Blaming adult children for being unable to care for their ageing parents and placing them in aged-care or nursing homes isn’t fair.
This was the collective response of advocates for seniors to Deputy Minister for Women, Family and Community Development, Datuk Siti Zailah Mohd Yusoff who said, in a news report last week, that the government’s expenditure of RM900 mil a year for elderly care could be reduced if adult children realised the importance of taking care of their parents.
Siti Zailah also said that sending parents to care homes should be the last resort and “not used as a premature measure to solve the issue of caring for the elderly in one’s family”.
The Malaysian Society of Geriatric Medicine (MSGM) pointed out that only an estimated 1% of Malaysia’s three million older citizens live in aged care facilities and that, in reality, nearly all social care for older persons is provided by older spouses, adult children, siblings and other extended family.
“We take exception to the Deputy Minister’s remarks which literally implies that the government is spending too much money because adult children are not looking after their older parents!,” said MSGM honorary secretary Prof Dr Tan Maw Pin.
She clarified that the majority of seniors actually live with their spouses or in multi-generational households. In comparison, 14.4% of older people in Singapore live in nursing homes in 2019, she highlighted.
Many factors involved
Gerontologist and founder of Seniors Aloud (an online platform for seniors), Lily Fu highlights there are many reasons adult children may not be able to, even if they want to, care for their ageing family members.
“These adult children may have their own family to support, they may not have room for their elderly parents, they may be working and may not be able to care for their parents during working hours, they may lack knowledge or experience if their parents require nursing care such as physiotherapy or tubefeeding or if their elderly suffer from Alzheimer’s and so on,” says Fu.
This is confirmed by findings in the Prevent Elder Abuse and Neglect (Peace) study conducted by Universiti Malaya academics, says Dr Siti Zaharah Jamaluddin who is currently with the Multimedia University law faculty.
“In our research we found that factors that affect the ability to care for elders included the migration and urbanisation of adults who move to the city for work, families that are large, single women families, financial constraints especially for those who are living in the city as well as family disputes which affect their relationship with the elderly family member,” she said. Better planning and spending
Instead of faulting adult children, the Peace researchers, in their study, suggest that the government provide assistance for family members to be able to care for their elderly and, more importantly, focus on empowering seniors.
“We need to focus on those who will be 60 when Malaysia becomes an aged nation. Everyone must take the responsibility to prepare for their old age, to be healthy, active and so on,” she said.
Fu agrees wholeheartedly.
“The budget for seniors requires better management and allocation. There should be a multi-ministerial committee for ageing as the Welfare Department has too much on their hands. We still have no laws against elder abuse, for elder support and elder rights.
“We must include the ‘young old’ (those aged 60 to 75) in upskilling programmes, especially in digital literacy and give them reemployment opportunities so that they have the option to work longer and save more. Maybe encourage seniors to be entrepreneurs and provide loans to get them started,” she suggests.
Prof Tan also highlighted the need for government allocations to be better planned and better spent.
“Planning for social care provisions for older adults in an ageing nation has profound implications for the future of our country.
The Deputy Minister claims that RM840 mil is spent on financial subsidies to 138,000 senior citizens. She also highlighted the RM1,400 monthly bill for senior citizens in 15 institutions managed by the Welfare Department (JKM) in Malaysia.
“The stark truth is that the budget allocations at the moment are simply not well spent, and for healthcare professionals in geriatric medicine, government provisions for social care in older persons within healthcare settings, are barely visible and hence woefully inadequate.
“The non-governmental sector also provides both physical and financial support, and there is no doubt that NGO homes vastly outnumber the ones provided by the government. The Ministry of Women, Family and Community Development should also address the issue of unregistered aged care facilities in Malaysia.
“There is an estimated 1,500 care homes in Malaysia though exact figures may be much higher, with only 380 found in the Welfare Department’s online listing as of January 21. Even from the figures above, JKM facilities only represent 5% of registered care homes. If a larger estimate is used, this figure would be lower than 1%. On what basis, therefore, could the government claim that they are spending too much money?” argues Prof Tan.
Fu also feels that there is “too much red tape” when it comes to enrolling seniors in government care homes.
“There are only two Rumah Ehsan for the elderly needing nursing care in the country. There should be more. And there is too much red tape and eligibility terms and conditions to be admitted into the country’s 10 Rumah Kenangan for the elderly.
“Why do so many homeless opt to return to the streets rather than remain in the welfare homes? We need to investigate,” says Fu who recently made a documentary titled Meniti Senja, addressing the alarming rise in cases of elderly persons being abandoned at aged care homes.
Prof Tan, however, welcomed Siti Zailah’s announcement of a “much needed case referral system” for seniors going into care homes. This, she said, would ensure that the older adults are appropriately placed.
“But MSGM would like to ask that the process should also demand for care that is empowering and restorative. We must ensure that we are not just providing the older adult with basic needs, but continue to maintain existing abilities, and where there is potential, to restore function that is lost due to acute illness or injury. We also desperately need more community-based support systems including daycare facilities and affordable home-based care.
“The care process is not just about providing for the older adult. Please do have more consideration for their feelings. We should continue to respect their autonomy and welcome their continued contributions to society,” she concluded.