How to care for someone with dementia in Singapore

“Take care”. We have all heard that phrase before. We use it often… and in many cases, as an afterthought. How do we "take care" when our loved ones are faced with dementia or any other incapacitating illness? Here are some tips from our community partners.

Accept support from others

Caregiving is not easy. It will challenge you physically, mentally, and emotionally. As such, support groups can be immensely helpful. They can be a valuable resource to share your struggles and an avenue to seek practical advice from other caregivers and experts. These groups are easily located online. Alternatively, you can refer to the list of support groups that the Agency for Integrated Care has compiled.

Actively empathise with the dementia patient

Many dementia patients feel rejected and believe they cannot be open about their condition. So when talking to someone with dementia, it’s even more important to display empathy. The changes in behaviour may be disconcerting for us, but these are even more so for those with dementia – who may suddenly find their home of 10 years unfamiliar, think they’re living through the 70s, or forget their own identity.

Be a realistic caregiver

Seasoned caregivers shared that dementia patients have good days and bad days. In fact, they would define success in caregiving as helping the patients to be as comfortable, happy, and safe as possible.

One practical way to help them retain their dignity is to consider making a few changes around the house. Install additional grab bars to help them up or sit down, non-slip bathroom tiles/strips, ramps or even an alarm button should they require immediate assistance. For those who are living in HDB flats, the Enhancement for Active Seniors (EASE) subsidy programme helps to retrofit flats. The best part is that up to 95% of the costs can be subsidised, depending on the type of flat they have.

Plan for financial matters

1. Lasting Power of Attorney (LPA)
   A Lasting Power of Attorney, or LPA, as it is known, allows anyone above 21 to plan their affairs in the event of mental incapacitation – whether it’s permanent or temporary.
   
   In Singapore, the Mental Capacity Act allows anyone to appoint one or more persons to make these decisions on their behalf. This can be due to a stroke, dementia or even an accident to the head. To get an LPA, you must be mentally sound at the time of the application and submit your documents to the Office of the Public Guardian.
   
   It is prudent to set up a LPA early while you are still in the right frame of mind.
   
   
2. Lease Buy Back Scheme (LBS)
   For families that may need to monetise their property, one option would be the Lease Buyback Scheme (LBS), if they are staying in a HDB flat. Under this scheme, elderly flat owners of 5-room or smaller flats can choose to sell the tail-end of the lease back to HDB.
   
   Certain restrictions apply, so do take note of those. For example, the flat must have at least 20 years of lease left to be sold back to HDB, and the gross monthly household income mustn’t exceed S$14,000. The net proceeds from the sale will be used to top up the owner’s Central Provident Fund Retirement Account up to a specified sum.
   
   
3. Protection
   Much has been written about the rising costs of living and medical expenses, and as we get older, these become more real to us. Insurance is an avenue to ensure there will be enough funds to care for our dependants.
   
   For instance, health or term life policies can help ease the burden of care should something untoward happen to us. They can help to take care of the unexpected onset of fees and hospital charges in a medical crisis. Insurance allows patients to bounce back, and helps prevent disruption to our loved ones’ (and our) lifestyle patterns, including daily living expenses, kids’ education cost, and other family expenses.
   
   
4. Subsidies for the Pioneer Generation and Merdeka Generation
   For those born before 1950 who helped build Singapore , the Pioneer Generation package offers a range of benefits including:
   
   
   • Subsidies on medical care;
   • Regular top-ups to Medisave accounts, and
   • Premium subsidies for MediShield Life insurance scheme.
   
   Do note that the Ministry of Health has introduced a Home Caregiving Grant to defray the costs of caring for persons with permanent moderate disabilities. If you need help with at least three of these activities - washing, dressing, feeding, toileting, walking or moving around and transferring from a bed to chair or wheelchair – this grant helps with the cost of care.
   
   For those born between 1950 and 1959, the government's Merdeka Generation package is there to help the cost of ageing as well. There are increased outpatient subsidies for chronic conditions and health screenings are capped at S$2. Eligible citizens will also receive an additional 5% premium top up on your Medishield Life Subsidies, and it will double when they reach age 75.