Friday 28 March 2014

Halimah Yacob reiterates call to legislate eldercare leave for workers

By Janice Tai, The Straits Times, 27 Mar 2014

THE elderly may have their healthcare worries addressed by the Pioneer Generation package, but it is equally crucial to look into the needs of their caregivers, Speaker of Parliament Halimah Yacob said yesterday.

One way would be for the Government to "seriously consider" legislating eldercare leave.

"Even if it's only for a few days, it will provide great relief and is a strong signal that the Government supports families in their effort to care for their elderly at home," she said.

This would help especially those "sandwiched" between looking after young children and frail elderly parents, said Madam Halimah at the Ageless in Singapore conference at Pan Pacific Singapore attended by 260 people.

She first called for compulsory eldercare leave last year on the back of feedback from caregivers who did not have enough leave to care for their aged parents.

The need for eldercare leave is "a lot more urgent than we realise", with some having to quit their jobs to care for their loved ones full-time, she told reporters yesterday.

An NTUC survey released last year showed that 77 per cent of working caregivers do not have eldercare leave. Among the caregivers who quit work, 21 per cent did so to take care of an elderly family member full-time.

Singapore's largest employer, the civil service, has led the way in formalising eldercare leave. Since 2012, employees can use two out of 14 days of unrecorded leave, which includes marriage and exam leave, for eldercare.

But SIM University's head of gerontology Kalyani Mehta said eldercare leave applies only to those caring for parents and should be extended to other caregivers: "It should be made more flexible because in some families, the daughters-in-law or spouses are the ones doing the caring."

To encourage more private firms to offer eldercare leave, Madam Halimah suggested having both the Government and employers share the costs.

"It can be similar to childcare leave where the Government bears part of the costs so that it is more manageable for the employers," she said.

Besides eldercare leave, Madam Halimah said caregivers can be supported with an allowance or home-based respite care services. Both options, she noted, will enable the elderly to age at home rather than be in institutions.

Caregivers who need time out usually leave their seniors at respite care centres for a few hours.

"I honestly don't think this is going to work," said Madam Halimah. Some old folk, especially those with dementia, may be unsettled when they move from their home to a centre where they do not know anyone.

She also proposed an allowance, either through cash handouts or Central Provident Fund contributions, to support and recognise caregivers who may have to sacrifice their careers to look after their elderly parents.

"Otherwise the caregiver may think that 'I might as well continue to work to build up my savings for retirement' and then there is no choice but to put the parent in a nursing home," she said.

Mr Gerard Ee, chair of Council for Third Age, a government-funded group that promotes active ageing, agreed it is important to invest in support for caregivers.
"Often, we count the costs of what all these additional measures may chalk up, but we don't count the costs that arise if these measures aren't in place," he said.
"Down the road, if the health of the caregivers deteriorates, it will be more costly for the Government and the people."

Why eldercare leave is not feasible

I DISAGREE with Speaker of Parliament Halimah Yacob's call for mandatory eldercare leave ("Halimah again calls for mandatory eldercare leave"; Thursday).

If mandated, it will become yet another type of compulsory leave entitlement that is difficult to police, in the same way that childcare leave has become a statutory entitlement that is being used for whatever purpose the employee chooses.

In recent years, more and more rigidities have been piled upon our labour market. Yet another type of mandatory leave will make our labour market even more inflexible.

While the impact on competitiveness will not be felt in times of growth and labour shortage, the reckoning will come when the business cycle turns.

Since the labour market is currently tight, why not let the market decide?

Let those companies that believe eldercare leave is needed to retain and attract talent offer it, but give those that cannot afford it the option of doing otherwise.

Cheng Shoong Tat
ST Forum, 29 Mar 2014

Show of support for families

I SUPPORT Speaker of Parliament Halimah Yacob's call to legislate eldercare leave ("Halimah again calls for mandatory eldercare leave"; Thursday).

My wife and I are considered part of the "sandwiched generation" as we have to look after our child and our elderly parents, while juggling our jobs and other commitments.

We appreciate the fact that there is childcare leave for young couples like us to take care of our children when required, but at the same time, we also have a duty and responsibility to take care of our aged parents and in-laws.

With Singapore becoming an ageing society, the Government should make it clear that it will provide support for families.

Currently, our elderly parents have no one to accompany them to medical appointments or to attend to important matters.

As children, we are obliged to show filial piety but our hands are tied where our work is concerned.

Thus, I urge the Government to consider legislating eldercare leave of at least three days each year.

The Government should bear some of the costs of this leave to signal its strong support for families.

Muhammad Dzul Azhan Haji Sahban
ST Forum, 29 Mar 2014

Role reversal in caregiving
Children caring for elderly parents may face adjustment problems and experience resentment
By Kezia Toh, The Sunday Times, 30 Mar 2014

Watching her 66-year-old dementia- stricken mother struggling to recall her name two weeks ago was the latest blow in a two-year caregiving journey for social entrepreneur Gan Ee Bee, 39.

It started when she found her mother, Madam Lim Sey Low, and her five-year-old nephew in tears as they were roaming around on the wrong floor of their apartment block.

The family lives on the sixth floor, but the pair were unable to differentiate between the numerals six and nine on the lift panel and panicked.

For Ms Gan, it was a shock to see her once-vivacious mother struggle with dementia. Madam Lim used to good-naturedly boss around staff and guests while running a youth hostel.

"Settling into the mindset that my mother is like this now, when she has always been very capable, was difficult," Ms Gan says.

She has been making tweaks to Madam Lim's routine and lifestyle, such as replacing her button-up blouses to shifts that can be easily put on over the head.

Grown-up children coping with the role-reversal experience of becoming caregivers to their parents struggle in some areas. The issues include trying to maintain their parents' dignity while helping them with day-to-day tasks, carving time from work and dealing with the demands of a sandwiched class having both elderly parents and young children to support.

For the adult child, there would be initial shock at the parent's illness, particularly if the parent used to be healthy, says Ms Christine Goh, head of senior services at Care Corner, who is in her 40s.

But counsellors say the initial shock of the role reversal seldom lingers.

"Singaporeans are very matter-of-fact. They think, what is the problem, let's solve it and move on," says clinical director Teo Puay Leng, 50, of O'Joy Care Services.

Resentment towards the role reversal and having to care for the parent, if any, arises among siblings rather than be directed towards the parent, says senior medical social worker Teo Swee Ngim from SingHealth Polyclinics, who is in her 30s.

This happens if the family cannot agree on which child is the main caregiver, coupled with the stress of a sudden onset of illness such as stroke, dementia or amputation from diabetes.

It helps if each sibling is assigned a role, like in the family of Mohamed Jasni Daud. The cleaner, 52, lives with his mother Patimah Askar, 76, who is suffering from osteoporosis and high blood pressure, with Alzheimer's disease slowly setting in.

He and his six siblings split the workload: A younger sister, a housewife, takes care of Madam Patimah for most of the day, when Mr Jasni is at work. The other siblings share their mother's living and medical expenses. They also turn to the Caregiving Welfare Association, which provides the family with food rations.

Mr Jasni says it was "very upsetting" to see his once-active mother take a fall 10 years ago, which reduced her mobility because she still wants to do what she used to do.

She kept straining herself to do household chores, despite his repeated attempts to dissuade her. To that end, he "assigns" her less strenuous tasks, such as folding laundry.

Mr Jasni takes pride in cooking her favourite dishes - assam pedas, chicken sambal and lontong - for her. He learnt how to cook them from her when he was growing up.

"Sometimes she is happy, sometimes she is not... but cooking and taking care of me was what she did, and now I do it for her," he says.

There might also be simmering resentment in families if the ailing parent subscribes to the "Asian traditional way" of favouring sons over daughters, and the daughters end up shouldering the bulk of the caregiving duties, says O'Joy's Ms Teo.

She adds that the most important thing is for the children to put themselves firmly in the shoes of their parents.

"The parent may have been doing something, such as cooking, for the past 40 years and is now unable to continue. This can be a tough transition for the parent," she explains.

The children, meanwhile, may assume their new caregiving role with the perspective that their parents are old and their diminished condition is "to be expected", she says, leading to a lack of empathy.

When elderly parents require help with day-to-day tasks such as eating and bathing, help them maintain their dignity by giving them a choice on how the chores should be done, says Ms Teo.

For example, the parent could decide if he would like to be showered or sponged, and what time of the day he wants this to be done.

Madam Lim, for example, prefers that her daughter Ms Gan assists her bath in the morning. "These decisions may help her because her mood is better and she is more cooperative," says Ms Gan.

Meanwhile, Madam Patimah is able to shower independently while seated, so Mr Jasni leaves the door "half-closed" for her privacy.

Being overly protective of the elders could backfire and humiliate them, says Ms Rachel Lee Siang Ju, 46, senior assistant director of Fei Yue Family Service Centres.

Choice of food, says Ms Teo, is also one of the biggest problem areas. The children tend to think their parents' diet needs a major health overhaul, while the cared-for folks may crave unhealthy fare.

"Singaporeans are such foodies and chances are, the older generation cooked well and have high standards for food," Ms Teo explains.

Her advice: Offer a compromise - an indulgent treat on the menu once in a while, depending on their health and condition.

Children also tend to pay more attention to their parents' physical rather than emotional needs, says Ms Wang Jing, 44, senior manager and counsellor of counselling and social work practice at Hua Mei Centre for Successful Ageing.

"If a parent mentions to his children that he has a headache, they may head to the doctor immediately. But if the parent says he is bored and has nothing to do in his life, the children might reply: You think too much," she says.

When these children, who might have their own families and young children to look after, feel helpless as their parents tell them about their unhappiness, they might start to distance themselves as they feel frustrated that they do not know how to respond, says Ms Wang. Their parents, then, might suffer from emotional distress.

Chances are, adds SingHealth Polyclinics' Ms Teo, these children have full-time jobs and find it difficult to take leave from work.

"Perhaps the general perception of caregiving for young children is greater than that for elderly parents. It is important for a change in a mindset so that adult children feel more supported to care for their elderly parents," she says.

Speaker of Parliament Halimah Yacob spoke of the need to legislate eldercare leave at a conference last week.

Three-and-a-half years ago, graphic designer Margaret Chung, 56, left her full-time job to work freelance so that she can take care of her 87-year-old dementia-stricken mother.

"The initial period was really tough because my mother used to be totally independent, which allowed me to have much space for myself. I guess I lost much of my 'free movement' when my mother was no longer independent," she says.

It took little tricks around the home to make life easier for her as a caregiver, says Ms Chung. For example, she installed a baby gate at the foot of the staircase of their two-storey house, so that her mother would not accidentally climb the stairs on her own and fall.

Her Catholic faith also helped keep her strong, says Ms Chung. "We caregivers do lose our cool from time to time, but this sacrifice is worth it because this is my parent and caring for her must come with love and compassion."

Few firms giving paid eldercare leave
Recent ST poll of 20 firms also shows only a few employees use such leave
By Janice Tai And Toh Yong Chuan, The Straitst Times, 19 Apr 2014

FEW companies here are giving paid leave for their employees to take care of their parents, partly because demand seems to be low for now.

A Singapore National Employers Federation (SNEF) survey of 300 firms last year found that only 4 per cent of firms provided eldercare leave. Seven in 10 of the surveyed firms were small and medium-sized enterprises (SMEs).

A recent straw poll of 20 companies - including large corporations and SMEs - by The Straits Times also found that fewer than a third grant eldercare leave.

In all except one of those companies, fewer than two in 10 employees have used such leave.

At Cathay Organisation, for instance, only 15 per cent of its employees took parental care leave last year because most did not require it, said its spokesman.

"Almost half of our employees are below the age of 27 and so correspondingly, their parents would also be younger, healthier or more mobile," he added.

Similarly, only three in 10 of those in the civil service - Singapore's largest employer with about 80,000 workers - have taken eldercare leave since it was introduced in 2012.

Its spokesman said: "There are officers who do not use it as they do not have such needs now."

Last month, Speaker of Parliament Halimah Yacob, who has repeatedly called for the Government to seriously consider legislating eldercare leave, reiterated: "Even if it's only for a few days, it will provide great relief and is a strong signal that the Government supports families in their effort to care for their elderly at home."

However, the Government has rejected repeated calls to make parental care leave compulsory like childcare leave, saying that it would add to costs.

SNEF executive director Koh Juan Kiat said that firms draw up their leave schemes according to the needs of their staff, and it is best to let them decide on whether to implement eldercare leave.

"Some companies already have generous annual leave benefits and additional statutory leave will be too onerous for such companies," he said.

Some employers prefer flexibility, saying that there is no need to make the arrangement formal because when emergencies arise, they allow their staff to go on short notice anyway.

"Employers need the flexibility, because the labour market is tight and most are short-handed," said entrepreneur Wei Chan, 42, who runs several small food and beverage businesses. "It is not that they do not support their staff looking after their parents."

Still, some employers do see the merits in providing eldercare leave.

Royal Plaza on Scotts is planning to do so in 2016 after it has fully rolled out productivity initiatives that will ease the labour crunch, said its general manager, Mr Patrick Fiat.

"It is to provide our associates with better work-life balance and increase the happiness index in the workplace," he said.

The civil service had decided to offer parental care leave in expectation of a rapidly ageing population and smaller family units. This means that its officers with elderly parents would need time to take care of them, it had said.

By 2050, 32 per cent of Singaporeans will be older than 65, up from 9 per cent in 2010.

Executive chairman Fang Koh Look of training and consultancy firm Absolute Kinetics Consultancy, a rare SME that provides eldercare leave, agreed. "It is good human resource practice because of the ageing population," he said.

About two-thirds of its 130 employees have taken the two days of eldercare leave since it was introduced two years ago.

One of them, management consultant Teo Geok Leng, 57, took her 84-year-old father for a medical check-up in January.

She said: "Such leave helps caregivers like me. Maybe the number of days can be tied to how old the parents are, because those with older parents will need them more."

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