Last month, my mother passed on. When she fell ill a few years ago, she underwent a long-drawn battle with many scars. She had to undergo dialysis for renal failure, and when there was nothing more that could be done to treat her, the hospital discharged her with a feeding tube for food and medicine intake. She lost the ability to walk and became wheelchair bound.

On a daily basis, I balanced critical care duties alongside work responsibilities, managing finances and planning to start a family of my own. I count myself among the luckier few who have a stable income. Even so, I too struggled financially to care for my elders.

Caring for mum the past few years has been a privilege, but not without some realisations about the support structure I needed to make it happen. For me, flexible work arrangements (FWA) were a lifeline, and I was grateful to own a car for hospital visits that didn’t warrant ambulance resources.

As I oscillated between work and caregiving, I often found myself asking: How much tougher is it for those less fortunate than myself to care for those whom they love? Can more be done so that resources to look after our ageing population are not just available to those with means?

Here are some suggestions from my learned experience.

Offer Work Flexibility

One needs to work, to provide.

In our 2020 population census, dual-career couples constituted the largest group among married couples, with the proportion increasing from 47.1 per cent in 2010 to 52.5 per cent in 2020. Dual-career couples have also become a necessity in view of inflation and the financial demands of an increased cost of living.

What seems to be needed now are super individuals – working adults prepared to work for income, while still having the energy and focus to be a caregiver to ageing parents. (The same could be said of young couples starting a family.)

Where is the give? For one, I benefitted from flexible work arrangements, and I am glad to see that all employers have to consider all FWA requests from 1 December 2024. This is a necessary and much needed change and I am hopeful that all employers will embrace it, and employees will not abuse it.

Broaden Options for Ageing In Place

I have reasonable means and the will to care for my elderly at home. What of those who aren’t able to do so, for financial, physical ability, or other reasons?

Beds in hospitals and nursing homes are for the ailing who require more intensive medical assistance. For those who are still independent and require less aid in daily activities, private eldercare options are costly. The government has stepped in to provide public options, but they are few and far between, with a long waiting time.

Spotlighted in The Straits Times recently, private eldercare facilities such as Joo Chiat Social Club (JCSC) and Allium Care Suites start from $4,800 and $7,000 respectively. They are suitable options for assisted living but are limited in supply and may be priced out of reach of most seniors who are relying heavily on their retirement savings.

At the Housing Development Board’s (HDB) assisted living public housing flats, HDB could consider having more of such flats especially in mature estates and have these flats rolled out also in newer BTO estates where the younger generation lives, for increased inter-generational interaction.

Train More Foreign Domestic Workers

The facts don’t lie: Singapore is hurtling towards a rapidly ageing population, where one in four citizens will be over age 65 by year 2030, according to our Population in Brief report in 2022.

Beyond brick-and-mortar facilities, there needs to be an increase in the supply of affordable eldercare packages.

Currently, private companies like Homage, Aseana Caregivers and Jaga-Me Home Care as well as public options like Agency for Integrated Care (AIC) provide a wide range of caregiving services by trained professionals. They offer those of us who are full-time caregivers some respite to take a few hours or a day off.

How about training and certifying more foreign domestic workers (FDWs) on eldercare? Just as FDWs are trained on housework and childcare so they can relieve working adults at home, the same could be done to equip them with the skills for eldercare. We could also consider paying these specially trained FDWs more.

Importantly, having trained help at home would also allow the elderly to age “in place”. For many old folks, the ability to stay in their homes will significantly enhance mental wellbeing.

Relook Transportation Framework

A trickier aspect to navigate is the availability of transport options for those who are bedridden or wheelchair bound. As the ongoing debate on the viability of our Certificate of Entitlement (COE) system continues, I urge the authorities to consider the transport needs of our wheelchair-bound population.

Their numbers are only going to increase in the coming years: the 2023 Action Plan for Successful Ageing states that by 2030, Singapore will have 100,000 seniors with at least mild disability, requiring assistance with at least one activity of daily living.

Home-bound elderly need safe and timely transport to get to their medical appointments or other outings. If we don’t have a car, our only options are public transport, or private hire cars.

It is commendable that all public buses in Singapore are now wheelchair accessible. But crucially, public buses do not run in the middle of the night when you might have an emergency hospital visit. So some months, the costs just add up.

Welcab vehicles are specially modified vehicles fitted with a ramp at the boot, which lifts wheelchairs into the vehicle without patients leaving the wheelchair. Currently, a Welcab is prohibitively expensive to own, though there are platforms where you can rent one. Some are also available in ride-hailing apps but the supply is limited and waiting time for one could take an hour.

We should look at increasing the number of service providers for wheelchair-accessible vehicles, and those with disabilities could be provided with vouchers to subsidise the use of such vehicles.

Preparing Ahead

Finally, there is a need to educate our younger generation on preparing for their post-retirement years or for the care of elderly family members.

Many in our parents’ generation did not discuss their end of days or make plans for their golden years – whether out of superstition, or lack of knowledge or resources. Millennials like me are now pursuing their dream jobs, mulling over starting a family or simply figuring out their lives. Planning for ill health and old age is understandably quite far from their minds. They may also not know where to start and what to do.

In my experience, the essentials are: buying hospitalisation and medical insurance; preparing your will; and doing your lasting power of attorney (LPA) and advanced medical directive (AMD). These are things we must do for ourselves when we are in good health.

The season of caregiving or being cared for may strike us before we know it. Our government has made strides in the right direction, but we need to do more and move faster as individuals and as a people.