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Paying For Aged Care: Trends & Challenges

Flip open the newspaper and you will likely find an article related to seniors – the care required, their living condition, struggles, healthcare, etc. Recently, The Star published an article on the need for laws that protect the rights of seniors in Malaysia as various social dilemmas – such as abandonment – have arisen from the lack of it. These social tensions are signs that our aged care system is being stretched by the growing needs of an ageing population.

Malaysia need laws that not only covers senior citizen’s rights, but also define the roles of stakeholders; from the state, the community, family members and service providers – such as long term residential and care homes, day care centres, housing developments, transportation, commercial outlets, etc. – alike. This requires all parties to be on the same page. It is clear our aged care system cannot sustain our needs. Hence, we must understand current aged care trends to determine what types of care services are needed and how to sustainably deliver it.

Trends & Payment Modes
As we age, the possibility of needing some form of long-term care is evident. Beyond the initial stages of care during hospitalisation, long-term care (also known as LTC) comprises a variety of services with the purpose of meeting both medical and non-medical needs of people with chronic illnesses/disabilities and are unable to care for themselves for long periods of time. It can be provided at home, in the community and in assisted living facilities like nursing homes and care centres.

As far as trends go, there is an increasing need for expertise by professionals to address multiple chronic conditions often associated with seniors in the provision of long-term care. Likewise, the need for non-medical care such as Activities of Daily Living (or ADL) – which involves activities such as feeding, bathing, dressing and handling of ‘nature call’ issues – is increasing. However, unlike medical care, funding options for non-medical care is not easily available.

In Malaysia, the care that is needed and provided to seniors are delivered through government welfare homes, private nursing homes & day-care centres, voluntary aged-care centres, or by families at home. Naturally, this mix of delivery channels and agents would result in each option having very different funding bases.

The finance options available to seniors to pay for long-term care services include: the individual’s own savings, their Employees Provident Fund (EPF) accounts, pension scheme, investments, government welfare and other sources of income like investments and business income. However, unlike developed countries such as Japan, there are no risk-pooling arrangements such as social insurance and tax-based funding for long-term care available in Malaysia.

As can be inferred by the nature of our available options (apart from government welfare), Malaysians generally make out-of-pocket payments to finance their own or a family member’s long-term care needs.

As a result of financing their care support, there is a noticeable trend in the growth of self-directed (or consumer-directed) services. Despite the obvious challenges inherent with an aged care system largely reliant on individuals making self-funded payments for care, the results of self-directed services grants seniors greater independence and control over their lifestyle choices.

However, while the trend of these self-directed purchases of services are believed to improve the quality of care while simultaneously being cost effective due to the supply and demand economic model, we need to work out the kinks and flaws in Malaysia’s aged care infrastructure – namely our payment options – to fully capitalise on its strengths and minus the weaknesses. The specific challenges inherent in our payment options lie in these four areas:

1. Lack of Representation When Impaired
The benefits of the self-directed payment approach are appealing. It not only provides consumers with greater lifestyle choices and higher accountability in the services supplied, it’s also attractive to some governments due to its links with market-oriented mechanisms.

However, the drawbacks lie in monitoring and purchasing of services, which hinges on the purchaser’s health and mental condition. If the purchaser is frail or mentally impaired and without family support, their bargaining power relative to service providers is compromised and may risk exploitation by service providers as well. Furthermore, this approach does not offer a guaranteed care provision “until end of life” for all individuals.

2. Education & Employment
One of the main factors affecting our Malaysian seniors’ financial resources is due to the low educational attainment, which impacts their ability to save for old age. It is compounded further when their chances of improving their economic conditions become increasingly limited as they get older and their capacity to work diminishes.


3. Insufficient Savings & The Sandwich Generation

Constant reports from the EPF stated that Malaysians aren’t saving enough for retirement and old age. When funds from their EPF accounts are exhausted, family members often become the main welfare provider – both financially and in providing social support to the senior.

Furthermore, the “Sandwich Generation” trend are also linked with the senior’s inability to accumulate sufficient savings or for the savings to last throughout retirement. Due to changes in family size and economic conditions such as higher cost of living (e.g. high prices for housing), Adult children find themselves taking care of their aged parents expenses in addition to raising their own children. In some cases, the senior parents also providing financial support to adult children.

4. Too New To Collect Results
In 2012, the Malaysian government introduced the Private Retirement Scheme (PRS). The objective was to improve living standards for retired Malaysians through additional fund savings. However, as the PRS was implemented six years ago, the effectiveness of this initiative is still too early to assess as an avenue of long-term care funding for elderly Malaysians.

What Lies Beneath
Regardless of overcoming the abovementioned challenges, developing better payment options would be mooted if the practice of inappropriate allocation of care is not addressed. As a senior’s care needs intensifies as they age and medical inflation rises, the appropriate placement of seniors is all the more paramount. When they are accorded the right level of care – which meets the minimum standards required by the regulators – the senior’s financial resources are more likely to be utilised optimally.

This is especially important in managing long-term care costs as it can be difficult to measure due to the nature of the care required by the senior. When costs are not properly managed, the quality of long-term care services may be significantly affected. Additionally, inefficient delivery of long-term care may also affect the price of services delivered and this could lead to the senior being unable to pay for the care needed on a sustained basis.

In Taiwan for example, it is found that care at home was cost-effective for people with “medium” physical disability, but became expensive for people with higher levels of disability when compared with nursing home care. Such findings raise issues about the relationship link between needs and actual care received.

Conclusion
Ultimately, the changing climate in Malaysia’s ageing needs dictates that our current infrastructure and practices cannot remain at status quo. New payment options for long-term care (or at the very least, a revision of our old ones) and the environment required for these options to flourish needs to be investigated, deliberated and developed.

Much of the efforts by the Malaysian government to implement avenues for retirement, and by extension aged care, are still relatively new and time will tell if these efforts are effective. However, for the foreseeable future the challenges that lies ahead for Malaysia is firstly a pension reform. We need a review of social protection for the purpose of preventing poverty for our ageing population and develop a plan that provides adequate benefits that includes long-term care.

This is because a full replacement of income for retirement cannot be obtained purely from one single source or scheme but different tiers must be incorporated so that full replacement can be achieved.

Secondly, we need a total structural adjustment of the economy to cater to Malaysia’s ageing needs. As industry players, we need to ensure that future developments in ageing policies should include the provision of better care services with more uptake to enable cost-effectiveness.

Finally, greater efforts to evenly distribute aged care services and facilities between cities and country areas to ensure no one is neglected.

 


 

Source: Smart Investor, July 2017

puzzle to represent social protection aspects

Social Protection For A Senior Inclusive Malaysia

A conversation with the Director of University Malaya’s Social Security Research Centre, Professor Datuk Norma Mansor discussing the drivers of poverty and vulnerability affecting Malaysian seniors and social protection endeavours to mitigate their social exclusion.

International Living’s guide to the ‘World’s Best Places to Retire in 2017’ places Malaysia at number 6 in rankings, describing two of the main reasons Malaysia is worthy of the rank. The first being our world-class facilities while maintaining a low cost of living and secondly, the excellent healthcare due to having some of the best-trained doctors in Asia.

While these facts make the ideal retirement paradise for foreign retirees, the reality is different for the majority of Malaysians. Many have come into contact with the aged care system and are often left wanting, not for lack of the aforementioned reasons, but due to the lack of the necessary mechanisms that advocate social inclusiveness of our own senior citizens.

Social inclusion as defined by the United Nations is as a process by which societies combat poverty and social exclusion. A socially inclusive society is one where all people within the community feel valued, their differences are respected, and their basic needs are met so they can live in dignity. On the opposite spectrum, social exclusion shuts one out from the social, economic, political and cultural systems which contribute to the integration of a person into the community.

As it is, Malaysia’s large ageing population in general – which continues to grow annually – struggles to access sustainable healthcare. Break it down further and the statistics indicates even more differences. As such, understanding the ageing populations’ dynamics is critical to developing policies that not only positively impact our elderly’s social protection, but also on their perpetuating factors of poverty and vulnerability.

Malaysian communities in effectively addressing them can partake in the social, economic, political and cultural dividends reaped from senior inclusivity. In our interview with Professor Datuk Norma, we discuss the existing factors of social exclusion that prevents – or at least, restricts – Malaysian seniors from fully partaking in these benefits, and the initiatives undertaken by the Social Research Security Centre to promote better social protection for Malaysian seniors.

 

The Drivers of Poverty & Vulnerability

Data recorded by the Household Income and Expenditure (HIES) survey in 2009 indicated that 9% of seniors are living below the national poverty income line (PLI). The survey also indicates that 12% of head of households (whose families have seniors in their care) and 17% of the family members of seniors are living below the poverty line.

According to Professor Datuk Norma, the findings have also indicated significant differences between seniors living in rural and urban areas, namely in areas such as education attainment and employment opportunities. Ethnicity and household status also play a role in differentiating their respective social and economic difficulties, making certain groups of seniors particularly vulnerable to poverty and restricting accessibility to healthcare.

“The urban – rural gap in poverty has not been fully addressed. Poverty is still 3 times higher among the elderly in the rural area compared to urban areas.” says Professor Datuk Norma.

In a survey conducted by the Social Security Research Centre – which include a research sample of 518 Malaysians aged 40 years and above – it was noted that the areas which required greater concerted effort to help Malaysians cope with ageing and enjoy quality of life lies in financial economic stability and health problems – which were rated at 45% and 35% respectively.

Concern for the future of their children/grandchildren were also highlighted, indicating difficulty to accumulate sufficient savings for retirement due to the ‘Sandwich Generation Cycle’ trend – i.e. financially providing for both children and their own parents.

 

Investing in Human Capabilities & Productive Capacity

To adequately address the ageing population’s diversified needs more comprehensively whilst tackling the issue of education attainment and employment opportunities, the research centre has made proposals based on these findings to call for developing policies that strengthen the rural areas by funding new agricultural projects and improving infrastructure as well as rural-urban connections.

The proposed suggestions include investing in rural tourism and development to attract tourists through agricultural festivals and reconstructed historical sites. The proposal aims to develop arural transportation system that link to major cities to promote greater demand. However, these policies must be measured and developed using an asset-based approach as opposed to an income-based one.

“When things were tied to an income-based approach it becomes inaccurate because many things are not captured when it is only focused on income.”

Professor Datuk Norma stated these policies should be designed using an asset-based approach as it is ultimately more productive. When assets such as social, human, physical, natural and financial capital is provided during the working age period, the vulnerability to poverty will not be an issue for the rural population once they reached old age.

 

Financial Saving Mechanisms & Other Initiatives

In regards to savings accumulation and financial stability, the centre is currently conducting research on savings adequacy to address the mechanisms and circumstances surrounding financial economic stability during active ageing. They have also undertaken a research project on social protection coverage that is focused on ASEAN countries.

“Malaysia is in a situation where we can still plan well for active ageing, as we still have the productive group – those who are 25 to 60 years old – whom we can reap from as population dividend. So we can still save in order for us to prepare for active ageing” Professor Datuk Norma.

However, she further states that social protection for the ageing population includes addressing many diverse aspects of social inclusion such as the labour force, social insurance and development. Therefore, the centre is currently looking to work with and support initiatives from any sector that fall within the field of social protection.

 

Ageism as a Social Inclusion Impediment

On the issue of ageism in Malaysia, Professor Datuk Norma stated one of the centre’s future projects will be looking into the aspect of post-retirement employment and the many labour issues involved.

“When you talk about employing people post- retirement, there are many labour issues involved such as contracts – whether it is formal or informal and etc. In Malaysia, ageism is not seen as discrimination because we have a clear defined mandatory retirement age of 60. We are still coming up with the blueprint for ageing and how to prepare for it in Malaysia. When more people start being aware of these things, policy-makers will be pushed to look into it as well. It is urgent and critical we do so in terms of policies.”

She also stated that this, along with the issue of using asset-based approaches in policies to curb poverty in rural-urban ageing, will be brought forward and discussed with the Social Protection Council, which was established by Cabinet in October last year.

“Malaysia is slowly becoming a matured society and growth cannot be at the rate that we used to experience in the past. We need to think in the long run and how are we going to add value to our society.”

 

Business Ideas

Business Ideas: Why Being Senior Inclusive Adds Value

Move over millennials! This is how and why you should market to seniors.
Father’s Day celebrations are just around the corner, we can feel it when our mailbox starts filling up with promotional brochures, flyers and even special events catered just for Dads. The only way that retailers and business are able to run campaigns are during special occasions but what if there is an opportunity to look into a specific demographic as we move towards an ageing nation. How often do businesses engage as well as reach out to the matured and elderly? How often are business ideas senior inclusive?

The answer might vary due to industry differences, but what is transparent is as the population ages, there would be an opportunity for businesses to fill in the gap if they were to stay relevant and competitive. Businesses must move towards marketing that subtly appeal to an ageing demographic.

As human beings we need attention, love and care from others no matter which stage of life or what age we are. It seems our worth suddenly plummets when we enter the life stage where society puts the “elderly” tag on us. At best, society in general starts to assume that they know what the elderly need and what they don’t. At worst, it starts to ignore their needs, desires and even forget that they too need people to socialise with, and an environment to interactive with.

We should not exclude the elderly from daily interaction, but include them in social activities or events. Social inclusion plays a big role in enhancing or maintaining our overall wellbeing.

According to United Nations Research Institute for Social Development (UNRISD), Social inclusion refers to social integration or social cohesion, representing a vision of “a society for all” in which every individual – each with rights and responsibilities – have an active role to play.

The Generation Game – Catering to Asia’s Future Life Stages” from Mintel revealed:
• That older lifestyles need change and that this often ignored consumer segment presents a lot of opportunities for companies that take the effort to find out the needs of older consumers.

• One of the best things brands can do is to stop ignoring older consumers as a potentially lucrative market in countries across Asia.

• Elderly Asians are increasingly enjoying their leisure time, finding new hobbies or learning new skills, while taking the opportunity to travel more and further afield.

“A society for all” without ignoring the elderly, should be the aim for all the industry players, retailers and advertisers because they will be able to reap “longevity dividend”.

While there is huge scope to work on in fulfilling the demand for products and services that are suited to the elderly needs in Asia, there should be a conscious change of mindset and perception towards the elderly and creating “a society for all”. Individuals, groups and institutions have to be interconnected to create a social system, maintain and enhance the relationship in a harmonious way.

Trends on ageing have shown that the belief whereby age does not create limitations to lifestyle is growing rapidly. Trendsreport.com have stated that this ideal is key to tapping into the elderly market: catering to an ageing demographic by providing comfort, independence and most importantly, the added merit that ageing is no longer a limitation.

In this endeavour, some organisations have taken the big step towards making the change, especially within the social networks considering initiatives are already being undertaken. For example, Pavilion Kuala Lumpur recently launched their Pavilion Silver Société programme, targeting Malaysian who are 55 years old and above. They offer members with leisure experiences, special celebrations and even discounts. Moreover, they’ve even partnered with Managedcare – a one-stop platform to find care services for care needs – to offer selected care services on discount. The social awareness of recognising the elderly as valued members of society with needs of their own is slowly taking root, but we need to be speedier on the uptake.

More Initiatives and programmes – similar to the Pavilion Silver Société – that shines the spotlight on the elderly to engage them will go a long way in weeding out their social exclusion from society and ultimately, enable them to live the lifestyle they wish to.

Man reaching for money bills under a box representing scams

Scams: Why do we fall for it?

A conversation with Raymon Ram, Founder & Lead Consultant at FAFE Management Consultancy and Certified Fraud Examiner, discussing the motivations that lead to falling prey to scams.

With the recent collapse of the 20% – ROI JJPTR scheme and the arrest of Johnson Lee, it would seem that the JJTPR episode is drawing to a close. However, the plot isn’t over by a long shot. Prior to Johnson’s arrest, media interviews with existing investors of the scheme seem keen to reinvest when Johnson stated the development of a new JJPTR plan, promising 35% ROI rates despite claims of losing RM500 million to hacking.

The JJPTR scheme is not the first, nor will it be the last case of fraud and scams. More of such cases will only continue in different forms – repackaged under different names – so long as the various factors that not only motivate fraudsters to commit the crime, but also ensure potential investors facilitate their own victimhood, are left unaddressed.

Based on his experience as a Certified Fraud Examiner and an advocate against Economic Crime, we interviewed Raymon Ram to elaborate on the factors that have investors falling prey to fraud and its ramifications.

Planting the Seeds of a Scam
Apart from having a specific skill-set to pull off a successful fraud, it takes a willingness to deliberately target, deceive and deprive another person’s means of living. So what are the psychological strategies that allow scammers to do what they do?

According to Raymon Ram, scammers often target both internal and external influencers of a person’s decision to take financial risks and make an investment.

“The internal influencers here are “Hope” and “Greed”. There is always hope that things would work out for the best and while such positivity is good, it could backfire for the worse when one does not take a calculated risk. Whereas greed is a trait of always wanting more and not being satisfied with things as they are. This presumably is the reason one looks at gaining better returns in one investment compared to lower promise of returns in others.”

On the other hand, external influencers – such as uncertainties of the current economic climate, rise of the cost of living, inability to maintain lifestyle, living beyond one’s means and financial constraints that may be due to gambling habits or at times the sudden loss of financial support – all play a part in a person’s decision to invest and scammers prey on these hopes, greed and fears to get their target’s buy in.

Creating Our Own Victimhood
The importance of educating oneself with financial literacy programmes and the basics of investment is never more evident in the face of the thousands of get-rich-quick schemes that are being peddled around.

Besides the internal and external influencers that fraudsters prey on to manipulate their targets – or perhaps because of it – people also fall prey to scams due to the inability to understand the full mechanics behind the investment scheme. An accompanying factor propagates this lack of understanding lies in trusting the endorsement of products by public figures or celebrities without doing their own research. Thus, setting themselves up for disaster by being unwilling to look closely at the details.

“An example would be Bernie Madoff, who scammed billions off intellectuals, professionals, celebrities, politicians and regular everyday Joes alike. People turned a blind eye to the mechanics behind the scheme or even legitimacy of what was happening due to the background of other investors and figures that were backing his company at that moment” says Raymon.

Programmed To Being Scammed?
Why do people keep getting scammed again and again despite the red flags? Some may be inclined to say that if you haven’t learnt your lesson from the first time, you probably deserve it. The reality is much more complicated as there are a number of other reasons that could motivate a person to step right back into the scammers trap.

One such reason would be to recover the monies which had been lost in the earlier investment. Such desperation could be caused by the fact that a loan was taken to invest the earlier sum. In the case of a retired senior, the money could have been taken out of a retirement fund or their EPF, leaving them to believe there is no choice but to reinvest the balance.

“There are groups of individuals who believe that ‘the night is dark right before the dawn’, hoping that things can only get better. Peer pressure plays a huge role as many succumb to the words of their community members, siblings or acquaintances.”

However, seniors should especially be aware of the factors that make them viable targets as they are generally viewed by fraudsters as more vulnerable and profiled as:

• Having accumulated a measure of wealth,
• Are often lonely,
• Have a reliance on family and friends,
• Having deteriorated cognitive ability to make financial decisions.

While the profile may not be applicable to all seniors in some form or another, it is important that seniors take steps to ensure they protect themselves should they find certain profile aspects true.

The Aftermath Devastation
While being positive about an investment is good, it must be checked with obtaining the right information and a realistic outlook from research prior to making an investment. Otherwise, the consequences are dire as the impact affects more than just your finances. It can devastate your mental, emotional and physical well-being.

The scope of the devastation varies depending on where the investment originated. The damage would be even greater if the sum invested had come from someone in need or a loan which could not be serviced. Furthermore, there is a profound sense of hopelessness and violation after being cheated by someone who is trusted.

“This hopelessness is further aggravated if one loses their home or loved one due to the investment. Following that, this will usually lead to self-damaging habits or suicidal thoughts” says Raymon.

Recovery & Closure
Those affected by fraud are often ashamed of the fact that they are unwilling to share their story with others, leading to many cases of fraud going unreported. The reasons for shame varies depending on the social status and position in a community which one holds.

“A person would be more embarrassed to make such disclosure if they are a public figure or social representative which the community looks up to. That said, no one would want to be associated with the words such as cheated, defrauded or corrupted”

However, the community alongside friends and family, should not leave the victims to stay stagnant in their mistakes and encourage them along the road to recovery, whilst urging them to report the scam. The reason is more than simply recovering lost monies, it is also a matter of health.

By not reporting the scam, the event is then internalised and the negative effect of shame heightens, which can then trigger depression and even suicide. It is important for the fraud victim to keep moving forward. While this is difficult, staying stuck in victimhood further destroys self-esteem and the ability to recover.

While recovery of the financial loss is not guaranteed, reporting the scam and shedding light on it to create awareness on the dangers of fraud will help to restore some feeling of control and self-esteem.

When perpetrators of fraud are caught, knowing that their report has enabled justice to be served would help to bring closure and a sense vindication. Being a victim of fraud, one can play a role in creating awareness on such issues as well as being informed, taking heed to what is happening in the news and media by taking precautions prior to embarking into further investments.

 


 

Disclaimer
Aged Care Group (ACG) is an organisation engaged in the business of elevating and providing aged care services in Malaysia. ACG is driven with a strong vision to advocate innovation and transformation in ageing by offering continuum care as a premium choice for enriched living. We operate in an ecosystem that provides integrated care services and products through meaningful partnerships with individuals, government, organisations and corporations. ACG seeks to be the forerunner in all things related to aged care, building on the years of knowledge and experience of its shared holders and management team. A detailed profile of who we are can be obtained at www.agedcare.com.my.

 

Source: Smart Investor, June 2017

Investing for Retirement – Local or Abroad?

Now that you’re retired (or soon-to-be-retired) and no longer receiving a salary, how do you approach your investment portfolio? Experts have a golden rule when it comes to investing post-retirement: you can’t earn back your retirement funds without a steady income. For this reason, you better make sure you are making wise and safe investment decisions.

When you’re working with an active income, but your investments did not do as well as you had hoped, you still have a margin of adjustment. You could work longer and postpone retirement. Once you have retired, that is no longer an option.

Hence, following events such as the Greek debt crisis, Britain’s ‘Brexit’ and China’s recent market crash (albeit recovering), making investments overseas may seem like a risky endeavour and structuring your investment portfolio 100% locally based sounds like a safe bet.

On the other hand, reports from Khazanah Research Institute and the Employees Provident Fund (EPF) show that the average Malaysian is retiring with insufficient funds. Compiled with other economic factors – such as the falling value of our Ringgit, the rising cost of living, care and medical inflation – you can’t help to wonder if perhaps you should take your chances and diversify your portfolio across countries.

If you’re in the midst of deciding whether to make an investment locally or abroad, here are a couple things to consider first.

Know your investment objectives
Whether to invest locally or abroad, it really depends on your investment objectives. You need to know the reason why you want to invest overseas. Making investments overseas does indeed carry various additional risks such as foreign exchange risk & geo-political risk. Therefore, as an investor, you would expect higher rate of returns to compensate for the risks taken.

However, if your retirement needs are already met or can be satisfied by a purely local portfolio, then making an investment overseas isn’t necessary.

4 Building Blocks to International Investments
There are good reasons to add international exposure to your investment portfolio. By broadening your investment horizon, you can tap on opportunities that are not available in Malaysia such as global conglomerates and high-growth emerging economies. Besides that, investing overseas can also add to the diversification of your portfolio.

But as a retiree (or soon-to-be-retiree), your retirement fund is critical to ensuring your quality of life and ability to live with dignity as you go down the journey of ageing. Hence, your decisions to make investments is especially critical at this stage in life. You need to be cautious and make prudent decisions to ensure it lasts.

If you have considered every angle and decided an international investment is what you need, decide on where you may need the spending. Keep in mind these 4 building blocks when constructing your investment strategy:

1. Understand the Risks
It is crucial to understand the risks involved in investing overseas. In addition to carrying all the general risks inherent to any underlying investments, there are also risks unique to investing overseas that you need to evaluate. Namely:

• Currency risks
• Political, economic & regulatory risk
• Selling time
• Additional costs
• Information risk
• Legal remedies

If you are concerned about any of these risks and need clarification, it is highly recommended that you seek professional financial advice before you invest overseas. Remember, as a retiree or soon-to-be-retiree, the aim is secure your quality of life during retirement. Its’ better to be safe than sorry.

However, once you are aware of the risks and possess the information necessary to navigate them safely, you’ll find the rewards are worth the effort. Despite the risks, foreign investments are a vital part of any well-balanced portfolio. There is plenty of growth and opportunities to be found overseas to not take advantage of.

If you have done your homework and maintain a well-diversified portfolio by investing only a percentage of your total assets in foreign securities, you can take advantage of worldwide growth in today’s global economy without taking on excessive risk.

2. Research the Region & Asset Options
You need to research what kind of assets that you would want to invest in, such as stocks, bonds, properties, REITS and etc. It is especially important to know what are the costs of investing in a particular asset overseas as it may be more expensive compared to the same investment locally.

Make sure you’ve compared the cost and risk to the expected returns to identifying high-quality income.

When you have decided on the assets you will invest in, you should consider which country or region to be exposed to. Understanding the country or region, the trends and socio-political environment is vital before you invest your money. It could make the difference between loss and gain.

3. Determine & Allocate
When you have understood the risks, the options available and the country/region of choice, you need to determine how much funds you have available and allocate the appropriate portion to invest overseas. You also need to determine what is your investment horizon – that is the total length of time which you expect to hold your investment.

However, if you are a retiree who is approaching the late stage of retirement, you will likely need to de-risk your investment portfolio and scale down the foreign exposure.

Another golden rule to follow is if you don’t have enough retirement fund, investing overseas may not be your main concern or priority. Your priority is to boost your retirement fund.


4. Monitor & Review

When you have made your investment, be sure to constantly review and monitor the portfolio. As foreign investments are more sensitive due to its additional risks, you need to ensure that it is well diversified to minimise any extreme risk or external shocks that may occur.

When to Make an Exit
Handling domestic investments can be challenging enough to deal with. Researching and analysing foreign companies puts an additional level of complexity as you have to deal with issues such as variances in legal and accounting standards, as well as obtaining up-to-date information as some foreign companies may not provide investors with the same type of information.

To navigate more securely as you make an international investment, you could outsource the management of the international portion of your portfolio to a professional who is well versed in the country or region of your interest.

The bottom line when it comes to making an investment overseas is to know how much money does your retirement needs costs and how these needs can be fulfilled by your retirement fund. When you have identified the funds you need, determine if you have the required amount to act as a buffer to investing overseas.

If this ‘buffer’ diminishes – that is to fall below the minimum capital that you need for your retirement needs – then you should stop the investment and make an exit, unless you have a good reason to continue.

 

Written by Aged Care Group in collaboration with FA Advisory

Source: First published in Smart Investor, May 2017

Pavilion Kuala Lumpur Launches Pavilion Silver Société

KUALA LUMPUR, 23 MAY 2017 – Pavilion KL, Malaysia’s premier shopping destination, known to provide unforgettable shopping experiences to visitors. Pavilion KL today launched Pavilion Silver Société, a new exclusive program for the silver society.

The Pavilion Silver Société, targeted at Malaysians 55 years and above, offers members leisure experiences, special celebrations and services ranging from workshops during festive seasons and pampering services, to birthday discounts and many more. Members of the Silver Société will receive exclusive discounts from over 250 tenants in the mall, as well as invitations to private events.

The ceremony commenced with the unveiling of the Pavilion Silver Société by Dato’ Joyce Yap, CEO of Retail of Pavilion KL. As a symbolic gesture to kickstart the programme, Dato’ Joyce was presented with a Pavilion Silver Société membership card as the first member of the esteemed programme, together with ten other valued recipients, including Tan Sri Dato’ Sri Dr. Ng Yen Yen, former Minister of Tourism in Malaysia.

To continuously offer attractive benefits and activities to Pavilion Silver Société members, Pavilion KL will endeavour to collaborate with major non-profit organisations and multi-national companies to engage the target audience.

 

Dato’ Joyce Yap, CEO of Pavilion Retail Group (left) and Dr. Carol Yip, CEO of ManagedCare (wholly owned by Aged Care Group) (right)

 

The first partner to collaborate on such an initiative is Managedcare, a care platform in the business of coordinating and administration of a variety of healthcare and long-term care services to achieve optimum value in terms of quality and affordability. A Memorandum of Understanding (MOU) Agreement between Pavilion KL and Managedcare was signed with the purpose of promoting social inclusion and enhance the holistic well-being of senior citizens through jointly organised events and activities.

The MoU will bring about mutually beneficial interests, as well as increased accessibility to learning and social events/ activities catered to senior citizens through mutual cooperation for both parties.

“It is with great pleasure that we launch Pavilion Silver Société today. Whether we are ageing or not, it does not mean that we stop indulging in an active and fulfilling lifestyle. To me, life begins when you hit 55. I hope that all shoppers aged 55 and above will embark on this journey with us and take advantage of Pavilion Silver Société” said Dato’ Joyce.

Shoppers who are interested to apply for the Pavilion Silver Société, may proceed to the Concierge
Counter located at level 3 to register.

 


 

Managedcare Sdn. Bhd.

Managedcare is in the business of coordinating a variety of healthcare and long-term care services as well as the administration of these services to achieve optimum value in terms of quality and affordability. We bring to market products and services that ease the provision and access to care, giving you the peace of mind you deserve. Managedcare is a wholly-owned subsidiary of Aged Care Group Sdn Bhd.

For more information, please visit www.managedcare.com.my

Pavilion Kuala Lumpur

Pavilion Kuala Lumpur is an award-winning, world-class mixed-use urban development located in the heart of Bukit Bintang, the shopping district of Malaysia. Pavilion Kuala Lumpur blends the best of the international and local retail world with over 550 stores and eight themed precincts. Attracting over 30 million visitors annually, this premier shopping destination is a duty-free shopping paradise and the defining authority in fashion, dining and urban leisure.

Visit www.pavilion-kl.com for updates on the latest trends, offers and events.

 

For media assistance, please contact:

Managedcare Sdn Bhd
Corporate Affairs
Tel: 03-2142 7166
Email: jason@agedcare.com.my
Website: www.managedcare.com.my

 

Pavilion Kuala Lumpur
Public Relations and Social Media
Tel: 03-2118-8282
Email: lararowena@pavilion-kl.com
Website: www.pavilion-kl.com

Professionalising Care Through Public-Private Partnerships

As we evolve into different stages of life, the possibility of requiring some form of care is prevalent. There are enough facts to pressure us to do something now – without hesitation and procrastination, especially when Malaysians are facing longer life spans.

The question we need to ask ourselves is: do we have the basic care necessities? The resources in terms of facilities, manpower and knowledge to care for our loved ones and even ourselves?

To address this question, a Memorandum of Understanding (“MoU”) was signed between University of Malaya and Aged Care Group on 18 April 2017 as both parties come together with a common goal in developing continuum care for the older generation.

Amongst the challenges faced by our ageing demographic, it is the lack of Malaysians who are keen or have the passion to work in the aged care industry that stands out. Rarer still are the care workers and professionals trained with the right skills to fuel this industry.

It should be acknowledged, aged care – no matter the sophistication of it’s infrastructure – is a labour-intensive industry. It carries a human-centred element where experience is etched into the hand that partakes the cause of care. Without that experience from which to learn from, our facilities are but ineffectual.

Beyond being simply a business, aged care is about birthing and nurturing human connections that provides warmth and personal attention, aspects that are important to the care recipient. As such, in order to elevate the aged care industry, there is an incumbent and vital need to professionalise aged care as career employment in care, hospitality and lifestyle living.

To that end, a forum on “How to encourage and attract human capital into the aged care industry” was held and organised by ACG in conjunction of the MoU with UM.

The distinguished panellists who gathered to discuss this issue at the forum were the esteemed To’ Puan Dr Safurah Jaafar, former Director of the Ministry of Health’s Family Health Development Division, Associate Professor Dr. Tan Maw Pin (Faculty of Medicine) of University of Malaya, and Simon Si, Head of Regional Communications of JobStreet. The session was moderated by Carol Yip, CEO of Aged Care Group.

 

Identify & understand the challenges

Talks regarding the lack of manpower in the aged care industry has always been a constant. The glaring reason that such talks persists is mainly due to a lack of research on the needs and nuances of the factors that would cultivate the necessary human resources in aged care.

As such, the implication to the aged care industry in terms of economic costs and social value to our communities remain unknown to us. It goes without saying that we cannot afford to be ignorant when a thriving aged care business is necessary for the betterment of Malaysia’s ageing population.

According to Dr. Tan Maw Pin, 26% (out of 1000 patients) of those who attended the University of Malaya Medical Centre’s (UMMC) emergency department in 2012 were seniors, which is an alarming statistic.

“During that period, the general senior population over 60 years old in Petaling Jaya district was only 6%. This give us a ratio of 26:6 which is extremely high if compare to United Kingdom, United States and Singapore which is nearly 1.” said Dr. Tan.

 

Dr. Tan Maw Pin further reiterated that the elderly tends to seek immediate medical attention by going to the emergency department; a distressing figure that shows a huge gap in the delivery of care due to:

  • Lack of or inadequate community care services for the ageing community in the neighbourhood; and
  • Lack of primary care services by general practitioners and nurses to elderly staying at home.

 

It also potentially indicates a lack of trained care workers or caregivers/family members at home who know how to take care of the elderly.

Carol further added that UMMC faces a large number of elderly who prolong their stay in the hospital. This is due to a lack of caregivers or family members at home to care for them.

So, how can various players in the value chain collaborate to smoothen the transitory flow of the elderly, starting at the transition from hospitals to their own homes or aged care facility (with quality care services)?

Dr. Tan Maw Pin mentioned that previously, caregiving was carried out by foreign domestic workers. “Until 2 years ago, you could pay foreign domestic workers RM600 to take care of the elderly, and most people could afford it. But things have changed and now I see the opportunity to introduce a structured approach towards caregiving.”

Among the solutions discussed, one such potential approach is to enable the provision of caregiving services at a lower cost by implementing an integrated care framework and training a large pool of care workers with certification.

Dr. Tan stressed that services offered by a caregiver or care worker should not be on a voluntary basis but it should be positioned as a career opportunity, thus creating employment for those interested to embark into the field. It could also provide job opportunities to those who have given up their previous careers to look after their loved ones.

Simon Si also shared an interesting insight: “Jobstreet.com has 30,000 jobs at any one time. With 3 million people on the database, there are only 6 jobs for caregivers out of 30,000 and 4 of them are based in Singapore. There are 360 job offers for nurses but half are for Singapore, and another quarter are for the Middle East market. The salary range for the jobs didn’t cross RM3, 000 monthly”.

With this in mind, Simon stated that the question industry players need to ask themselves is “How can the industry make the caregiving profession attractive in recognizing the fact that such a profession is highly in demand?”

In order to elevate the role of ‘caregiver’ into a career for Malaysians, there must be purpose-built facilities just like hotels and hospitals, with an attractive salary structure to remunerate the care staff.

Other criteria that were discussed amongst the panellists in regards to ‘professionalising caregiving’ involved requiring the aged care facilities to be built to standards similar to that of developed countries and creating certification of caregiving training programmes which are accredited just like a nursing course.

It was also stated that remuneration structures needed to be addressed appropriately to befit the caregivers’ professionalised status.

Currently, there are local caregiving training for individuals or nurses who wish to seek employment overseas, which clearly indicates we are already experiencing a ‘brain drain’ and a shrinking caregiving pool as other countries offer better remunerations.

 

Changing Perspectives

Celia Yeo from The Victorian State Government, Australia, who look after the services and education sector of South East Asia shared her experiences from Australia:

“Using nurses to do aged care is a waste of resources. In Australia, we have different types of certificate for different users in aged care. You would be specialised in dementia for example even if you are not a nurse.”

Edward Lim (from the audience), an engineer from Vector One proposed the idea of providing caregiving training to kids when they are still at school, “We can encourage students to take the caregiving courses in the school as part of their curriculum and introduce a points system to fulfil the subject requirements via internship. We also can partner with nursing home for their internship.”

It was also noted that Government support plays a crucial role in elevating the aged care industry. According to To’ Puan Safurah, there must be a cohesive effort by various sectors i.e. private sectors, non-profit organisations, the silver community with the relevant authorities to drive a movement action.

Mr. Yoong Yoon-Kit, Performance Management and Delivery Unit (PEMANDU)’s Executive Vice President responsible for the Healthcare portfolio stated that under the National Key Economic Area (NKEA), the business of aged care is mainly meant for the private sector. The government’s role is to facilitate or ensure the smooth progression of the projects by way of giving incentives (for example, from the Malaysian Development Authority (MIDA) etc.

 

Moving Forward – Taking Action

Wawasan 2020 which encompasses all aspects of life – from economic prosperity, social well-being, world class education, political stability, as well as psychological balance — is only 2 and a half years away, which leaves us little time.

Additionally, we have the Transformasi Nasional 2050 – an initiative to enable Malaysia to achieve ‘developed country’ status within the period of 2020 to 2050. The question is – can the rate of our rapidly growing ageing population afford to wait another 30 years, delaying development of a better aged care framework for ourselves?

Simon Si emphasised the importance of changing the mind set and perception of what ageing means and that building aged care facilities would have to be driven by the private sector. Innovation and technology would also be key to driving industry growth, as well as making it an attractive endeavour.

“It will be expensive and maybe only the top 5-10% of population could afford it, but the spill over effect from it is going to impact the rest of the industry. We need to make it a viable business and attractive for people to join into this industry.

Speaking with the middle-income bracket in mind, To’ Puan Dr Safurah had this to say:

“We can provide quality care by way of community care via day care centres or facilities that will charge lower rates according to the middle-income group’s affordability, while for the poorer ones, NGO’s can help out. By engaging and attracting more players into the industry, there will be economies of scale to deliver quality and affordable care services”.

On the topic of proper budgetary allocation, Dr. Tan stated that “We have enough budget to do the right things, but we keep channelling it wrongly”. Failing to Plan is Planning to Fail.” She emphasised that it is a ‘huge financial issue’ for the elderly that needs to be restructured appropriately as many become bankrupted by checking themselves into a private hospital or hiring 24 hours nursing services at home.

Dr. Tan further suggested that with technological innovation and well-planned care, Malaysians could engage Managedcare (a one-stop care platform) to assist them by coordinating a variety of health related and long- term care services, together with CareTRUSTTM to help individuals to allocate some monies in a living trust to pay for their care needs.

In conclusion, Carol added, “Malaysia is rated as the 6th best place to retire in the world. With the introduction of Malaysia My Second Home Program (MM2H) since 2002 and our own ageing population, we need to build human capital for this billion Ringgit industry— The Silver Industry. Together, we can implement an integrated care framework that is supported by a large pool of trained human resources”.

Aged care services for future Eco World projects

Eco World Development Group Bhd is discussing with Aged Care Group Sdn Bhd (ACG) to offer services to the property developer‘s older buyers in future projects, including retirement homes.

Eco World‘s Ijok development in Selangor, may become the first to offer independent living and retirement homes with aged care services, leading to nursing home facilities for residents.

Eco Sanctuary, near Kota Kemuning, Shah Alam, and Eco World‘s other projects are possible candidates for the niche market.

The Australian Institute of Health and Welfare says an aged care facility usually provides accommodation and support, including assistance for day to day living, intensive care, and independent living.

Eco World has ties with ACG, through the former‘s wholly owned subsidiary, Managedcare Sdn Bhd, which is the healthcare services partner for Parque Residences condominium in Eco Sanctuary.

Called the Eco Sanctuary Care Hub, the pilot project will offer 24/7 nurse-oncall services and a care manager to attend to requests from the condominium residents.

ACG builds and assists in designing townships by integrating healthcare and aged care services to achieve specific design standards.

This makes the homes adaptable, accessible and safe for the aged to live in.

Source: Focus Malaysia, 29th April – 5th May 2017

Integrated Care: Defining The Future Provision Of Care

A conversation with To’ Puan Dr Safurah Jaafar, Panel Advisor to Aged Care Group and Head of Sub-Specialty for Family Health in the Academy of Medicine’s Public Health Medicine Chapter, discussing the definition of integrated care and how its gaining importance in the future delivery of continuum care.

Trends are the sort of thing that comes and goes. Yet, they typically capture the moment and represent the times we live in. As of late, integration is a hot topic and buzz word in health care. With an ageing population and a growing number of people living with chronic or complex health conditions, alongside changing health needs and increasing demands on the healthcare system, it comes as no surprise that integrated care is the future in the provision of care.

Achieving integrated care requires that those involved with planning, financing and providing services have a shared vision, employ a combination of processes and mechanisms, and ensure that the patient’s perspective remains a central organising principle throughout.

Based on her vast experience in Health Services Management and Primary Healthcare, we interviewed To’ Puan Dr Safurah Jaafar, the esteemed former director of the Ministry of Health’s (MOH) Family Health Development Division, to take a closer look at what exactly is integrated care, what makes it an important element for the delivery of care moving forward and where it stands today in Malaysia.

Integration in Care Defined
As a buzz word being thrown around, integrated care as a term has been used loosely on various occasions. So, what exactly is the concept of integrated care, apart from an intangible impression? Globally, the term refers to the systematic coordination of general and behavioural healthcare to produce the best outcomes when caring for people with multiple healthcare needs.

“Integrated care would mean medical and social care provided as real-time as possible to members or individuals of a population needing such services at point of care across physical, mental and social health needs rendered through an efficient and effective orchestrated approached by all care providers within a country” says To’ Puan Dr Safurah.

To put it in perspective, the elements of integrated care consist of four components of care:

·         promotive care Refers to the process of enabling people to improve and increase control over their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions.
·         preventive care Refers to the care you receive to prevent illnesses or diseases. It also includes counselling to prevent health problems.
·         curative care Refers to health care practices that treat patients with the intent of curing them, not just reducing their pain or stress.
·         rehabilitative care Refers to the restoration of patients to functional health and allow their return to useful and productive life

Likewise, establishing these four components requires the involvement of four parties; namely the public, private, non-governmental organisations and the Malaysian population itself. Each party must be unanimous in sharing the objectives and values to achieve together positive ageing and ageing with adequate financial and social support, whilst the provision of friendly and warm services observes dignity and respectfulness.

Putting all of these components together will require the medical and non-medical sectors; from the medical fraternity to architects, engineers, interior decorators and chefs – to name a few examples – need to envision and fit into the big picture and play their roles effectively.

“There should not be differences, instead there should be synchronization between all these players” says To Puan Dr Safurah.

However, she also notes that the outcome of care in Malaysia will differ from our neighbours. As resources in middle-income countries differ from their rich-income counterparts, the outcome of integrated care cannot be compared apple to apple with mature countries – such as Japan, Australia and Germany – that have the opportunities of the lead time to improve their care framework.

Integrated Care in Malaysia
In terms of delivery of care, To Puan Dr’ Safurah stated Malaysia – despite being fairly young in the aged care industry and not having earned an ‘integrated care model for the aged’ yet – has begun taking steps towards developing its’ resources to address the growing need for integrated care.

“The Ministry of Health has begun increasing the training of geriatricians and gerontologists together with their allied healthcare providers, while the Ministry of Women and Community Development has provided various facilities, shelters and assistance to support the needing elderlies.”

She also stated that the Ministry of Local Government is currently reviewing various standards and policies in the logistics requirements of city planning. Meanwhile the Economic Planning Unit is forming various committees to develop options that would best optimise and harmonise various efforts within delivery of care, both presently and in the future.

On the other hand, thousands of care providers and facilities have mushroomed to accommodate the growing needs of the ageing population. A fact made evident in the growth of hundreds of private hospitals that are well governed by the prevailing Private Healthcare Facilities & Services Act and patronized by growing communities that can afford it.

However, the needs are ballooning to proportions that Malaysia’s current healthcare system – with its’ fragmented delivery of care and social services – will be unable to sustain.

It is projected that with the coming of the Private Aged Health Care Facilities Act, the standards of care can be gradually aligned to improve the standards of delivering care, management of nursing homes and ensure sustainable development to benefit the aged.

Financial Affordability is a Two-way Road
Another immediate challenge facing public and private hospitals in implement integrated care lies not only in the area of financial affordability of the aged population seeking care. The sustainability of the facilities to maintain and provide the appropriate care while having a sound financial balance is also of concern.

According to To’ Puan Dr Safurah, the Economic Planning Unit and the Ministry of Finance are aware of this concern and are looking into developing various policies and financial plans.

“These plans are crucial as it will have bearing on the incentive and dis-incentive system. This is critical as it will be the principal factor that accelerates the advancement of aged care in Malaysia.”

Building Bridges
The structure of public and private hospitals in Malaysia raises unique challenges. On one hand, public hospitals are governed by the MOH, while on the other, the Association of Private Hospitals of Malaysia (APHM) represents private hospitals. Hence, collaborative efforts to deliver integrated care are thus hindered.

So how can public and private hospitals – with different challenges arising from different settings – overcome these challenges together?

“The public and private hospitals have their unique objectives and clientele. Each aspire to do their best for the aged population within the policies and resources they have assembled. What the can do is find common areas in which they can share resources such as human resource, professional expertise, equipment, beds or training. Many have already started sharing but can be further expanded.”

However, with each party having different models, To’ Puan Dr Safurah stated that seamless delivery of integrated care – the free flow of patients between private and public hospitals – may not develop the way we envisioned it unless the financial models are changed.

Conclusion
Currently many “green areas” exist in Malaysia’s delivery of integrated care, with many gaps to be filled in both medical and non-medical fields. Our infrastructure; from training, facilities, nutrition, food & beverage to our architectural, engineering, interior and technological designs, alongside communication and many other fields crucial to an aged care ecosystem – has yet to be fully developed and established.

However, while integrated care is a relatively new game to Malaysia, as a country ranked as the 6th best place to retire in 2017 by International Living – with our healthcare noted as excellent, we aren’t doing too shabby. We do have the foundation, resources and potential to evolve our healthcare system. It’s only a matter of time.

“Every seminar and meeting we attend, we will always find opportunities to work together to improve or offer more competitive ideas to enhance the development of care to provide the best care and survivability possible” said To’ Puan Dr Safurah.

 

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