TL;DR – The least we can do is to help our parents age with dignity.
If you’ve watched this video, you might get the sense that nursing home is a place that an elderly would avoid. Unless they’re sick or there is no one looking after them at home, they would not consider the option of checking into a nursing home.
Nursing homes in Singapore resemble hospitals and there are reasons why they are as such. But that’s a story for another day. However, because of the environment and the people who end up in nursing homes, it is inevitable for the elderly to perceive it as a place for the sick.
They also worry about the cost of staying in a nursing home. It costs between $1,200 to $3,500 a month (before MOH subsidy.) Private nursing homes don’t offer subsidised rates.
Nursing homes as an option
Orange Valley nursing home, for instance, is a private operator that offers a one-stop comprehensive eldercare service. Earlier this year, the business was acquired by the Singapore Press Holdings for $164 million.
An elderly under category three (wheelchair-bound and/or with dementia) can expect to pay $4,910 for a single bed at any of the Orange Valley nursing homes.
This excludes other charges such as consumables (diaper etc), monthly doctor consultation fee of $55 and ambulance transport cost of $55 per trip.
Residents at Orange Valley are also not allowed to use their own purchased diapers. They have to use diapers dispensed by the home, costing $1.50 to $2 per piece.
Here are the costs for other types of rooms in Orange Valley for an elderly under cat 3.
NTUC Health has also been expanding its eldercare services and seems to offer a more integrated approach towards ageing-in-place compared to Orange Valley.
Before we talk about that, let’s look at the cost of staying in a NTUC Health nursing home.
There are five to seven beds per ward and it costs between $17 to $60 per day depending on eligibility of MOH subsidy.
For subsidised rates, it will include the cost of consumables (diaper etc). However, similar to Orange Valley, ambulance transport cost will be borne by the family.
NTUC Health, a social enterprise under the Labour Movement, currently does not accept direct admissions. They only take in elderly referred by the hospital and evaluated by the Agency for Integrated Care (AIC) for eligibility on subsidies.
The process of checking into its nursing home isn’t as straight forward as Orange Valley’s. But that’s understandable as one is a private operator, while the other is a social enterprise and many of its admissions involve application for subsidies.
Given the cost and state of nursing homes in Singapore, is it the best option to provide care for our ageing parents by placing them in a nursing home?
Of course, nursing homes continue to serve an important function in our society especially for elderly who require high level of medical attention.
However, there are other care options available that we can consider.
1. Senior Activity Centres (SAC)
These places provide activities that keep elderly engaged in the day.
Residents who stay near Orange Valley’s SAC get to read newspaper for free and mingle with other elderly who live in the same neighbourhood. For a small fee of $1 to $3, they get to play mahjong for two hours and sing karaoke.
As long as residents are above 55 years old and pay a membership fee of $10 a year, they can use the centre’s facilities. Once in a while, residents get to learn new things like “Hanyu Pinyin” and interact with preschool and primary school students.
The only downside of Orange Valley’s SAC is the cost. Elderly must be prepared to pay a minimal fee to access the facilities.
NTUC Health also has a similar service known as SilverACE (Silver Senior Activity Centres). However, they are only available at housing areas with rental flats. The upside of this service is that it’s free for all low-income families!
2. Home care services
This option is good for caregivers who need help in caring for their loved ones for a short period of time. It may be particularly useful for those looking for respite care while the domestic helper is away.
The home care assistants can help with grocery shopping, light housekeeping and even maintaining personal hygiene (showering etc.).
Some of these are Filipinos or Burmese who can converse in English but not in other languages. However, most, if not all, are not medically trained so they won’t be able to provide nursing services like changing of tubes or wound dressing (a home-based nurse would be more appropriate).
In the case of NTUC Health, they have been trying to attract women who are interested to return to the workforce after taking a break from their career to spend more time with their family, so they do have local part-timers like Geok Bee.
The cost of NTUC Health’s home care services can be reduced depending on the eligibility of MOH subsidies.
If the person needing care is eligible for 50% subsidy, the total cost of engaging a home care assistant under NTUC Health will only cost $11 per hour. GST will also not be charged.
3. Day Care Centre
This is a service unique to NTUC Health and explains why the brand provides an integrated approach towards ageing-in-place compared to Orange Valley.
NTUC’s Silver Circle provides day care, dementia care, community nursing, active rehabilitation and even weekend respite care (only at the Serangoon centre).
This is a helpful option for caregivers who are not able to care for their ageing parents or relatives in the day because of work and do not have a domestic helper at home.
Silver Circle opens from 7.30am to 6.00pm on weekdays and provides breakfast, lunch and tea break. They also cater to elderly with special dietary requirements (vegetarian etc.)
It costs $924 a month (before subsidy) and another $497 for transport (optional). However, the monthly cost can be reduced to as low as $100 a month if the person needing care is eligible to receive 75% worth of subsidy.
Silver Circle does not accept direct admissions like most other day care centres in Singapore. The elderly in need of care will have to get a referral letter from a GP or polyclinic and then submit to AIC who will then assign the elderly to a day care centre nearest to their home.
It is possible to request for a day care centre of your choice and AIC will assign the elderly there if the centre has available slots.
This process might sound slightly cumbersome but it’s necessary for the day care centres to know how to provide the best care for elderly who have different medical conditions.
For comparison, Orange Valley’s Senior Activity Centre closes during lunch time so residents are not able to stay in the centre for the entire day.
Ageing with Dignity
Aside from the affordable costs of eldercare services at NTUC Health, the social enterprise also constantly innovates to keep our elderly engaged and allow them to have a stronger sense of purpose.
For instance, they recently partnered NTUC First Campus to roll out a structured inter-generational programme to facilitate interaction between pre-schoolers and elderly.
NTUC Health is also moving towards an integrated model of care for elderly by opening a new Silver Circle centre (Ci Yuan) at a community club that has a hawker centre, auditorium and family medicine clinic.
These are positive changes to help our elderly age with dignity.