Disability/Caregiver Support/Theory of Change

Click on each outcome in the Theory of Change to explore services, gaps and ideas.

To change anything in this page, feel free to contribute directly or to propose revisions and amendments in the Discussion page.

Theory of Change

Short-Term Outcomes(skills, knowledge, attitudes)		Mid-Term Outcomes(behaviours)		Long-Term Outcomes(impact)		Social Impact
Respite care options are accessible to caregivers	→	Caregivers can easily access respite care	→	Caregivers are in physical health and psychosocial well-being	→	Caregivers can sustainably care for disabled care recipients to the best of their capabilities and capacities
Real and perceived barriers to regular self-care are reduced	→
		Caregivers have informal social support around them	→
				Caregivers are equipped with information and skills at different steps of the care journey
		Caregivers acquire reliable information and training to perform care	→
Access to touch points is reasonably accommodated to caregivers' needs	→	Caregivers can easily access touch points for information and skills
		Caregivers do future care planning	→
		Caregivers can access financial support	→	Caregivers can bear the financial costs of care

Caregivers are in physical health and psychosocial well-being → Caregivers can sustainably care for disabled care recipients to the best of their capabilities and capacities

• 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 14 agencies provide these services as of 02 August 2018	Caregivers reported a lack of opportunity for respite, especially when care recipients require round-the-clock care.	EM3 (Recommendation 13) To expand the continuum of support and respite options, including the implementation of caregiving leave, and to build trust between caregivers and formal respite services Ease access to counselling services, such as counsellors, social workers or volunteers - be it coming to terms with diagnoses of disabilities or assistance with job placement, social assistance and marriage counselling Create more opportunities for caregivers to meet each other as a source of informal support, such as leveraging existing support networks to reach out further For service providers to take family relationships into consideration, as family dynamics are affected if a member has a disability. This could mean designing
Community Support Groups 13 agencies provide these services as of 02 August 2018
Caregiver Activities in the Community 14 agencies provide these services as of 02 August 2018
Caregiving Welfare Association - Caregiver Counselling Services For family caregivers providing care for a senior with physical or mental disabilities

Caregivers can access financial support → Caregivers can bear the financial costs of care

• 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 $200 annual subsidy for caregivers, per care recipient, every financial year, to attend training
Home Caregiving Grant Replaced the Foreign Domestic Worker (FDW) Grant from October 2019.  $200 monthly cash payout to support your loved ones with at least permanent moderate disability, i.e. always require some assistance to perform 3 or more Activities of Daily Living (ADLs).   This grant can be used to defray the costs of caregiving expenses, such as the costs of eldercare and caregiver support services in the community, or hiring of a Foreign Domestic Worker (FDW).	Even after subsidies, the remaining cost to hire an FDW is still more than many low-income families can afford Employers must be of sufficient mental capacity to hire an FDW, and cannot have a disability that impairs mental capacity to this degree
Foreign Domestic Worker Levy Concession Lets families pay a monthly foreign domestic worker levy of just $60, instead of $265
Community Long Term Care / Financial Planning Services 4 agencies provide these services as of 02 August 2018		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 Assistive Technology Fund (ATF) (from 2020) CareShield Life ElderShield Senior's Mobility and Enabling Fund ComCare
Handicapped Child Relief (HCR) Eligibility: Child is below the age of 16, and parent earns less than $4,000, which includes income from bank interest, dividends and part-time jobs. $7,500 per child		Raise or remove the 16-year old limit cap, in the case of single parents as marital breakdown is more common among parents of special needs children, and single parents from the middle/low income group will face additional stress to raise their children single-handedly

Caregivers do future care planning → Caregivers are equipped with information and skills at different steps of the care journey

• 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) Helps parents of graduating cohorts in Special Education (SPED) schools apply to Court to be deputies for their child, so that they can continue to make legal decisions for their child after he or she turns 21	"Demand for affordable deputyship applications greatly exceeds supply of available help, including NUS Law undergraduates - in MINDS, the waiting list runs to a few hundred parents"	EM3 (Recommendation 14) To simplify deputyship and Lasting Power of Attorney processes for caregivers MINDS is heading a pilot to simplify deputyship applications for caregivers of graduating SPED students For the government to take up the mantle of facilitating deputyship applications, free-of-charge if possible
Special Needs Trust Company (SNTC) Trust Allows family members to set aside money and assets in SNTC accounts, and aims to safeguard these assets to enhance the beneficiary's financial security and well-being 447 SNTC accounts have been opened, out of 117,000 estimated people who might require it (ST 29 Mar 2017)	While caregivers acknowledged that SNTC was a good start, they were worried about the lack of options for future care needs and planning, beyond placing their loved ones in Adult Disability Homes	EM3 (Recommendation 14) To raise awareness of importance of legal, financial and care planning, and services. SNTC to continue expanding outreach to caregivers, and consider partnering agencies providing direct services to disabled people for more integrated and holistic support to caregivers Service providers, including the Office of the Public Guardian and Law Society, to educate caregivers on legal/financial matters such as applying for deputyship To create a system of support at caregivers' natural touchpoints, that would help them in future care planning such as identifying the next caregiver and transitioning of the caregiver role when the time comes, and including documenting and passing on caregiving knowledge. Enable disabled care recipients to make more independent decisions for themselves for the future, something which caregivers tend to do. Depending on the disability type and functioning level, some caregivers can unintentionally prevent their care recipients from learning useful independent living skills through mollycoddling.
Special Needs Savings Scheme Enables parents to set aside CPF savings for the long term care of children with special needs Parents may nominate their loved one with special needs to receive a regular stream of fixed pay-outs upon the parent’s demise.