Difference between revisions of "Disability/Caregiver Support"
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==== Caregiver Training ==== | ==== Caregiver Training ==== | ||
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=== Workplace and Financial Support === | === Workplace and Financial Support === | ||
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|Increase the means testing of Assistive Technology Fund to cover more persons with disabilities from lower-middle income households | |Increase the means testing of Assistive Technology Fund to cover more persons with disabilities from lower-middle income households | ||
|} | |} | ||
+ | |||
=== Physical Health and Mental Well-being === | === Physical Health and Mental Well-being === | ||
'''There are some community-based support services for caregivers, though caregivers have difficulty finding time to access them — they continue to report stress from care work, and the need for self-care.''' | '''There are some community-based support services for caregivers, though caregivers have difficulty finding time to access them — they continue to report stress from care work, and the need for self-care.''' | ||
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*For family caregivers providing care for a senior with physical or mental disabilities | *For family caregivers providing care for a senior with physical or mental disabilities | ||
|} | |} | ||
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+ | ==== Respite Care ==== | ||
+ | '''Home-based respite services are convenient, but are expensive and not always available. Centre-based services are routinely available, but their operating hours can be restrictive for working caregivers. Caregivers also differ in their utilisation and acceptance of respite care services.''' | ||
+ | {| class="wikitable" | ||
+ | |- | ||
+ | | style="width: 33.3%;" |'''<big>Programmes</big>''' | ||
+ | | style="width: 33.3%;" |'''<big>Gaps</big>''' | ||
+ | | style="width: 33.3%;" |'''<big>Ideas</big>''' | ||
+ | |- | ||
+ | |'''[https://www.sgenable.sg/pages/content.aspx?path=/for-adults/home-based-care-services/ Home Based Care Services]''' | ||
+ | *Provides alternative care support for adults with disabilities, with the aim of keeping them in the community for as long as possible. | ||
+ | *Delivers services such as therapy, personal hygiene care, housekeeping and medication reminders. | ||
+ | *2 service providers as of 01 July 2018 - AWWA and MINDS | ||
+ | | | ||
+ | *Caregivers reported a lack of opportunity for respite, especially when care recipients require round-the-clock care<ref name=":162">https://ink.library.smu.edu.sg/cgi/viewcontent.cgi?article=1007&context=lien_reports</ref> | ||
+ | *'''[Need to know what are the costs like to use these services]''' | ||
+ | *'''[Need to know utilisation rates of services by caregivers of PWDs]''' | ||
+ | |To consider commercialising caregiving (e.g. piecemeal/gig caregiving services) | ||
+ | *In light of an ageing population, decreasing family sizes and caregiver fatigue | ||
+ | *Can also consider tapping on people who live in the neighbourhood/not working with free pockets of time to provide paid, temporary caregiving services, with financial remunerations and incentives | ||
+ | *Examples from the eldercare space: '''[https://www.homage.sg/ Homage]''', '''[https://www.jaga-me.com/ Jaga-Me]''', '''[https://www.caregiverasia.com/?locale=en-SG Caregiver Asia]''', '''[https://www.activeglobalcaregiver.sg/ Active Global]''' | ||
+ | |- | ||
+ | |'''[https://www.sgenable.sg/pages/content.aspx?path=/for-adults/drop-in-disability-programme/ Drop-in Disability Programme]''' | ||
+ | *Provides social, recreational and/or therapeutic training activities for persons with disabilities for a few days a week up to 9 hours | ||
+ | *4 DDPs provided by Thye Hua Kwan Moral Charities as of 01 July 2018 | ||
+ | |'''[Info gap: What is the utilisation rate of these services?]''' | ||
+ | | | ||
+ | |- | ||
+ | |'''[https://www.sgenable.sg/pages/content.aspx?path=/for-adults/day-activity-centres Day Activity Centres]''' | ||
+ | *Community-based facilities that provide care and skills training to persons with disabilities aged 16 and above. | ||
+ | *30 DACs as of 11 Sep 2018 | ||
+ | *[https://www.msf.gov.sg/media-room/Pages/Number-of-Day-Activity-Centres-clients-and-staff-in-DACs.aspx Clients]: 1,200 | 200 are young adults | ||
+ | |[Anecdote: "DAC operating hours are mainly till 4 or 5pm, thus caregivers who use DAC services find it difficult to find full-time work. Part-time employment opportunities are limited too, if un-ideal."] | ||
+ | |<nowiki>Consider operating DACs on a shift system to complement working hours of caregivers, e.g., 7.30am - 2.30pm | 12 noon - 7pm, or to open till later</nowiki> | ||
+ | |- | ||
+ | |'''[https://www.sgenable.sg/pages/content.aspx?path=/for-youths/homes-for-children-with-disabilities/ Children Disability Homes (Short-Term Respite)]''' | ||
+ | *Provides long-term residential care, but also short-term respite care for those whose families are unable to provide care temporarily. | ||
+ | *3 homes provide respite care services as of 13 August 2018 | ||
+ | | | ||
+ | *'''[Info gap: costs & utilisation of these services]''' | ||
+ | | | ||
+ | |- | ||
+ | |'''[https://www.sgenable.sg/pages/content.aspx?path=/for-adults/homes-for-adults-with-disabilities/ Adult Disability Homes (Short-Term Respite)]''' | ||
+ | *Provides long-term residential care, but also short-term respite care for adults with disabilities whose caregivers are temporarily unable to provide care for them. | ||
+ | *8 homes provide respite care services as of July 2018 | ||
+ | |'''[Info gap: costs & utilisation of these services]''' | ||
+ | | | ||
+ | |- | ||
+ | |Respite services offered at selected day care centres and nursing homes under the ambit of AIC | ||
+ | *AIC page and E-Care Locator [https://www.silverpages.sg/care-services/Respite%20Care '''here''']. | ||
+ | | | ||
+ | | | ||
+ | |- | ||
+ | |[https://www.sgenable.sg/pages/content.aspx?path=/for-youths/special-student-care-centres/ '''Special Student Care Centres'''] | ||
+ | *Provides subsidised before and after school care services for students with special needs aged 7 to 18 | ||
+ | *MINDS' First Special Student Care Centre to open in 2019 | ||
+ | | | ||
+ | | | ||
+ | |- | ||
+ | |[http://www.come-into-my-world.com/one-child-one-skill '''One Child One Skill'''] | ||
+ | *A volunteer project that sends pairs of tertiary students to homes to teach autistic children a skill over 8 one or one-and-a-half-hour sessions | ||
+ | *Parents identify skills that they would like their autistic children to learn and volunteers choose the child they teach based on the stated skills and location. | ||
+ | *Caregivers also obtain respite | ||
+ | |[Anecdote: "While caregivers welcome the opportunity for respite, some expressed concern about students’ well-being in taking care of and working with their children without parental supervision."] | ||
+ | | | ||
+ | |} | ||
+ | |||
+ | |||
=== Family and Peer Support === | === Family and Peer Support === | ||
Conversations and planning so that larger family network can provide support to primary cargeiver | Conversations and planning so that larger family network can provide support to primary cargeiver |
Revision as of 12:18, 8 April 2020
Contents
Overview
Summary
Main concerns caregivers have:
- Caregivers continue to be concerned about the need for respite care[1]. They reported a lack of opportunity for respite, especially when care recipients require round-the-clock care[2]. At the same time, relying on respite care options can create a sense of guilt.
- Caregivers expressed the concern that they require self-care[3]. Stress from caregiving, along with increased time spent on care work affects caregivers' personal health and well-being[3]. At the same time, self-care is not able to get on the priority list because caring for care recipient is perceived to be more important.
- Caregivers are worried about their future inability to care for their loved ones with disabilities[4].Caregivers of children with special needs are also concerned about the post-18 trajectory.
Knowledge Gaps
- [What is the number of informal caregivers caring for people with disabilities (e.g., % of PWDs who have caregivers), and their demographic profiles (age, SES, relation of care recipient to caregiver)?]
- [Can we quantify how much financial schemes alleviate total expenses for caregiving? See Chia Ngee Choon’s op-ed for example]
Policy Advocacy
- [To insert, if any]
- [To insert, if any]
Actionable Opportunity Areas
- [To insert, if any]
- [To insert, if any]
Key Statistics & Figures
Definition of Caregivers
Caregivers of persons with disabilities are those who provide care to a person requiring support due to disability. Note that not all people with disabilities need constant care.
While this can include professional or formal caregivers such as social workers, doctors and nurses, the focus of this report will be on informal caregivers which include spouses, children, grandchildren, siblings and foreign domestic workers hired by their families:
- Special note to two groups of family caregivers: Elderly caregivers caring for disabled adult children, disabled people playing caregiver roles
- See The Survey on Informal Caregiving by MCYS
- 20% of family caregivers providing care to elderly persons aged 75 years and above with functional limitations are themselves above the age of 65.
- See A Profile of Older Family Caregivers by CARE and Duke-NUS
- Older family caregivers are in declining health themselves but spend long hours (up to 60 hours per week) caring for their family member. More than half of family caregivers up to the age of retirement (55-65 years) are juggling long hours of both formal employment and caregiving.
- More than half of family caregivers aged 70-74 years do not receive help from anyone else to care for their family member
- Well beyond the retirement age, family caregivers are spending 50 to 60 hours per week caring for their older family member.
- See The Survey on Informal Caregiving by MCYS
- [Is this landscape overly centred on ID/ASD??]
Size & Profile of Caregivers
Add Synopsis: something like "Caregivers are typically employed, and provide almost 7 hours of care per week and about 40% have done so for over a decade. They receive some form of support from family members or domestic workers, but some are sole caregivers. They are themselves ageing"
- An estimated 210,000 people aged 18 to 69 provide care to a family member or peer[5].
- Caregivers are ageing and are becoming less and less able to care for their disabled kin; 70% of caregivers in Singapore (including those who care for the elderly and disabled) are above 40; 10% are between 60 and 69 years of age[6]. Caregiving in Singapore (Sep 2011)
- On average, caregivers provided around 6.8 hours of care per day in a typical week. Caregiving in Singapore (Sep 2011)
- 37% of caregivers reported that they had been providing care to their care recipients for over a decade. Caregiving in Singapore (Sep 2011)
- Close to 74% of caregivers were employed. Caregiving in Singapore (Sep 2011)
- About 80% of caregivers received some form of support, be it from other family members (70%) and/or domestic helpers (14%). 21% of caregivers reported being the sole caregiver. Caregiving in Singapore (Sep 2011)
- Over 1,600 people have tapped on respite services offered at selected day care centres and nursing homes. Usage of these respite services has increased by at least 50% between 2015 and 2017.
Theory of Change
- The TOC can be articulated this way: If caregivers have the requisite skills and knowledge to take care of their dependents; are physically & mentally healthy; have strong family & peer support; adequate financial & work support; and make long-term plans for when they pass on; then they will be able to sustain the provision of care.
- Put a different way, we can also say: There are 4 key pre-conditions for parents to provide quality caregiving for the long term: 1) Caregiving Knowledge & Skills; 2) Health & Well-being, 3) Family & Peer support, 4) Financial and Work Support, and 4) Future Care Planning
Programmes | Areas of Needs / Desired Outcomes | |||||
---|---|---|---|---|---|---|
Information on services
Caregiver Training |
→ | Caregiving Skills & Knowledge | ↘ | |||
Respite | → | Health & Mental Well-Being | ↘ | |||
Family & Peer Support | → | → | Caregivers sustainably provide quality care | |||
Financial & Work Related Support | ↗ | |||||
↗ | ||||||
Future Care Planning |
Areas of Needs / Desired Outcomes
Useful to Note: When you talk to caregivers, they understandably conflate their needs with those of their dependents, such as education, employment and social inclusion. Those needs are covered elsewhere in the linked wiki pages. The needs listed here are those that pertain to caregivers themselves.
Caregiver Skills & Knowledge
Information on services
While referral, information and training resources are available, caregivers remain uneven in their knowledge about disability, and support received — they desire to access more rigorous training to better perform care.
Programmes | Gaps | Ideas |
Diagnostic Agencies
(e.g., hospitals) |
For caregivers of children diagnosed with disabilities, touchpoints are poorly equipped in advising parents on where to obtain reliable help during the post-diagnostic phase |
|
NeuroDiverCity
|
[Need to know how useful and utilised the website is to how many users] | |
All In (in development)
|
||
SG Enable
|
|
|
Caregivers Alliance
|
||
Caregiver Training Courses by VWOs and KKH/NUH
|
| |
Caregivers Training Grant
|
[How sufficient is this to cover the costs of training to care appropriately for a disabled care recipient?] | |
Handbooks
|
[Feedback/utility rate/dissemination data on these publications?] |
Caregiver Training
Workplace and Financial Support
Financial services such as tax reliefs, training subsidies and grants/concessions are available, though relative to the total expenses required to support a child/person with disability, it may not be enough.
EXISTING RESOURCES | GAPS AND THEIR CAUSES | POSSIBLE SOLUTIONS |
Caregivers Training Grant
|
||
Home Caregiving Grant
|
||
Foreign Domestic Worker Levy Concession
|
||
Community Long Term Care / Financial Planning Services
|
Can we quantify how much financial schemes alleviate total expenses for caregiving? See Chia Ngee Choon’s op-ed for example | |
Additional Financial Support for Care Recipients with Disabilities | ||
Handicapped Child Relief (HCR)
|
| |
Financial & Transport Support
|
High transport costs[14]
|
Increase the means testing of Assistive Technology Fund to cover more persons with disabilities from lower-middle income households |
Physical Health and Mental Well-being
There are some community-based support services for caregivers, though caregivers have difficulty finding time to access them — they continue to report stress from care work, and the need for self-care.
Programmes | Gaps | Ideas |
Community Counselling/Emotional Support Services
|
Caregivers reported a lack of opportunity for respite, especially when care recipients require round-the-clock care.[15] |
|
Community Support Groups
| ||
Caregiver Activities in the Community
| ||
Caregiving Welfare Association - Caregiver Counselling Services
|
Respite Care
Home-based respite services are convenient, but are expensive and not always available. Centre-based services are routinely available, but their operating hours can be restrictive for working caregivers. Caregivers also differ in their utilisation and acceptance of respite care services.
Programmes | Gaps | Ideas |
Home Based Care Services
|
|
To consider commercialising caregiving (e.g. piecemeal/gig caregiving services)
|
Drop-in Disability Programme
|
[Info gap: What is the utilisation rate of these services?] | |
Day Activity Centres
|
[Anecdote: "DAC operating hours are mainly till 4 or 5pm, thus caregivers who use DAC services find it difficult to find full-time work. Part-time employment opportunities are limited too, if un-ideal."] | Consider operating DACs on a shift system to complement working hours of caregivers, e.g., 7.30am - 2.30pm | 12 noon - 7pm, or to open till later |
Children Disability Homes (Short-Term Respite)
|
|
|
Adult Disability Homes (Short-Term Respite)
|
[Info gap: costs & utilisation of these services] | |
Respite services offered at selected day care centres and nursing homes under the ambit of AIC
|
||
Special Student Care Centres
|
||
One Child One Skill
|
[Anecdote: "While caregivers welcome the opportunity for respite, some expressed concern about students’ well-being in taking care of and working with their children without parental supervision."] |
Family and Peer Support
Conversations and planning so that larger family network can provide support to primary cargeiver
Future Care Plans
Although long-term care planning services exist, caregivers worry about the lack of supply of such services and the lack of options beyond loved ones in residential homes.
EXISTING RESOURCES | GAPS AND THEIR CAUSES | POSSIBLE SOLUTIONS |
Assisted Deputyship Application Programme (ADAP)
|
|
|
Special Needs Trust Company (SNTC) Trust
|
|
EM3 (Recommendation 14)
|
Special Needs Savings Scheme
|
- ↑ https://www.msf.gov.sg/policies/Disabilities-and-Special-Needs/Documents/Enabling%20Masterplan%203%20(revised%2013%20Jan%202017).pdf
- ↑ https://ink.library.smu.edu.sg/cgi/viewcontent.cgi?article=1007&context=lien_reports
- ↑ 3.0 3.1 https://www.msf.gov.sg/policies/Disabilities-and-Special-Needs/Documents/Enabling%20Masterplan%203%20(revised%2013%20Jan%202017).pdf
- ↑ https://www.msf.gov.sg/policies/Disabilities-and-Special-Needs/Documents/Enabling%20Masterplan%203%20(revised%2013%20Jan%202017).pdf
- ↑ https://www.straitstimes.com/singapore/singapores-caregiver-crunch
- ↑ https://www.singstat.gov.sg/-/media/files/publications/society/ssnsep11-pg12-14.pdf
- ↑ 7.0 7.1 7.2 https://www.msf.gov.sg/policies/Disabilities-and-Special-Needs/Documents/Enabling%20Masterplan%203%20(revised%2013%20Jan%202017).pdf
- ↑ 8.0 8.1 8.2 8.3 National Volunteer and Philanthropy Centre (NVPC). (2017). Issues faced by people with disabilities in Singapore. Retrieved from https://www.nvpc.org.sg/resources/report-on-issues-faced-by-people-with-disabilities-in-singapore
- ↑ http://www.asiaone.com/health/plight-caregivers-disabled-children
- ↑ https://www.msf.gov.sg/publications/Pages/The-Survey-on-Informal-Caregiving.aspx
- ↑ 11.0 11.1 https://ink.library.smu.edu.sg/cgi/viewcontent.cgi?article=1007&context=lien_reports
- ↑ https://www.mom.gov.sg/passes-and-permits/work-permit-for-foreign-domestic-worker/eligibility-and-requirements/employer-requirements
- ↑ https://www.straitstimes.com/singapore/more-funding-help-for-polytechnic-ite-students-with-special-needs
- ↑ http://www.dpa.org.sg/wp-content/uploads/2018/08/Incusion-in-Education2.pdf
- ↑ https://ink.library.smu.edu.sg/cgi/viewcontent.cgi?article=1007&context=lien_reports
- ↑ https://ink.library.smu.edu.sg/cgi/viewcontent.cgi?article=1007&context=lien_reports
- ↑ Cite error: Invalid
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tag; no text was provided for refs named:1225