Reduce Individual Caregiver Burdens; Strengthen Communities For Caregiving

“Caregiver stress has received greater attention in the past decade, as the population is rapidly ageing, family sizes shrink and the burden of care for a senior falls on fewer shoulders” (Home Front: Does New Support Plan for Caregivers Go Far Enough?, Theresa Tan).

The new Caregiver Support Action plan, which seeks so strengthen government support for senior caregiving (ST, Feb. 21), sidesteps two important, related, and fundamental challenges to caregiving in Singapore: First, the persistent over-reliance on individual caregivers – either family members who have to make personal sacrifices and who are subject to physical and psychological stress, or foreign domestic workers who are oftentimes overstretched in the household and who receive remuneration which are not commensurate with their work and living conditions – whose experiences are also not necessarily well-understood, to care for loved ones:, and second, the urgent need to strengthen communities and institutions for caregiving, emphasising not only the self-reliance of individual- or family-based systems but also the further professionalisation of the sector and improvements for productivity gains.

Put otherwise: The crux is to confront the unsustainable realities faced by caregivers, to ease their caregiving burdens, and to ultimately shift these caregiving roles and responsibilities into better community- or institution-based settings.

Continued reliance on individual caregivers is unlikely to be sustainable in Singapore. The expected fall of the country’s old-age support ratio from 4.8 in 2018 to 2.1 in 2030 means fewer family members for each older Singaporean. And whether the practice of having foreign domestic worker will continue to be accepted, notwithstanding the willingness of countries to supply these low-wage workers or the economic development of these countries, cannot be taken for granted. Moreover, it is well-established that the experience of senior caregiving can be isolating and depressing, and no amount of training or the provision of social networks will be adequate. In the even longer term, these senior caregivers – who are unable to accrue substantial savings or work experience – might end up requiring caregiving themselves, further perpetuating an unhealthy cycle which relies disproportionately on individuals and their goodwill.

What is more urgently needed, consequently, are moves away from individual to collective caregiving. Grants, respite options, and other support initiatives are useful for existing caregivers in the short-term, yet they are not the answer to Singapore’s ageing population. For a start, Singapore would benefit from a more comprehensive understanding of existing caregiving patterns in the country: Preferred caregiving practices across time, the routines and first-hand perspectives for caregivers, and more importantly the collective state of communities and institutions for caregiving. How do they work together? Are options diverse, accessible, and affordable? And are families adequately informed to consider and to choose from different caregiving options? Even for themselves, in the future? Ultimately, the question for all Singaporeans is: What type of caregiving do I want for myself, and how would that look like?

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A version of this article was published in The Straits Times.