3 alternatives to placing your parents in a nursing home

Singapore's elderly population is projected to grow exponentially. Based on projections from the UN, 47 per cent of Singapore's total population will be aged 65 years or older in 2050.

With the government taking a "your family, your problem" approach, unless you're destitute and can qualify for a welfare home, don't expect welfare payouts during your golden years.

If you're caring for an elderly parent, you may also be raising your own children and building a career at the same time. Faced with space and time constraints, a nursing home seems only practical.

But with news of staff hitting nursing home patients and elderly not wanting to be cared for by strangers, it is also an unpalatable solution for most.

How can we care for ageing parents who don't want to live in a nursing home? Here are 3 alternatives to consider.

1. HAVE YOUR PARENT(S) MOVE IN

There's no higher form of filial piety than to invite your aged parents to live with you. You could free up a room within your own flat, or, if you foresee it to be a permanent and long-term arrangement, invest in a dual-key property.

The sacrifice is that your family members will have to bear the caregiving load. In order to share the duties, everyone can take a caregiving course together.

You may also want to senior-proof your house with rails and grips so that your parents can move around without risking too much injury. It's inexpensive to do so under HDB's EASE programme.

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When the burden of caregiving becomes overwhelming, family tension tends to build up and may strain the relationships between spouses and children. But if your family typically enjoys a healthy family synergy across generations, and the children in the family are old enough to be responsible for themselves, having your parents move in may not be as difficult as it sounds.

After all, this arrangement probably has been how families coped with the care of ailing elderly since time immemorial. It falls on family members to learn how to communicate and resolve conflicts together.

If the stresses of modern life makes caregiving too much to bear, the solution can be in the form of a trusted domestic helper who can share the load.

HIRING A DOMESTIC WORKER TO TAKE CARE OF ELDERLY - AGED PERSON SCHEME CONCESSION

If your elderly parent is a Singaporean citizens or PR married to a Singapore citizen who are at least 67 years old, you enjoy a monthly concessionary rate of $60 instead of $265 for the Foreign Domestic Worker Levy.

Hiring a domestic worker may require you to cough up slightly over $6,000 (including security deposit) for one-time fees. With the concessionary rate, you would probably pay around $500 a month.

PLAN FINANCES IN ADVANCE

While it's not an easy thing to do, planning your finances in advance of the move is a practical thing to do as there will definitely be added costs when your elderly parent moves in. Consider how much more you'll need to pay for utilities, food, transportation and even medication. If you have siblings that you can share the burden with, have an open communication about this matter. Or, speak to your parent(s) about contributing some expenses.

2. HIRE A CAREGIVER TO LIVE AT PARENT'S PLACE

Some elderly are so independent that they'd rather "age in place," instead of living with relatives, or you. It will be especially so if they have been living in the same house for decades.

In that case, depending on how far you live from parent(s), and how busy your work/family schedule is, frequent visits may be difficult. If you're worried about their daily well-being, hiring a full- or part-time caregiver can give you peace of mind. The caregiver can monitor the health and hygiene of your parent(s) and ensure that they go for their scheduled medical appointments.

A full-time live-in nurse costs $600 to $1,000/month before subsidies.

Finding a good caregiver is about asking the right questions. Here are several important factors to consider when hiring a caregiver:

- Trained to care for specific needs: If your parent(s) has any special care requirements, such as being wheelchair-bound, diabetic, or suffering from Alzheimer's disease, you need to hire a caregiver that has the training and experience to care for Mom and/or Dad.

- Check if she can help out with daily activities: Write a list of activities that your parent(s) do on a daily basis e.g. shower at 7 am, breakfast at 7:30 a.m., watch TV from 8am to 12pm, etc. This will give your prospective caregiver an idea of what his/her daily duties will be and also highlights any training deficiencies on the part of the caregiver.

- See if she can cook what your parent(s) like: Diet requirements are usually dictated by religion, health condition, or ideology. So your prospective caregiver must be able to cook suitable meals.

- Background questions: Come up with a questionnaire that surveys work history, references, duties, training, cooking experience, ability to administer medications, smoker/non-smoker, past patient emergencies, and personal feelings on being a caregiver.

3. ELDERLY DAYCARE

Remember the days when your parents used to drop you off at day care? You can do the same for your parent(s) by sending them to an adult day care centre too, which will organise activities and carry out simple care.

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Day care is a good option if your parent is relatively healthy. It prevents caregiver burnout by providing a welcome break without having to worry about the quality of care your parent receives. Also, day care provides your parent with the social interaction and activities, such as gossip, mah jong, and football discussions to help them engage their minds.

If your parent suffers from any physical or mental disabilities, some day care centres are staffed and equipped to provide therapy and medical services.

Here are some adult day cares that provide social day care services:

- Lion Befrienders: Appointed by the Ministry of Social and Family Development (MSF), Lion Befrienders operates Senior Activity Centres (SAC) at Queenstown, Tampines/Changi and Clementi/Bukit Timah. Most of the activities are either free or heavily subsidised. Senior citizens who are 60 years and above and are staying near an SAC are welcome to join.

- United Medicare Centre: Elderly parents can be placed in the United Medicare Centre day care on a regular monthly basis, or as and when. The centre has social activities as well as rehabilitation for elderly who may have had strokes, fractures, spinal cord injuries, Parkinson's disease or recent operations. They have 3 centres at Toa Payoh, Elizabeth Drive and Queensway.

- COMNET Senior Activity Centre: COMNET operates 4 Senior Activity Centres and a Senior Group Home in Ang Mo Kio, Bishan and Sengkang.

To look for more social day care centres near you, you can use silverpages.sg's E-Care Locator to filter based on specific needs.

The tool also allows you to add specialised requirements such as care for dementia, physiotherapy, and other rehabilitation services.

Although many day care centres have normal daytime operating hours, some can provide 24-hour supervision for your parent(s). Monthly fees can vary from $400 - $1,500 per month for social day care. You can also apply for government subsidies based on means testing.

This article was first published in MoneySmart.