Source: The Star (28 August 2015)
THE time for creating awareness is past. Now is the time for us to educate families on the type of quality care needed for their elderly parents and where they can go when they need help.
“No matter how much we want to advocate holistic care services for the elderly, one of our biggest challenges is education. We are no longer talking about awareness because I think a lot of us know what type of services are available here compared to the western countries and that we are about 30-40 years behind them.
“It’s about time we educate the adult children because they are the pillars of the aged care for their elderly parents.
“Is having a helper to take care of your aged parents good enough? Does it help to give your parents quality of life?” asked Carol Yip, Aged Care Group (ACG) chief executive officer.
She was speaking at the 11th National Geriatric Conference organised by the Malaysian Society of Geriatric Medicine at the Grand Seasons Hotel in Kuala Lumpur, where the theme was
“Grey Matters: Sifting the Evidence to Optimise Care”.
According to Yip, her first priority is to educate families, in particular adult children, on what needs to be done and what is quality care. From there, they need to know where to go to get such quality care.
She emphasised that government, private sector and non-governmental organisations (NGOs) should work together to provide such services as well as inform families where they can obtain the necessary assistance and care in each state.
She informed that getting help for the elderly is not so straightforward because sometimes the elderly themselves do not want to come forward to get the care and help that they need. It might be that they don’t want to pay for the care, they can’t afford it, or they don’t want to inconvenience their family members who might have to pay for it.
So, what happens? They suffer in silence.
Yip, who was involved in a senior living laboratory facilitated by the Performance Management & Delivery Unit (Pemandu) in 2012, said that while there is a very small number of licensed homes for the elderly, there are many unlicensed ones.
This is not helped by the fact that there is no one legislation to regulate the care centres and nursing homes in the country. Currently, there are two Acts governing the care centres and nursing homes in Malaysia – the Care Centre Act 1993 (Act 506) which regulates the care centres and is under the purview of the Welfare Department; and the Private Healthcare Facilities and Services Act 2006 (Act 586) which regulates the private nursing homes.
According to her, one of the most important outcomes of the Pemandu lab is the impending Aged Healthcare Act which the Ministry of Health (MoH) is now working on.
With one Act to govern all the elderly care centres and nursing homes, there will be better adherence to regulations and a rise in standard of living in such homes.
According to her, there is still much to be done as the aged care industry is in its infancy here. Business investors know that the aged care industry is now ripe for picking. It is just a matter of finding the right model that gives them the return on investment.
While property development has been a booming market in Malaysia over the past 50 years, the area of senior living has sadly been neglected until now.
“In any township you must have a school and a hospital, but how about a registered nursing home? The problem is that it’s not in our township regulation guidelines. So, it’s really up to the property developers if they think they want to provide that type of facility in the township,” said Yip.
She revealed that in the pipeline are town planning guidelines that look into the inclusion of nursing home facilities.
But, nursing homes are not the only type of senior living facilities needed. The other models that need to be looked at are home care, day care and retirement villages.
“And there is the integrated residential care centre (IRCC) instead of the nursing home. Nursing homes make people think of old folks homes.
“The IRCC would be purpose-built homes for the elderly which can look as good as a hotel. It can also be rated two, three, four or five-star, depending on what facilities and amenities you provide.
Then we have step down care, rehabilitation care, palliative care, and more importantly, dementia care.
“If you look at Malaysia now, how many dementia care centres can you find? Sad to say, we have less than five. Whereas in Singapore, I was told, there are at least 15,” said Yip, noting that dementia care is another area that the country needs to look into.
She revealed that during a recent meeting with the MoH, there was mention of dementia care centres. However, such a centre would need specialised medical practitioners and a special licence.
“If I were to build a four-storey building with about 200 beds for the elderly, focusing on dementia care, can you imagine the manpower I would need … the skills, the doctors, the therapists, and where would I look for them?” she asked.
Staffing is not a matter of just hiring foreign workers or even new graduates. In the area of elderly care, it is key to have experienced personnel and skilled workers.
This is why ACG is also working with hospitals, universities and NGOs to find, train and develop the necessary skills for aged care.
“We want to be a platform where we can collaborate with all the medical practitioners, hospitals and geriatric doctors,” she said.
As for those who prefer home care, Yip questioned how qualified helpers are to take care of the elderly, not just physically but medically, socially and emotionally as well.
“Perhaps a day care centre might be an option. Just like a child care centre, but for old folks. A place where you can drop off your parents when you go to work, and take your parents home after work,” she said, highlighting the need for day care centres.
Of all the senior living facilities, the day care centre would be the easiest to set up as you can have it in an existing neighbourhood clubhouse or a shoplot, unlike building a brand new retirement village or an IRCC.
Yip explained that ACG focuses on the mental, social, physical, emotional and financial aspects in all its programmes.
“Why do we want to do this? We want to transform the perception of ageing in Malaysia. We want to be the preferred choice in enriching the lives of the elderly in the space of continuum care, that means from home care right up till end of life care.
“Our philosophy is that whatever care plan we come up with must always feature these five areas.”
According to Yip, the financial aspect is the biggest challenge in the aged care industry.
“In Malaysia, sad to say, our retirement planning depends on ourselves. We have to save enough money for our retirement and aged care,” said Yip.
Having been in financial planning in the early years of her career, Yip has noted that many Malaysians don’t think about their old age care and how much money is really required for it.
In her doctorate thesis, on how senior citizens pay for their aged care, Yip has found that 100% of those surveyed don’t have EPF savings, while more than 90% depend on their family members.
She informed that insurance products in Malaysia currently do not allow any claims for old age care.
“We are now working with financial institutions to help our clients, and for all of us, so that we know when we have to go to a nursing home, we will have money to pay for it,” said Yip.
She emphasised that ACG wants to work with everyone in the healthcare and aged care industries to come up with a structure, a system and a platform to improve the aged care services in the country.
“Let’s move forward by putting in a system for our elderly parents,” she said.