Upgrade of home, centre-based services needed: Study

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Study says areas for improvement include funding, capacity and affordability

An upgrade of home and centre-based care services in Singapore is needed as more seniors are being cared for outside of hospitals and nursing homes in fast-ageing Singapore, a Lien Foundation study on long-term care services revealed.

Citing Ministry of Health (MOH) figures, the study said around 14,000 people used subsidised home and centre-based services late last year, up from 12,000 the year before.

In contrast, the number of subsidised nursing home residents has remained stable at around 10,000 over the past two years, signalling a shift in the main mode of long-term care for seniors.

As the Singapore population is rapidly ageing, more needs to be done to help seniors age in place, the study concluded.

It highlighted areas such as funding, capacity, affordability, manpower and regulation as key areas of focus.

The number of people in Singapore aged 65 and above crossed the half a million mark last year and is set to double by 2030.

"This is a study that impacts every one of us... If we want to be sustainable as an ageing society and age healthily and happily, we actually need to put in the steps now rather than wait for the demographic explosion to take place," said National University of Singapore (NUS) Associate Professor Elaine Ho at a media briefing yesterday.

If we want to be sustainable as an ageing society and age healthily and happily, we actually need to put in the steps now rather than wait for the demographic explosion to take place NUS Associate Professor Elaine Ho

She co-authored the study with NUS Associate Professor Shirlena Huang.

Both are from the Social Science Research Centre at the Department of Geography.

The study sought feedback from 103 individuals, including interviews with 50 non-profit and private care provider representatives, government representatives, experts in the field of ageing as well as caregivers.

They found that despite the increase in demand for home and centre-based care, only 2.5 per cent of Singapore's $9.8 billion healthcare budget, or $240 million, was spent on such care in 2016 - the latest year for which figures are available.

And despite a substantial rise in long-term care spending by MOH in recent years - $800 million in 2016, up $200 million from 2015 - the spending amounted to only 8 per cent of the healthcare budget and 0.19 per cent of Singapore's gross domestic product for the year.

In comparison, advanced nations from the Organisation for Economic Cooperation and Development spent an average of 1.4 per cent of their GDP on long-term care in 2014.

The study acknowledged that home and centre-based capacity has more than doubled in recent years. There were 13,000 places last year, up from 5,900 in 2011. Another 3,200 places will be added by 2020.

Yet, the report found some evidence that capacity may still be falling short of need.

For instance, the Agency for Integrated Care, which coordinates Singapore's long-term care services, received 7,800 referrals for day care services in 2015, when only 3,500 day care places were available.

There were 5,000 places available last year, but this still fell short of the 2015 demand, and the need has likely increased since then.

Cost is also a concern.

While the vast majority of people want to age and be cared for in the comfort of their own homes rather than in institutions, the costs of community care can be considerable, the report found.

A family looking after a severely disabled senior at home could pay up to $3,100 a month, including transport and consumables before subsidies.

This is higher than the median full cost of $2,400 for looking after the same person in a nursing home run by a voluntary welfare organisation.