In the past weeks and for the next few weeks, I have been tasked by a few governmental agencies to talk about the topics on Caregivers. In all these seminars and conferences that I have the privilege to be involved, I will share some of my thoughts and things learnt from other experts.
We are all either being the carer at one stage of our lives or have been cared for, when we are young, when we are sick, and when we grow old and frail one day.
Caregiver can be formal (paid and as a full time work) or informal (spouses, children, relatives, friends and even neighbours). The work of caregiving has been increasingly important and perhaps I would say it should be of National Issue! But why?
With ageing population, number of chronic sick patients is ever raising in the current modern healthcare era. Singapore's efficient and fast tertiary healthcare support system have been ever so effective in saving and prolonging life. With the number of dependent patient raising, families are stressed to have the responsibility of caring for their dependent loved ones. Without properly trained and empowered caregivers, these group of dependent elderly may have repeated admissions into the hospital, stressing our already sardine packed restructured hospitals and increasing healthcare expenditure from a mere SGD $4 Billion just a few years back to $13 Billion on 2016. Not only the governmental health care system is stressed, the families are also being stretched, both emotionally and financially. If every and each of us stay home and care for us dependent family members, with smaller family units now and even so in future, we might not be contributing in Singapore economy! The country might fail as such!
I have been called upon to talk about various topic in caregiving; namely, Role and Skills a caregiver should acquire, Perspective of a Singaporean Caregiver, and Future possibilities of caregiver. To me, the simplest topic will be the role and skills of a caregiver. Caregiver training and care plans are part of my daily work and I can rattle off lots of details anytime. Having written a book on skills for caregiver (which NUS press deemed it was too difficult for a normal reader), I feel that caregiver skills are not too difficult to learn and master (That is for me to say of course!). I am currently giving an outline of the caregiver skills for public audience as a MSF Family 365 programme: Families for Life. https://www.familiesforlife.sg/unite-at-an-event/Pages/FamilyTimePreciousTimeEV.aspx
Experiences from each and every caregiver differs greatly. Depending on the culture, religious belief, financial status, patient's profile on physical and mental disability, care giver's profile, solutions for each and every family differs, as well as the needs and support. The challenges every caregiver faces is very different, some stresses on patient's care, for example, a demented and agitated elderly refusing to bath or to dress even, to external stress from relatives telling caregiver to give up and "let go" of the chronic sick, bed bound, tube fed elderly. As a supporting crew, I see many and supported many in these caregiving journeys.
There are too many permutations and I find it easier to share experiences with the families, often than not, reassure the family of their decisions and others had similar decisions made and the outcome. We are not alone in this world and fortunately, these problems are not solely being "bestowed" to certain families, others had faced similar or worse! Some caregivers are truly commendable in every sense, inspiring and brave in the face of many adversities imaginable in a caregiver journey. These are the people that actually are the most pleasant, down-to-earth and practical. I myself have learnt much from all the carers I come to know and respect.
The future of caregivers will depend a whole lot on governmental policies, sometimes, not only ours, but also policies of our neighbouring countries providing us with the caregiver workforce. I was requested in one of these caregiver sharing sessions to talk about some of my recommendations on the future of caregivers. Here are some of which I can think of:
1. A national caregiver organisation offering "membership" - liken a country club membership with perks like cheaper diapers from bulk purchases, and depending on the length of caregiving, we can then separate it into Silver, Gold, Platinum, and even Diamond Members (esp. one of my previous client with 2 cerebral palsy children who are severely disabled and brought both of them up into their thirties and going.) Plus perhaps transportation perks and even cafes for caregivers only to share and support each other. (Idea from Japan).
2. A means of remuneration perhaps for Singaporeans quitting their jobs to care for their dependent elderly instead of institutionalisation. This will be very difficult to achieve from the government point of view and how to fund the caregivers instead of funding the institutions (which is definitely more costly) and how to fund the informal caregivers. Formal caregivers current has both FDG and FDWG to offset some of the costs for families. But if they choose to care for their elders themselves, I don't see any form of financial support at present.
3. Starting a module on caregiving skills in Secondary schools or perhaps have a CCA on caregiving liken Red Cross/Girl's guide/Scout etc. The students can then have the skills and help out in respite care if needed. They will be a good source of support for families.
4. A more consolidated help portal for caregivers based on patient's conditions rather than listing them by services. For example, see my article on listing services based on the condition of the patient: http://www.lotuseldercare.com.sg/index.php/ideas/item/90-ideas-from-pre-mit-hacking-medicine-sg-workshop
5. Certifying caregivers as a healthcare worker with courses, so that the FDW can upgrade their skills and knowledge and can use Singapore as a training ground. For local caregivers, once their family work is completed, they can be rehired as caregivers in other families to help guide and support. I have many FDW whom are such wonderful carers and often I felt it is very wasted for them to return home after patients has pass on. Their skills and local healthcare knowledge will be invaluable.
With such intense interest in the recent years on caregivers, I am sure there will be more initiatives in future on caregivers. Globally, it is a bigger issue and the topic was discussed in international conferences as well. But, that is for another time!