Practicalities of making care-giving arrangements for those with dementia

How to choose a caregiver for your parents

One of the best things you can do for your family is to recognise the early signs of Alzheimer's or dementia in your parents or in-laws and consult a doctor. The next step is: to help them come to terms with the diagnosis and be prepared to face dementia together.

In this article, we list the top three considerations, and identify the government schemes that can help you offset some of the caregiving costs.

Consideration 1: Do your parents have a 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 mentally alert.

Consideration 2: How will their daily needs change?

Apart from the legal aspect of dealing with dementia, it is time to consider how to go about living day to day. Inevitably, there will be changes to routine and schedule – for both you and the ones you will be looking after. Some families might even decide to take on a full-time caregiver or nurse depending on the level of care needed. Even then, it might change year by year and require frequent reviews.

It is prudent to set up a LPA early while you are still mentally alert.

Consideration 3: Could a domestic helper help with caregiving duties?

This may be a time when you are pondering the value of bringing in additional help to cope with your own needs and to ease the burden on your family.

Finding the RIGHT caregiver is never easy, especially when there are many factors to consider: training, personality traits, background knowledge, how many people to care for and a person's state of mind.

Some caregivers come with experience of looking after vulnerable persons while others may have different skillsets. Then, there’s the cost involved in hiring one.

If you are considering domestic help, these are some things you need to know:

  • Agency fees: These fees can go up to around S$2,000 or higher depending on the agency and how they train their helpers before they arrive in Singapore. It can also depend on if the helper is a transfer helper. Some helpers have specialised training in dealing with the elderly and have specialised nursing or first aid certification. These costs can add up too depending on family need.
  • Security bond and levies: The Singapore government requires all employers to place S$5,000 in security bonds, and it is usually paid through insurance. The only exception is if your helper is a Malaysian. Each month, maid levies can go up to S$300 for the first helper and S$450 for a second, although there are concessionary rates (more below).
  • Maid insurance: In Singapore, it’s compulsory to get insurance for your domestic helper. This needs to provide medical coverage of at least S$15,000 each year, and personal accident coverage of at least S$60,000 each year. Some policies offered by insurers also include the mandatory S$5,000 security bonds mentioned earlier, that is payable to the Ministry of Manpower.
  • Contracts: Upon completion or premature termination of the contract, you as the employer are obliged to send your helper back to the nearest port of entry to her home.

While these are useful considerations, it might be better to set expectations early and decide on what are primary and secondary responsibilities that you want your helper to carry out. Helpers are human too, and like us, they need proper rest, personal space and perhaps some arrangement that allows them to communicate with their families back home, especially those that have children. A better understanding of the rights of both parties will be a good way to start.

helping parents live well

Government schemes to help with the cost of hiring a domestic helper

The Singapore government has several assistance schemes that help defray the cost of hiring a domestic helper. Depending on your income level and job, seek help from the Ministry of Social and Family Development or the Manpower Ministry.

Home Caregiving Grant by the Ministry of Social and Family Development

This grant provides families caring for a loved one with certain intellectual and physical disabilities a monthly grant payment of S$200 based on certain criteria. An assessor will also be sent to your home to see how best the government and its accredited partners can help you in your time of need. If your parents or in-laws 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.

Additionally, for families with a person aged above 67 in the household, a Foreign Domestic Worker (FDW) Levy Concession is available via the MOM website. It sets the FDW levy at S$60, leaving additional funds for other areas.

Caregiver’s Training Grant by the Agency for Integrated Care

The other government grant you might want to consider is the Caregivers' Training Grant administered by the Agency for Integrated Care. It is a $200 annual subsidy that lets caregivers attend approved courses to better care for their loved ones, including dealing with conditions like dementia and Alzheimer's.

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