Call it the silent surge. As Singapore ages, thousands of daughters, sons, in-laws, spouses and siblings have become caregivers to sick, dependent or frail older folk at home.
While people are living longer, many are not necessarily living well.
According to estimates derived from the latest National Health Survey made public in late 2011, Singapore may already have around 210,000 people who are looking after elderly, sick or disabled folk at home.
Last year, researchers at the Duke-NUS Graduate Medical School released results of the most in-depth survey done on caregivers here so far. It polled nearly 1,200 caregivers and unearthed several startling facts. Around half the caregivers surveyed, for instance, were employed but still spent 38 hours every week on caregiving chores, which was like holding a second job. Only half employed a maid.
And although support services - such as home medical care or adult day care - are on the rise, take-up rates are low. Only 3 per cent of those surveyed use day rehabilitation services, for instance, while 4.5 per cent use home medical services.
Long at the periphery of the debate on services for the elderly, caregivers took centre stage during the Budget debate in Parliament last month. At least five MPs - Dr Fatimah Lateef, Mr David Ong, Dr Lily Neo, Mr Sitoh Yih Pin and Mr Low Thia Khiang - spoke passionately about the need to ramp up home care services.
In response, Minister of State for Health Amy Khor gave an update of all government initiatives to enable more disabled or older folk to be cared for by family members at home rather than in nursing homes.
Moves are afoot to enhance the capacity of home care services and caregiver support, she said. New programmes are also being initiated.
For instance, from last week, those who pass a government means test can get subsidies from the Ministry of Health to help pay for physiotherapy sessions at home.
Patients can receive subsidies of up to $97 for home rehab. They will still need to pay between $18 and $37 for each visit, but those who qualify can get additional subsidies from Medifund, said a Health Ministry spokesman.
Director of Touch Home Care Kavin Seow welcomed the greater subsidies. His organisation provides both home medical and personal care services for frail old folk at home.
"Earlier, our staff would try and help secure subsidies from external sources like the Tote Board," he said. But the funding was not guaranteed and had to be renewed every year. "The new subsidies will make it easier for us to plan long term for patients who need care for months or years."
Since 2012, home care providers have also been receiving funds to scale up services. They can now serve 5,400 seniors needing home-based health care and 1,100 seniors needing home-based personal care every year.