver Burnout
Caring for someone 24/7 can be physically, mentally, and emotionally draining, which may leave you feeling stressed and upset about your situation. While you may feel guilty about these feelings, it is essential to recognise the effects of caregiver burnout and seek short-term elderly care to give you a chance to rest and recuperate.
3.2. Understanding The Pros & Cons Of Nursing Home
While many may understandably struggle with placing their loved ones in a nursing home, this option often comes from a place of love and empathy for oneself and their family members. While you might want to support your loved ones, you may not have the time and resources to provide adequate long-term care on a regular basis. In this circumstance, it is beneficial to seek the aid of a nursing home.
Pro #1: 24/7 Professional Medical Supervision
Unlike home care settings, where the availability of medical professionals and equipment may vary, nursing homes in Singapore typically boast round-the-clock trained professionals to ensure residents receive prompt attention and intervention when the need arises. The constant access to medical care offers you peace of mind and a sense of security, alleviating any concerns you may have about potential delays in addressing health issues or emergencies.
Pro #2: Specialised Care Services
From advanced monitoring devices to specialised rehabilitation tools, nursing homes are well-equipped to support seniors with activities of daily living and provide extensive care for their various medical conditions, enhancing their overall quality of life. Moreover, the nursing staff are trained to provide a holistic approach to care, tailored to address the unique needs of each resident, ensuring every aspect is meticulously attended to.
Pro #3: Structured Care Programme
In addition to providing long-term care, nursing homes often integrate onsite amenities and structured programmes to keep seniors physically and cognitively active. For instance, at Orange Valley’s various nursing homes, we encourage our residents to participate in our daily morning exercises and afternoon social and recreational activities.
We also seek to enhance our residents’ quality of life through tailored rehabilitation, providing a supportive environment for them to embark on their path to recovery. Operated by a team of Allied Health Professionals, our specialised rehabilitation programmes aim to aid optimum recovery, ensuring residents receive the best care they deserve.
Pro #4: Opportunities To Socialise With Other Seniors
While home care allows your elderly loved ones to remain in a familiar environment surrounded by loved ones, their health and limited mobility may prevent them from leaving the house and socialising with others. In contrast, residing in a nursing home with their peers provides them with more opportunities to socialise, preventing isolation and depression.
For instance, our Orange Valley facilities play host to different activities, such as arts and crafts sessions, interactive games like bingo and mahjong, and pet therapy sessions, to encourage residents to interact and socialise among themselves and our nursing staff.
However, you should also be aware that opting for a nursing facility requires trade-offs and is dependent on you meeting specific requirements.
Con #1: Loss Of Independence
While nursing homes in Singapore offer numerous benefits, it is essential to recognise that transitioning to life within these facilities can pose a challenge for some seniors and their families. For instance, nursing homes often maintain structured schedules and regulations, which may cause residents to feel like they are losing autonomy and control over their routine.
Con #2: Separated From Loved Ones And Friends
While you can still schedule visitations with a loved one residing in a nursing home, you are often restricted to specific timings. For seniors accustomed to being surrounded by friends and family, this reduced interaction with family and close friends can leave them feeling lonely and disconnected, making the transition to nursing care even more challenging.
Con #3: Higher Cost
For some, navigating the cost of nursing homes in Singapore can be daunting, as the higher level of care provided, coupled with the need for trained professionals and state-of-the-art amenities, often result in substantial expenses associated with residency. This perceived costliness can lead to further apprehension and uncertainty, adding an additional layer of stress to an already challenging decision-making process.
Fortunately, MOH has introduced various nursing home subsidies to help Singaporeans and Singapore permanent residents defray these costs. These grants are not just limited to government nursing homes or those operated by Voluntary Welfare Organisations (VWOs). Some accredited private facilities, including Orange Valley Nursing Homes, also qualify for these schemes.
Con #4: Nursing Home Spots Are Subjected To Availability
Even Singaporeans who wish to send their loved ones to a nursing home to ensure they receive the best possible care are not guaranteed a spot, as admission priority goes to seniors with complex nursing care needs or a severe disability who require specialised assistance beyond the support available at home. As a result, there is often a waitlist for admission.
In fact, the waiting period can average around a month. However, this can vary among facilities depending on facility capacity and the specific care needs of the individual. During this timeframe, seniors and their families may be in a state of limbo, grappling with the challenges of home care while awaiting placement in their preferred nursing home.
3.3. Factors To Consider When Choosing Between Home Care & Nursing Homes
In addition to reviewing the pros and cons of both options, we recommend considering these specific factors to help you and your family with the decision-making process.
Factor #1: Your Loved Ones’ Health And Medical Condition
Do your loved ones suffer from a debilitating condition that requires full-time supervision, such as late-stage dementia? In that case, a nursing home may be better equipped to provide constant monitoring and specialised care, ensuring they receive the extensive medical support they need.
Conversely, if they only require care for the short to medium term and are expected to recover after rehabilitation, respite care may be sufficient to meet their temporary care needs while you consider transitioning them to home care upon recovery. Likewise, healthy seniors who require minimal support with their activities of daily living can consider home care or other elderly care services like active ageing centres and old folks homes.
Factor #2: Your Ability To Provide Care
While we understand your desire to care for your elderly loved ones, you may not always be capable of providing the adequate support they need to thrive, whether due to a lack of training or the inability to focus on being a caregiver 24/7. So, if your loved ones require specific care or constant support, something you may not be able to provide, nursing homes may be the best option to ensure their health and well-being.
Factor #3: Your Loved Ones Preferences And Concerns
As your loved ones age, they may require more assistance. However, this can be challenging for some seniors to process. Involving your elderly loved ones in this discussion is an excellent way to address their concerns and relieve them of any distress they may be feeling regarding this transition. They may also have preferences regarding their personal care that they wish to be respected.
CONCLUSION
Searching for a suitable long-term care arrangement for your elderly loved ones can be a long and arduous journey. Hopefully, our guide can provide you with helpful pointers to assist you in making a well-informed decision for you and your family.
If you decide a nursing home is in the best interests of your loved ones and your family, look no further than Orange Valley for your senior care needs. At our private nursing homes, our staff is committed to ensuring our residents feel valued, assured, and comfortable in every aspect of care rendered towards them. Contact us to enquire about our nursing home prices and services today.