More families opt for home care for sick, elderly relatives

Number of patients referred for such help up by 50% in three years

By Poon Chian Hui, The Straits Times, 16 Jun 2012

FAMILIES are increasingly choosing to have their sick or elderly relatives looked after at home.

The number of patients being referred for this kind of care has jumped by 50 per cent in three years. Health workers come to their homes to nurse them or perform check-ups.

'We have observed the growing number of families who prefer to care for their loved ones at home rather than in an institution,' said Dr Wong Kirk Chuan, chief operating officer of the Agency for Integrated Care (AIC).

'There are also more elderly people who prefer to spend their golden years in a familiar environment.'

Dr Wong's organisation oversees long-term care of the elderly in Singapore. The number of patients it referred to home care service providers increased by half between 2009 and last year. The agency is working with the Health Ministry and service providers to ramp up capacity in order to meet the demand.

Home care helps people who are suffering from longer-term ailments such as fractures but prefer to recover at home. There are 13 providers in Singapore - six voluntary welfare organisations, four nursing homes, two community hospitals and one hospital.

One of the bigger players on the scene, Touch Home Care, said client numbers had more than doubled from 333 in 2006 to about 800 today.

'Staying at home is generally preferred to other options like going to a nursing home,' said its director Kavin Seow.

'But many do not have family members around all the time to look after them.'

Meanwhile, smaller outfit Yong-en Care Centre's new home care service is gathering pace, despite starting operations only last year. Staffed by a core team of just four, it now cares for 26 elderly people. Half are aged above 70.

The voluntary welfare organisation began offering home help, which covers only household chores and errands, in 1996. It later expanded into full home care.

Executive director William Chua said: 'Now, we see the trend moving towards home care, as our clients grow older and encounter more health problems.'

In the latest Budget, the Government announced it is channelling $250 million into caring for the elderly - 30 per cent more than last year. Part of the money goes towards home care, which can help ease the shortage of hospital beds.

Mr Seow said: 'If not for such a service, the only option for many people is to call 995.'

Three-quarters of those referred for home care are aged above 65, and need help with daily activities such as eating and going to the toilet, said Dr Wong.

Madam Chua Ah Moi, 64, a former amah, is bedridden after losing the use of her legs in 2004 due to a nerve problem.

'Previously, I do everything on my own,' she said in Mandarin. 'Now, I can't stand up, can't walk, nothing.'

Since last April, she has been receiving regular home visits from a doctor, nurse and therapist sent by Touch Home Care.

Yong-en's Mr Chua said there are plans to expand its service to care for 250 people within three years. He added that by 2030, 60 per cent of elderly people here will suffer at least one chronic ailment.

'Home care needs to grow. The hospitals cannot cope.'

However, the service does not come cheap. Each house call can cost $80 to $200 without subsidy. Madam Chua admitted she dared not take up the service at first in case she could not afford it.

'Medical fees are so high nowadays,' she said. She was later offered a package at $46 a month.

Mr Seow added: 'People should not be turned away just because they cannot pay for it. Going forward, we will need more funding and donations.'

Nurse tends to medical needs, provides company
By Poon Chian Hui, The Straits Times, 16 Jun 2012

CONFINED to a wheelchair and suffering from blurred vision, Madam Ong Tieng Chee finds even the simplest of tasks a struggle. 'My arms are weak,' she said. 'I have no strength to push the wheelchair around.'

But the 72-year-old has found life a little easier since a nurse began visiting three times a week. The home-care service is being offered by voluntary welfare group Yong-en Care Centre, which is based in Chinatown.

Madam Ong was referred to the organisation by the Singapore General Hospital, which was treating her for a hip fracture due to a fall.

The injury causes pain to shoot up her right torso when she coughs.

Both her feet are also infected because of complications from diabetes. The wound dressing needs to be changed regularly, but Madam Ong said she can 'only do a little'.

She added in Hokkien: 'I can't see. My vision is very blurry these days.'

Space in her one-room flat on Banda Street in Chinatown is cramped, so manoeuvring the wheelchair around the house is a problem.

During each hour-long visit from the nurse, Madam Ong has her blood sugar measured, and her leg wounds washed and dressed. The nurse helps to pack her daily medication into separate pill boxes.

'Sometimes I forget. My memory is not so good now,' said the retiree.

This is the first time she has been placed under home care - which she needs because she does not have anyone to look after her. 'My children, they don't bother about me,' Madam Ong lamented. She has a son and a daughter. Her husband has died,

Home care has another benefit. It provides company for the patient. This is something that Madam Ong appreciates.

'Sometimes I feel like I'm going crazy, just sitting alone at home and thinking about all sorts of things,' she said.

'Most things are inconvenient for me now, so it's good that they come here - they can help me with anything.'

Types of services available

FOUR types of home-care services are available here, catering to a range of patients - from those who need regular medical assessments to those who simply need nursing help to stay comfortable at home.

Charges are estimated, and do not include subsidies.

Home medical care is for those requiring primary care from doctors, such as health check-ups and monitoring of chronic conditions such as hypertension.

Each visit costs $130 to $200.

Home nursing is for those who need procedures like injections, wound dressing, changing of feeding tubes and checking of blood sugar and blood pressure.

Those taking several types of medication at one time can also get help with packing and sorting out their daily dosages.

Each visit from the nurse costs $80 and up.

Home therapy comprises exercises or activities aimed at improving a patient's ability to carry out daily tasks, especially when the patient is unable to leave the home for a day-rehabilitation centre.

Those who use home therapy include those recovering from strokes or fractures.

The physiotherapist or occupational therapist will assess the patient's home and recommend modifications such as handrails to make it safer for the patient to get around at home.

Each visit costs between $100 and $150.

Hospice home care is for the terminally ill, such as those with cancer.

Services include medical and nursing care like administering painkillers, as well as emotional support to the patient and the family.

Each visit costs between $100 and $150.

Coordinating help for the dying

Trained volunteers will visit the terminally ill to ensure they have access to the services they need
By Janice Tai, The Straits Times, 17 Jun 2012

Trained volunteers are to be sent into the community to befriend the dying and make sure they are being cared for properly.

The scheme by the North West Community Development Council aims to solve the problem of terminally ill people not knowing where to turn to for help.

As soon as they leave hospital, needy residents will be referred to a coordinator, after being asked for their consent.

They will next be assigned four or five trained volunteers called community befrienders, who will make regular home visits to get to know them and assess their needs.

The dying person can then be put in touch with the relevant services, such as hospice care.

Called Home Care Link@North West, the new community support network is meant to ensure that those with terminal illnesses have access to the comprehensive range of services that they need.

Minister for National Development Khaw Boon Wan said this extra help is crucial as those who have recently been diagnosed may find themselves at a loss, especially if they are not aware of how and where to get help.

Speaking at the launch of the network yesterday, he added: 'When certain traumatic events happen, made worse if the person is a breadwinner, it is very stressful.

'It will be helpful if there is someone you can call who has the local knowledge to 'matchmake' and hand-hold you until you get back to a normal routine.'

The council aims to train 100 befrienders to help about 250 needy residents every year.

Before they fan out for their home visits, the volunteers have to undergo training, which covers topics such as mental health and grief management.

Partners helping with the initiative include Khoo Teck Puat Hospital and home care or hospice service providers such as the Sunshine Welfare Action Mission Home and Thye Hua Kwan Moral Charities.

These partnerships will hopefully mean that as well as being cared for medically, the residents will have their social and financial needs met.

For example, the coordinators and befrienders can help them apply for financial assistance or arrange for family members to attend training sessions on how to improve their careers.

School counsellor Clara Yap, 48, has been visiting a terminally ill resident over the past month - accompanied by her 19-year-old niece and three other volunteers.

Besides offering a listening ear, the team found other ways to reach out to the dying man - from offering to bring his ageing mother out for a breath of fresh air to playing games with his two- year-old son.

'To get them to open up and share their problems with you, we must first build rapport and gain their trust,' said Ms Yap.

* Free hospice home care

LAST Saturday's report ('More families opt for home care') stated that for hospice home care for the terminally ill, medical and nursing care is available with each home visit costing between $100 and $150 per visit.

While the fee applies in general, some organisations like Agape Methodist Hospice Homecare (AMH Homecare), which we run, provide this service free for patients who are not under any subvention from the Ministry of Health.

AMH Homecare also provides discretionary free or very low charges for subsidised patients who receive subvention assistance.

The organisation has a medical team of two doctors and three nurses who administer palliative care to those suffering from terminal illnesses in their own homes.

A medical social worker also helps to assess the needs of patients and their caregivers.

Befrienders are assigned to families to provide social and emotional support during this time of stress and illness.

For more information, please contact Moira or Indira on 6478-4725 or e-mail them at admin@amh.mws.org.sg

Jenny Bong (Mrs)
Group Executive Director
Methodist Welfare Services
ST Forum, 21 Jun 2012