Holistic approach to elderly healthcare

HEALTHCARE for the elderly can no longer be viewed in silos; the time has come to take care of the elderly in a more comprehensive and holistic manner.

It is no longer about just taking care of the physical aspect and disregarding the emotional and mental side of things. Similarly, elder care doesn’t start and end in the hospital. There needs to be continuity.

“Nowadays we have to look at aged care on a more global basis; continuity of care is extremely important. There’s too much emphasis on acute care and not enough emphasis on preventive and followup care and step-down care,” said Tan Sri Dr Ridzwan Bakar, cardiologist and former CEO and chairman of Pantai Holdings.

With the increasing number of elderly and about 35% of the population expected to be over 60 years old by the year 2020, Dr Ridzwan believes it is high time healthcare providers started looking at continuum care.

“From my experience in the hospital, I can see a great need and necessity for after-care. Quite often, some patients pay high rates just to stay on in private hospitals when actually they don’t need to, provided there are step-down facilities where they can rehabilitate from home,” he added.

Treatment options

Marc Daniel, chartered physiotherapist and director at Synapse Physiotherapy, who has been in the business for about 18 years, said that there is a high demand for allied healthcare options like physiotherapy.

However, very often families do not know where to go and who to go to.

“Of course, the public is also confused by all the various therapies. We are still a developing nation and the mentality needs to be developed.

“Getting the right therapy from the right therapist comes down to awareness and education. The people need to be aware of those services, and that it’s not just nursing homes,” said Daniel, who was at the Aged Care Group (ACG) Partner Appreciation Dinner.

These services and options don’t just consist of what is available in western medicine. In Malaysia, we also have access to traditional and alternative options.

Prof Dr Cheong Soon-Keng, Dean of Universiti Tunku Abdul Rahman’s Faculty of Medicine and Health Sciences, believes that Chinese medicine should not be overlooked.

Chinese medicine plays an important role in elderly care. A great majority of the world’s population believes that Chinese herbal treatments can improve health and boost our immune system,” he said.

Dr Cheong believes that traditional Chinese medicine has earned wide recognition, adding that even though those of other races have their own traditional medicine, they are still very interested in Chinese medicine.

However, many elderly and their families are still at a loss as to where to go.

Dr Ridzwan believes that while doctors can recommend healthcare service providers like homes and service providers for the elderly, there firstly needs to be proper facilities.

Housing needs

Datuk Dr Soon Ting Kueh, president of the National Council of Senior Citizens Organisations Malaysia (Nascom) believes that there is an urgent need to look into housing for the elderly.

According to him, many Malaysian homes are not aged-friendly, with slippery bathroom floors, stairs and dark corners.

“Recent trends show that there is a lack of appreciation for family values, and many children refuse to look after their parents. We should be prepared to tackle issues with regards to the ageing population,” he added.

Ishmael Ho of Ho Chin Soon Research pointed out that it is important to cater to the elderly population when creating living spaces.

He believes that there should be more awareness about creating a living environment suitable for the older generation, so that property developers can work towards it when undertaking township development projects.

Admitting that more needs to be done, Ng Yiek Seng, principal of Veritas Architects, said many architecture designs are not tailored for the ageing community.

In the past, many designers have taken these elements into consideration when designing buildings but this move did not really win the public’s approval. Fortunately, people have begun to learn and accept their importance,” said Ng.

Addressing the need for convenience over aesthetics, he added, “When designing a product, we should take its practical use and flexibility into account, instead of its appearance.”

Government support

While there is general acknowledgement of the growing needs of the elderly population, not many are prepared to invest in this market.

According to Khoo Chuan Keat, senior executive director at PricewaterhouseCoopers Taxation Services, many investors avoid going into the elder care industry because they think it may not be lucrative.

He believes the industry faces stiff competition from hospitals, which have relatively more resources and are eligible for tax incentives. On the contrary, establishing a legal Integrated Residential Care Centre (IRCC) is a complicated process with lots of terms and conditions.

Should the government offer tax incentives, more investors would be encouraged to be a part of the senior care industry. This new industry needs greater support from more people,” he said.

The law

With the growing number of aged and the increasing demand for services in the aged care industry, there is also an urgency for proper legislation.

Understandably, everyone involved in the aged care industry is excited about the impending Aged Healthcare Act which is expected to be tabled in Parliament this year.

Dr Ridzwan said it is timely and a step in the right direction. In fact, it shows that the government is becoming more aware of taking care of senior citizens.

Also welcoming the Aged Healthcare Act, Raphael Tay, partner in the Chooi & Company legal firm, believes that everything is coming together at the right time. However, he thinks the legal framework in Malaysia needs to be refined.

“There are lots of areas and pockets where there are gaps that need to be filled and I think legislation must be put into place to cater to those needs. Having said that, the actual legal framework that we have, generally speaking is sufficient, however it needs to be enhanced. I think it is something we can learn from many of our neighbouring countries that have looked into some of these things.

“Laws are important and enforcement is equally important. I think that’s applicable in any society. Without good, consistent enforcement, the best laws in the world are meaningless. It’s not just the enforcement, because enforcement connotes, denotes and suggests that you’re reprimanding someone because he has made a mistake or erred or breached a law. I think equally important is education; we need to educate people on why these laws are there, why it is good for society and we should all co-operate in trying to maintain and adhere to the law,” said Tay.

His advice to operators going into the aged care business is that they should not look at it merely as a business.

“It is far more than that. I think you must believe and subscribe to the principles of a better society, a caring society …. If you are in it for the short haul, just because it’s a lucrative market, then I think you will not be able to sustain and maintain that, and it will in fact destroy what is inherently good because the emphasis of where you’re coming from is totally wrong.

“At the end of the day, of course, we all want to make money, but in the first place, why are you in it? Is it because you believe in it? Is it because you believe there is a need to look after the aged of our society?

“I think it’s important even for aged care operators to ask themselves why they do what they do.

“In whatever you do, it must be for the right reasons. You must do the right thing for the right reasons, with the right attitude. That philosophy must also be subscribed by aged care givers,” said Tay.

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