WHEN an ageing parent can no longer bathe, use the toilet, or move around the house independently, love alone cannot provide the care they need.
Yet many Malaysians find themselves becoming carers suddenly and without the training or financial preparation to do so, says Malaysia Caregivers Association (Kendana) chairman Rashidi Yahaya.
“There is a very important distinction between loving your parents and knowing how to care for them,” he says.
As Malaysia considers introducing a Parental Care Act to address the abandonment and neglect of elderly parents, experts say the country must distinguish between adult children who will not care for their parents and those who cannot provide the level of care they require.
Families today are smaller and their circumstances have changed, Rashidi says.
Both husband and wife may work while supporting children, mortgages, and other financial commitments.
At the same time, parents are living longer and may develop frailty, dementia, mobility limitations, or the effects of a stroke.
Their children can therefore become caregivers “by accident”, while continuing to work full-time and with little idea how to perform increasingly complex care tasks.
The financial burden can also be substantial.
Rashidi estimates that hiring a reasonably good caregiver could cost around RM4,000 a month, and if such care were required for five to seven years, caregiving alone could cost a family between RM240,000 and RM336,000.
If the family cannot afford professional care and a child instead leaves his/her job or reduces working hours, he says the cost has not disappeared but become less visible through lost income, career progression, and retirement savings.
This is why legislation must make clear a distinction between deliberate abandonment and an inability to provide care, he says.
“Abandonment is conduct. Care dependency is a condition.
“Poverty is not neglect. Lack of caregiving competency is not abandonment,” says Rashidi.
Someone who deliberately leaves a dependent parent without food, shelter, or necessary care despite having the means to help is very different from a family struggling to manage dementia, stroke, or severe frailty without sufficient resources, he says.
Assoc Prof Dr Rahimah Ibrahim, director of Universiti Putra Malaysia’s Malaysian Research Institution on Ageing (MyAgeing), similarly cautions against assuming inadequate care is always caused by unwillingness.
Families may be dealing with financial pressures, caregiver burnout, inadequate housing, and a lack of accessible formal support.
A filial responsibility law could provide a last-resort mechanism in cases of genuine neglect or abandonment, she says, but it should not become the centrepiece of Malaysia’s response to population ageing.
Instead, she advocates a shared-care model in which families continue to play an important role while government, communities, and formal services provide the support families cannot reasonably supply themselves.
Gerontologist Lily Fu, meanwhile, believes elderly Malay-sians do need greater legal protections.
“The elderly need a voice. They need support, preferably from the government,” she says.
But Fu also acknowledges that there are circumstances in which children genuinely cannot afford to care for ageing parents.
As such, she cautions against equating placing a parent in residential care with being unfilial.
Families may lack money or space, while caring for an elderly person with complex needs also requires knowledge that relatives may simply not possess.
Fu herself cared for her mother, who had dementia, for 11 years, and says she initially knew little about how to provide such care.
She eventually pursued further studies in gerontology partly to better understand her mother’s condition.
Rashidi says that if the government imposes a duty of care on families, it must also create an environment that enables them to fulfil it.
This would include accessible respite, community and day-care services, home-care support, trained professional caregivers, quality residential and assisted- living facilities, workplace protection for family caregivers, and sustainable financing for long-term care.
Other ageing societies have also shown that filial responsibility legislation cannot stand alone.
Rahimah notes that Singapore, despite having its Maintenance of Parents Act, has subsequently developed a broader network of elder protection, long-term-care financing, and caregiver support, including CareShield Life and the Home Caregiving Grant.
Japan and South Korea, meanwhile, have developed national long-term care insurance systems that reduce reliance on families providing all care themselves.
“The most important international lesson is the development of long-term care systems that share the responsibility among individuals, families, and society,” she says.
For Rashidi, family responsibility should therefore remain part of Malaysia’s response to ageing but should not become a substitute for a long-term care system.
“We must be very careful when translating a moral obligation into a legal liability,” he says.
Rather than asking only how children can be compelled to care for their parents, he says the question should also be what Malaysia must put in place so older people receive appropriate care while families are enabled to participate in providing it.
