Government grants can help defray cost of looking after seniors with dementia by up to 36%

Caring for a loved one with dementia can cost a family more than $380,000 over 10 years.

Caring for a loved one with dementia can cost a family more than $380,000 over 10 years, but, with government support, the amount can be reduced to around $240,000.

The costs can spike by about 33 per cent as the condition worsens from the mild to moderate stage, owing to higher care intensity and dependency needs.

With various government support schemes, such as long-term care subsidies, expenses can be defrayed by as much as 36 per cent of the total cost.

Such grants can cover as much as 46 per cent of the total cost for families caring for someone in the severe stages of dementia.

These findings from a study commissioned by Dementia Singapore suggest that government support is effectively targeting those with the greatest care needs.

"One aspect of dementia that is overlooked is that patients with dementia often have a whole host of diseases, and those need to be addressed. Also, many often worked until they were diagnosed, and that is where there is a loss of income," said Dr Philip Yap, chairman of Dementia Singapore.

"(Another) problem is that families are getting smaller and there will be a growing number of people with dementia with no familial caregiver in the future. That means they will have to go into institutions."

The social service agency specialising in dementia care, caregiver support, training, consultancy and advocacy announced the findings on Oct 14. Conducted from May 27 to Aug 3, the study looked at 260 caregivers to those with dementia.

The caregivers were defined as "primary or secondary caregivers, who have visibility of the true cost of caring for one living with dementia", said Ms Eugenia Chung, research lead at Pureprofile, a global data and insights organisation, which conducted the study.

"(They) include family members who provide financial, physical, supervisory support - whether they live together (with the person with dementia) or not," she said.

Ms Chung, who led the research, said the calculations of direct and indirect costs reflected what each caregiver, whether primary or secondary, personally contributed in money or time, or both.

"We are not assuming that all respondents provide the same type of care, but rather, we are capturing the real mix of contributions across caregivers," she said.

She also told The Straits Times that the indirect cost is meant to reflect the unpaid time and effort of caregivers themselves, and not that of hired or paid assistance.

"If respondents mentioned that they hired foreign domestic workers to help (with caregiving), that will be under direct cost - their salary," she said, adding that the research team recognised that foreign domestic workers play an important part in caregiving arrangements.

"The goal of the study was to understand the personal cost to caregivers as defined for this study - family members who provide financial, physical, supervisory support."

According to the study, more than nine in 10 people with dementia live in their own homes, with care most often provided by family members such as their children (75 per cent), spouses (14 per cent) and siblings (5 per cent).

Caregivers also face a balancing act, with about three in five who are employed managing work demands and caregiving, and more than two in five who are not working bearing the costs of care.

For direct costs or tangible, out-of-pocket expenses, the study found that out-of-pocket medical expenses are the most common cost incurred (80 per cent), followed by transport (73 per cent) and supplies or equipment (60 per cent).

The cost of supplies or equipment increases with the severity of dementia.

The survey also looked at the time caregivers spent providing personal care, supervision or household support.

The total time spent helping with daily grooming, daily tasks and supervision averaged at 217.1 hours or about nine days a month.

Converting this to a dollar value, it amounted to $1,218.75 a month.

Ms Michelle Ong, 55, who is the primary caregiver for her 87-year-old father who was diagnosed with dementia six years ago, said the study reflected what most caregivers go through as the condition progresses.

"When my father was first diagnosed, I was not worried about the expenses but more about where I could find the best help for him. However, with inflation and the GST going up, my challenge is finances. I often ask how I could stretch my dollar. I am not a business owner, so I am not well-off; neither am I in need where I qualify for higher subsidies," said the independent consultant who trains executives.

"Like many Singaporeans in the middle layer, I find that we are struggling. I am in the group that does not qualify for means testing. I still need to fork out of pocket for some of these expenses.

"With the Government's help, there is a bit of a buffer... Have we done well? Yes. But I feel we can still do better to support caregivers."

To reflect the net financial burden of caregivers, the study incorporated key subsidies that residents in Singapore commonly receive when providing caregiving support to those with dementia.

They include:

  • long-term care subsidies, which include one-off rebates to bridge the transition to enhanced subsidies;
  • the Home Caregiving Grant, which offsets informal caregiving costs;
  • the Seniors' Mobility and Enabling Fund, which subsidises home healthcare items and devices;
  • the Pioneer Generation Disability Assistance Scheme for Pioneer generation seniors with disabilities;
  • CareShield Life, the national long-term care insurance which provides payouts if a person develops severe disability; and
  • the Migrant Domestic Worker Levy Concession, which reduces the monthly levy to $60 for households employing foreign domestic workers.

Judith Tan for The Straits Times

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