Tag Archives: Aged Care Group

ACH Group Vision Of Providing Care To Diverse Markets

ACH Group sign MOU with Malaysian company, Aged Care Group, to deliver an innovative care model

ACH Group and Malaysian care provider, Aged Care Group (ACG), signed a Memorandum of Understanding to officialise a joint initiative to provide better care in both Australia and Malaysia.

The MOU affirms that ACH Group and ACG will work together to share knowledge of each other’s countries and experiences to better provide care to older people.

The signing of the MOU was witnessed by the Honourable Zoe Bettison, Minister for Ageing, recognising the Office for the Ageing played an important role in developing Age of Opportunity: A Policy Framework for the Development of the Ageing Well Industry in South Australia, which was launched in August. This policy sets a framework for cross government, industry and community collaboration to support business growth and innovation throughout the Ageing Well industry in South Australia.

The new agreement will bring together both organisations and provide ACH Group the opportunity to learn and develop tools such as how to provide care to different populations in a multicultural society.

“We have many things to learn about providing care for such a diverse market place,” said ACH Group CEO Ray Creen, “Australia is one of the most ethnically diverse societies in the world today and as an aged care provider, we need to continue to learn how to cater for such an extremely broad market, something that ACG does in Malaysia so well.”

As well as diversity in the market place, ACH Group hopes to learn about ACG’s advanced use of technology to develop their already strong community-based care model. A model which involves community, public and private sectors.

“ACH Group’s integrated continuum of care is made up of a comprehensive array of health services,” Creen said, “developing this even further and combining it with a progressive use of technology will mean South Australia’s aged care sector is a leader for the Nation.”

The bilateral relationship between South Australia and Malaysia will elevate and introduce a care model of international standards to the state.

ACG & ACH Group Signing Ceremony

Aged Care Group signs MoU with ACH Group, South Australia to Deliver an Innovative Care Model in Malaysia

From Left To Right: Dr. Carol Yip, CEO of Aged Care Group Sdn Bhd, with Zoe Bettison, South Australia’s Minister of Ageing, and Geoff Holdich, Chairman of ACH Board of Trustees.

 

South Australia, 16th October 2017: Aged Care Group (ACG) and ACH Group signed a Memorandum of Understanding to officialise a joint initiative to offer high standards of care to senior residents living in Malaysia.

The signing of the MOU was witnessed by the Honourable Zoe Bettison, Minister for Ageing, recognising the Office for the Ageing played an important role in developing Age of Opportunity: A Policy Framework for the Development of the Ageing Well Industry in South Australia. The MOU affirms ACH Group – one of Australia’s largest aged care organisations with over 65 years of practice, 2,000 staff across 50 locations both South Australia and Victoria – would lend ACG their experience and knowledge in developing senior living housing and aged care facilities.

This joint initiative will bring both parties to work together in delivering new opportunities for older people in Malaysia by adapting ACH Group’s proven smart partnership such as ViTA with SA Health and Flinders University, enabling us to markedly improve health and lifestyle outcomes for Malaysia’s ageing population.

The collaboration will see ACH Group participating in some of ACG’s projects to develop a care model of elder care services which meets Malaysians’ culture and diversity. ACG’s know-how of the local environment coupled with ACH Group’s years of expertise would be incumbent to the development of an integrated continuum of care framework for Malaysians drawn upon a strong community-based care model which involves the community, public and private sectors.

As ACH Group – a strong advocate of diversity in their business of care, this innovative model of care would support culturally and linguistically diverse communities and their needs for aged care in sync with Malaysia, truly a melting pot that is Asia.

Framed under existing local regulations, this bilateral relationship between South Australia and Malaysia will elevate and introduce a care model of international standards. At the same time, leveraging on ACH Group’s elder care service experience to give comprehensive guidance, coordination, cooperation and support in terms of policy update, administrative procedures and operating standards amongst others.

The successful implementation of a financially sustainable care model for Malaysians is expected to become a significant formula for more potential projects that the two organisations would embark on in Malaysia.

Affordable Housing

Paying For Aged Care: Supporting Ageing-In-Place With Healthcare & Affordable Housing

As property prices rise, the topic of affordable housing becomes an increasing concern. Factor in the growth of the ageing population and you’ve got new variables to consider when planning anything from policies to finance, housing and infrastructure. To overlook these factors is to invite a slew of social issues. As such, it is more urgent than ever to bridge the healthcare-housing divide.

In our previous article “Paying for Aged Care: The Trends & Challenges”, we discussed how the appropriate placement of seniors with the right level of care is essential to effectively managing the cost of long-term care. Whilst in “Paying For Aged Care: Can Malaysians Afford it?”, we’ve identified accessibility to care is a need regardless of lifestyle.

Affordable housing is more than merely the ability to pay off the house loan. It’s also being able to meet long-term care costs – such as assisted daily living, rehab and medical care – when needed, apart from basic living needs like food, clothing and transportation.

So the question is: how can housing for seniors be made an affordable affair?

Preference For Age-In-Place
Malaysians have a cultural preference to age in one’s own home. We would rather remain in our communities with family, friends and neighbors for as long as possible during our old age. Yet many homes and communities lack key structural features that enables seniors to live there safely and independently.

Meanwhile, family members often provide the backbone of the informal long-term care routine at home, becoming caregivers and financing the senior’s care. It costs no small amount to pay for long-term care services and support when the senior requires assistance with daily living tasks.

Hence, while ageing-in-place is cost-effective, it is only so if the challenges in our care delivery’s efficiency – which naturally affects the cost – is addressed. To respond to these challenges and create affordable housing that supports seniors – and by extension their caregivers – we must more tightly link our nation’s housing and healthcare system under an integrated care model.

Home & Continuum Care
An integrated care model for ageing-in-place is a concept much practiced in developed countries. The model integrates a network of formal home care and respite care services with day care centres, as well as nursing homes into the community – catering to moderate and severe needs alike. Continuum care is a chain of services provided seamlessly from the moment one needs care till he/she no longer requires it is.

Embedding continuum care into communities would enable better utilisation of financial resources when households seek out care services, thus mitigating unnecessary spending arising from inappropriately allocation of care. In developed countries, day care centres are cost-effective alternatives to nursing homes.

For example, Singapore builds many senior activity centres and care centres as part of their initiatives for ageing-in-place within the community. The regulators aim to develop a range of aged-care services in every neighborhood to meet the social and healthcare needs of seniors, as well as to support their caregivers. This would also allow families to remain in close contact with the seniors while they are being cared for within their community.

As Malaysia is very much similar to Singapore, community-based day care centres would fit comfortably in our own integrated care model of aged-care facilities. Day care services would not only delay the need for entry into a nursing home or care centre, it is also a less costly route for seniors and their families to maintain their well-being if compared to home care – which can be more expensive due to the provision of personalized and skilled services at home. It’s a bonus that active seniors can enjoy social interactions with friends and neighbors, and learn new things to maintain positive mental and emotional health.

Setting Up The Pieces
In order to bring together a cohesive and comprehensive integrated care model while tightly linking our nation’s homes to the resulting network of continuum care, Malaysia’s stakeholders – public and private sectors alike – need to spur development of facilities, care services and new standards to uphold.

There are some day care centres for seniors set up by the Malaysian Department of Social Welfare throughout the country, however, the number are still too low and insufficient to cater to our growing ageing population. More day care centres within the community need to be built and operated by non-governmental organisations and business from the private sector.

Policy makers need to look into incentives for operators to set up more day care centres, while new standards for professional home care services – delivered by licensed home care operators – need to be designed in a manner that encourages provision of quality services at an affordable price. This would not only naturalise the use of these services by families as their first option, but also minimise the strain on limited government financial resources.

We also need to look into developing financial mechanisms that encourage sustainability of families to continually participate in the continuum care cycle. Financial support from the family may not always be possible due to the shrinking size of Malaysian families and emigration of grown children, as well as the possibility that family members may run out of money.

Examples of such mechanisms to ensure sustainability could be in the form of:

  • a means-test that determines how much subsidy each senior would be eligible for,
  • financial counseling and advisory initiatives to help families make better informed decisions regarding their ability to sustain payment for long-term care services. Or,
  • a compulsory long-term care insurance.

Conclusion
Time waits for no man, so does ageing. The question is if Malaysians can meet ageing prepared and on our own terms. The context of affordable housing has changed and the demand for ageing population is significant. We want quality communities in which to age well and enjoy life, free from deprivation of basic human needs. If we wish to age in acceptable terms, improved collaborations and efforts between stakeholders, regulators and the private sector is not only necessary, progress also needs to hasten as the window to come up with an integrated system that better connects our housing and healthcare grows short.

 


 

Source: Smart Investor, September 2017

Written By: Aged Care Group

*Quotation Source:
Yip, C. (2017). Provision of Long-Term Care and Payment Options for Elderly People Living in Kuala Lumpur and Selangor, Malaysia (Doctoral dissertation). Retrieved from Figshare Database. (MD5: 27fe2fa9e373fd58476ef48896a524c1)

Tingkat Kualiti Penjagaan Warga Emas

Harian Metro, 19 April 2017

Kuala Lumpur: Universiti Malaya (UM) dan Aged Care Group (ACG) menjalinkan kerjasama bagi membangunkan Continuum Care dalam usaha memastikan penjagaan warga emas di Malaysia diurus dengan lebih baik, berterusan dan menyeluruh.

Inisiatif penting membabitkan sektor awam dan swasta itu bagi menangani cabaran dihadapi warga emas seperti kekurangan pusat penjagaan dan kemudahan mencukupi untuk mereka, modal insan yang terhad termasuk kekurangan pakar perubatan dan pusat pakar perkhidmatan.

Menurut Naib Canselor UM Prof Tan Sri Dr Mohd Amin Jalaludin, pada masa ini Malaysia menghadapi keperluan akut untuk kualiti dan perkhidmatan penjagaan orang tua yang berpatutan.

Menurutnya, melihat kepada demografi semasa, Malaysia sedang bergerak ke arah sebuah negara penuaan pada 2030 di mana rakyat berusia 60 tahun dan lebih tua akan menjadi sehingga 15 peratus daripada jumlah penduduk.

“Tujuan kerjasama ini adalah untuk menangani beberapa cabaran dihadapi landskap penuaan iaitu kekurangan infrastruktur yang lebih mesra warga tua, bekalan terhad modal insan dan perkhidmatan penjagaan khusus yang tidak mencukupi,” katanya ketika berucap pada majlis perjanjian persefahaman (MoU) itu di sini, semalam.

Where do the private sector and NGOs come in?

By BRIGITTE ROZARIO

THERE were many questions and several business models discussed for the retirement industry and aged health care at the recent Sustainable Retirement & Aged Care Conference (SRACC), organised by Kenanga in partnership with Aged Care Group (ACG).

While the one-day conference saw many questions raised, it also offered several ideas and solutions.

During the third panel discussion on Private Sector and NGOs Getting Involved in the Retirement and Aged Care Ecosystem in Malaysia, moderator Carol Yip, chief executive officer of ACG, pointed out that the budding industry faces many challenges:

  • Human capital
  • Infrastructure – It takes at least three to four years to build a purpose-built infrastructure.
  • Legal framework – What is the legal framework you need to comply with?
  • Standard operating procedures
  • Specialised care services
  • Enforcement

From a quick survey done at the conference, it was found that participants are ready to join this industry, but many are still unclear of how to go about building the facilities and providing the services.

Slow growth

Khoo Chuan Keat, director of several public and private companies and former partner and senior executive director of PriceWaterhouseCoopers Malaysia, offered his thoughts on why the retirement industry growth has been slow:

Niche market – Because it is a niche market, people are concerned that they will only be selling to a small group of people.

Business model – There is still a lack of Malaysian tested and accepted business models. So, those who are interested are not sure how to go about it. Some are taking a wait and see approach.

Khoo pointed out that while there are no tried and tested Malaysian business models, there are many in other countries that we can learn from and adapt to suit our country.

Return on investment – Business enterprises are concerned about return on investment (ROI) and wonder if they can get the same ROI as they would from building a condominium or office block.

Tax breaks – While Pemandu, Ministry of Health, Ministry of Finance and MIDA (Malaysian Investment Development Authority) are very supportive of tax breaks for those entering the industry, we will need to wait and see if the government approves the recommendations.

Legislative framework – The Aged Healthcare Act is hoped to be tabled in Parliament before the end of the year.

khoo-chuan-keat

Khoo Chuan Keat: ‘I am always a firm believer that the industry must drive the legislation, and not the other way around.’

“I’m very worried that if we leave it to somebody in Putrajaya to draft those legislations, without experience in the market place, they are likely to put everything, the worst of the lot that they can pick from all the other countries, just to cover themselves, to make sure that everything is so overly stringent that it will stifle the industry in its infancy. In this context, I am always a firm believer that the industry must drive the legislation, and not the other way around,” said Khoo.

No incentives

Tan Sri Datuk Dr Abu Bakar Suleiman, president of International Medical University, chairman and director of International Medical Colleges Malaysia, explained that aged healthcare did not just pop up overnight. The government has been talking about it for the past 20 years or so, but nothing concrete has been done.

He was the director-general of health with the Ministry of Health from 1991 to 2001.

“I think there are two things that are important in terms of funding. The health financing system has to be developed through a health fund. The proposals have been there for the past 20 years. Hopefully something will come out of this. The importance of this is, how does the coverage for the aged group be translated into the services? If you look at the policy now, we want good access, we want continuous, committed and integrated care from the living end to the end of life. So, how do we translate it?

abu-bakar

Tan Sri Datuk Dr Abu Bakar Suleiman: ‘We have to be creative, we have to be disruptive, and the care model cannot be around doctors or nurses, but based around the elderly and their families.’

“We have to be creative, we have to be disruptive, and the care model cannot be around doctors or nurses, but based around the elderly and their families.

“This is tough, but we’ve got to do that because if the healthcare system that we want to develop through a new funding system is based on the existing system, it will be a wreck. It will not be sustainable,” he said.

According to Dr Abu Bakar, the capability for technology-enabled care is already available but nobody is using or implementing it because there is no incentive to use it.

He highlighted that the truth is everything in the hospital can be brought into the home, and this is how we can keep the cost down.

“Around the world now, what we are fighting for in healthcare is safety and patient-centredness. Doctors are trying to learn this very late in the day. How do we get individual-centred services to people where they want to be. Let’s have care in the institution, care in the community and care in the home. So, there are actually market segments that we can address,” he said.

Complacency and sustainability

Tan Sri Dr Ridzwan Abu Bakar, cardiologist, executive chairman of Pacifixhealth and one of the directors of Cyberjaya University of Medical Sciences, said that the country has been slow to move so far because of complacency and sustainability.

“We are very complacent. This morning we heard speakers saying that we’re going to be an ageing nation in five years’ time. Now, that’s not a figure that’s been plucked out of the air. We will hit that figure in the year 2020. So, we’ve got five years. Have the government agencies, has the public been made aware of that – that in five years we will be defined as an ageing nation? I think that’s where we are a bit complacent.

“The other aspect about complacency is the particular setup that we have in this country. Most of us have elderly to take care of, but we also have an inexpensive way of doing it and that is by getting maids. So, many of us would hire maids, mainly from the Philippines and Indonesia. By paying for a couple of them, they would look after the loved ones at home, therefore keeping to the eastern philosophy of filial piety.

“So, that’s been the ongoing solution so far, but as we all know this system of getting maids in is going to be a big problem in the near future. Therefore, there is a demand very soon for an alternative way to look after the elderly,” he said.

According to Dr Ridzwan, the other reason why Malaysia has not moved faster into aged healthcare is sustainability, not just from a fiscal standpoint, but also from a provider’s view.

ridzwan

Tan Sri Dr Ridzwan Abu Bakar: ‘Is there a sustainable workforce that can look after the elderly that we want to take care of?’

“Those who are going to provide the services … can they sustain it? So, we’ve got to look at the workforce, for example. Is there a sustainable workforce that can look after the elderly that we want to take care of?

“Then there is the social sustainability part – the expectations of the country as to how they look after the elderly. These are the additional issues that we want to think about,” he said.

Which model?

Yip asked the panellists which model Malaysia should look at in terms of financing, where to start and who developers should partner with – the public sector, other private companies, or NGOs.

Khoo believes no one model will suit the needs of all. Malaysia will need to adopt several different models depending on the developer’s perspective and preferences. Some developers may only want to build and not manage it, in which case they may partner with an operator. Others may prefer to build and manage it. And, a third group may want to build, own and rent.

Dr Abu Bakar said that Malaysia should learn from others’ experiences and understand the model and see what we can do. But, before we decide on the business model, we first need to know what is the role of the public sector, the private sector and where does the public-private type of partnership come in.

He advised developers and operators to look at Eden on the Park in Kuching to see how they have done it and learn from them.

Khoo, who was involved in the Eden on the Park project, explained that it is a co-location model. It offers active independent living, just like any of the high-end condos in the cities. However, it also has aged-friendly features to provide residents with the opportunity to age in place. That means, if you move into that facility, you can stay there until the day you go.

According to Khoo, places like Eden on the Park focus on the lifestyle. That is their selling point.

“The people behind that project are nobody, they are not the big boys in town. They are just a group of passionate people who are prepared to put their money where their mouth is. That is where I see this industry being driven. It’s the smaller boutique developers who will say, hey, I can’t beat the big boys. If I build one condo, they are going to build five condos. So, I am going to play the game by focusing on a niche market that they may not get into yet,” he said.

According to Khoo, businesses need to cater to the middle income group. Those in the lower economic bracket will need government help, while those at the other end of the scale will be able to stay anywhere as they can afford it.

“I think the target market that we are looking at as a business enterprise is the 35% between these two groups. That itself is a big, big market for which we have very little alternatives right now,” said Khoo.

Dr Abu Bakar shared his experience with the National Kidney Foundation, where he is president of the Board of Governors.

According to Dr Abu Bakar, Malaysia is able to keep the cost of haemodialysis down because the public sector, private sector and NGOs work together.

“The public sector provides just under 40% of the services. The private sector, hospitals and clinics, provides a bit over 30%, and the balance is provided by the NGOs.

“The funding total – 70% is provided by the government. They provide the funding directly and through insurance and subsidies.

“As for the National Kidney Foundation, we raise about RM6 million a year through donations. From the RM50 per dialysis the government provides for patients who need the help, we receive the funds for that also. Whatever else we have to do, the patient pays only a bit.

“The NGOs’ contribution has a multiplier effect because most of us serving there donate our time and our expertise. I think we can learn something from this for aged care,” he said, explaining that he sees the aged care industry following a similar pattern of government, private sector and NGOs working together to cover the needs of all Malaysians.

The question of funding

Yip believes that while everyone is ready to start building the facilities, funding is still a big question mark.

Khoo expressed his opinion that there is a future in private equity.

“I’ve spoken to some private investors as well. They are also getting to be interested. The only thing is, they want to see a track record, they want to see an annuity of income. We don’t quite have that yet,” said Khoo.

He pointed out that investors also want to know what the exit strategy would be.

Dr Abu Bakar offered many suggestions to make aged healthcare more affordable.

“The issue right now is the services are not sufficiently patient-friendly or patient-centred. In fact, far, far from it. For example, can the hospital provide services outside the hospital because we have the expertise,” he said.

He suggested having video-conferencing or sending the doctor-nurse team to the home.

“That will not be an issue, but the long-term is a problem. How do we look at that? How do we fund that? And, I think we need to have a different business model for that because what you want is 24-7 and not transaction basis. That model is not there, doctors are not familiar with it,” said Dr Abu Bakar.

Dr Ridzwan gave the conference a very sobering look at the industry. He informed that despite heavy government funding, only 70% of aged care facilities in Australia are profitable. He said that 30% of them don’t make money at all.

“So, there are other problems involved that need to be addressed. In Malaysia, I think the additional problem is the legislative network. For example, if a facility is sold to an aged person, what happens when he passes away? The laws on inheritance in this country are pretty complex, depending also if you’re following the Islamic law or even the ordinary inheritance law. How do you prevent that aged care facility from passing on to a yuppie who wants to convert it into a normal condo? These are the things that we need to address. Maybe developers will say that they have the right of first refusal. I believe this is easier said than done. The laws in this country do not provide for the fact that if you set up a retirement facility that you can maintain it with subsequent generations. I think that’s another area to look at,” he said.

He pointed out that many developers may be waiting for the Aged Healthcare Act to come into force because they don’t want to run afoul of the law.

Both Khoo and Yip believe that developers need not wait for the Aged Healthcare Act, as it is merely a step down from the Private Healthcare Facilities and Services Act.

“As long as we comply with the Private Healthcare Facilities and Services Act, we will definitely comply with the lesser Act. That is what Eden on the Park has done – they opted to go for the gold standard,” said Khoo.

Dr Abu Bakar said that the aged care industry is now at the same point as the private hospitals were in the 1960s and 1970s when nobody wanted to build hospitals.

“So, who built hospitals? The doctors. Pantai Hospital was built with RM1 million by the doctors. Nobody else wanted to invest. They showed that it’s a viable business. After that, others came in.

“We are now in that stage of the game,” he said.

Sustainable retirement income – myth or reality?

MOST Malaysians are not prepared for retirement and ageing. Pension and EPF (Employees Provident Fund) will only take them so far and with the average lifespan for Malaysians estimated at 75 years, many will have to rely on family, friends and charity in the last years of their life.

Seeking to change this scenario, the panel discussion at the Sustainable Retirement & Aged Care Conference (SRACC), organised by Kenanga in partnership with Aged Care Group (ACG), delved into the topic of “Malaysia’s Financial Options for Retirement and Aged Care to Ensure Lifelong Sustainability”.

Moderator Carol Yip, the chief executive officer of ACG, outlined the current Malaysian retirement system based on the World Bank’s pension conceptual framework:

  • State
  • Pension for civil servants – mandatory
  • EPF – mandatory
  • Savings, insurance, unit trust, properties, PRS (Private Retirement Scheme), other investments – voluntary
  • Family, community, charity – voluntary

“We would like to see how financial institutions can work together because moving forward we need to have the money to sustain our retirement.

“In order to have a sustainable retirement, we have to continue saving our money. The question is how do we help Malaysians put it aside so that they will not use it until the day they need it to pay for their aged care services,” asked Yip.

Multilayered replacement income

Balqais Yusoff, head of EPF’s Strategy Management Department, said that EPF believes that in order to sustain financial security, Malaysians must have a replacement income after retirement.

“We believe people should have multiple sources of income to cover themselves, because when they become aged, they will need to have more income as they are no longer productive. So, they need to have an income to sustain their basic needs, wants, as well as the rising medical costs.

“Right now, in Malaysia, we are seeing an increase in life expectancy whereby the average life expectancy is 75. How do you accumulate your wealth during the 30-35 years of working life and can it cover the years after retirement?” asked Balqais.

Yip pointed out that there is a segment of society that wouldn’t have sufficient or any EPF savings. This includes homemakers and the self-employed who often do not make contributions.

Dato’ Steve Ong, chief executive officer of the Private Pension Administrator Malaysia (PPA), which is the independent central administrator for the PRS, said this is where savings comes in.

“The big consequence is not that at age 60 you stop work; it’s that you stop earning. The minute you stop earning, your income stops. That is the crux of the matter.

“All of us who are employed are gainfully earning our income and that supports our housing, healthcare and lifestyle.

“So, when you stop working, it means you stop earning and you stop that income stream. You need that to have savings to generate a passive replacement income. We have to educate the public to really get the message across that EPF savings at the moment isn’t even enough. For those who withdraw their EPF money end up spending it all within five years, while their retirement might go on for 20-25 years,” said Ong.

He explained that this is where PRS can help as it offers Malaysians a way to save their money for retirement.

“PRS is not a product. It is a voluntary national scheme. It addresses the need to provide a formal voluntary pillar so that people can have the confidence that it is safe, regulated, and provides a system for private employees who have EPF but still need to top up; for civil servants who retire and have pension which is still insufficient; and for the self-employed who may not be contributing to EPF or putting money into the bank.

“We have various savings vehicles in the country. The question is, are they designed specifically for retirement? If not, then the issue is simply this: Most of the money that people save is in the banks. What do they do? It’s like a giant cookie jar. When they need money, they take it out. They take, take, take and what’s left is for retirement. It’s inadequate; it’s insufficient; and it’s not sustainable,” he said.

What about the role of insurance? Anusha Thavarajah, chief executive officer of AIA, said that 20 years ago, Malaysia was still a very young society and one where the family network was very strong. Because of this, we never worried about retirement. We assumed that our children would look after us. However, society has changed a lot in the last 25 years, and the baby boomers increasingly want to take care of themselves as they age instead of relying on their children.

Quoting Martin Luther King, Jr., Anusha said, “It’s the quality and not the longevity that is more important in people’s lives.”

According to her, it is important to create awareness on the importance of having enough.

“Today, what we want to do is make people aware that it’s important that they have enough. We’re teaching our distributors that when they meet customers and friends, they have a social obligation to make sure that their friends and family are adequately protected,” said Anusha.

Cohesive system

Yip asked the panellists if financial institutions can work together to make it easier for the elderly, so that when the money is needed, it will almost automatically pay for the care and services. This way, the elderly don’t have to think about which stream to get their money from – EPF, PRS, insurance or unit trust – as all of these would work together seamlessly to pay for the elderly’s needs.

According to EPF’s Balqais, the government is trying to establish a national social security task force to look at an integrated ecosystem. “That will cover not just healthcare, but also basic income security for working aged people as well as care for the aged. It will be a concerted effort that will require working with employers, employees, NGOs, academia as well as financial institutions to develop more products for pre and post-retirement.

“The national social security task force will look at this whole ecosystem and work with all the stakeholders to minimise duplication of efforts currently being undertaken by various agencies and also duplication of benefits. It will address basic poverty eradication and guarantee a comfortable lifestyle, especially for the aged,” said Balqais.

Toh Puan Dr Safurah Jaafar, director of Family Health Development Division with the Ministry of Health, said currently more than 70% of the elderly are sourcing medical care from the government.

“That limits their choices in terms of care and facilities. I think, if only they have the savings then their choice is bigger. How do you facilitate that?” she asked.

According to AIA’s Anusha, more and more Malaysians are buying private health insurance, which has extended its coverage in recent years.

“Originally, the insurance cover expired at the age of 60, then it became 70. Today, people are covered till the age of 100. So, basically people are covered for life. I think it comes back to awareness and making people understand that they can buy healthcare insurance,” she said.

Explaining one of AIA’s products, Anusha said that the public can buy a policy where they pay very minimally for the premium while still employed because their employer has group insurance coverage for all employees, so they wouldn’t need much cover then. But, when they retire, the cover then drops down to the first level.

“So, in post-retirement you continue to have this insurance coverage that you bought yourself which didn’t cost much initially and you continue to be covered until the day you die,” she added.

Anusha believes it all boils down to raising awareness so that the public knows what products are available to help them save for retirement and which ones offer them the best coverage in old age.

The public also needs to be educated on how to accumulate money while working and the decumulation after retirement. PPA’s Ong believes that it boils down to money management.

“As to who is going to manage this money … it’s very personal. I think most of us would like to do it ourselves until we can’t. In the case of when you can’t, because you are disabled or have dementia or some other serious illness that prevents you from making a conscious decision, the good thing about our society is we still have our family members.

“I think, that is our first line of defence because we have family members whom we can trust. Failing which, we would have to go to an outside party called a trustee. If you go to a trustee, then there are pros and cons. The advantage is that you can define what the trustee is going to do with your money, the disadvantage is the cost of doing that and losing flexibility because basically you are giving ownership of your finances and properties to an outside party,” he said.

Suitable model, products

In developed countries, the decision of who should manage your money is taken out of the equation. According to Yip, in those countries, the government takes on the responsibility of managing the money for the people.

“When you need it, they see how much you can afford to pay. Then, the government either subsidises or pays 100%,” said Yip.

She questioned if it is possible to have a similar system in Malaysia, with a central administrator working with the financial institutions.

Balqais explained that that type of system is quite different from the one we have adopted in Malaysia, and while it has obvious advantages, there is also a high price to be paid.

“In Scandinavian countries, for instance, the rights of the people are protected at various levels in terms of healthcare, education and maternity. So, when a person retires, they have a sustainable income because the income will come for life.

“But, in Malaysia, we are operating under a defined contribution system whereby there are no defined benefits. In most developed countries, there are defined benefits where you know you will be getting some sort of pension but that system has some concerns in terms of financial sustainability because of the demographic shift.

“But at the same time we also see a trend of high tax rate. In UK for instance, it is 40% and in some Scandinavian countries it is 60%. Are Malaysians ready to pay that kind of high tax regime to finance a defined benefits contribution system?” she asked.

Another option that the financial industry in Malaysia might look into is reverse mortgage since Malaysians still believe in buying property.

Yip questioned if it is possible for those who have properties to use reverse mortgage to pay for their care in their advancing years. According to her, this is one of the products that Singapore is trying out.

Anusha pointed out that reverse mortgage, which is currently not available in Malaysia, has its pros and cons.

Sharing her experience in the UK about 20 years ago, Anusha said a lot of elderly were real estate rich but cash poor there. They would buy a product called equity release where the insurance company would pay them about 70% of the value of the property. Some of the aged who took equity release used the money to enjoy the remaining years of their life. However, there were also cases which did not have a happy ending as the elderly failed to inform or explain their decision to their family members. When they died, their family members became very upset that the insurance company suddenly owned their parents’ houses.

Nonetheless, Anusha believes it is something that can be looked into here. “Perhaps back it with an annuity for life so you don’t give out a lump sum but have an income for life.

“Then when they pass away, the remaining value of the property goes back to the family. But it’s important that family members understand what’s happening,” she said.

While she believes reverse mortgage is a good product, Balqais reminded the floor that we have to look at it from a cultural context. “Are we ready to not have home ownership? Culturally, people want to own a house. At the same time, are financial institutions ready to offer this kind of long-term payment? In terms of take-up rate, we have to question and study that because the public may not be as prepared as the financial institutions,” she said.

PPA’s Ong agreed with Balqais, saying that for most Malaysians, our home is our biggest asset. He also believes that reverse mortgage works only if you have a debt-free property.

“The other thing about relying on your property to fund your retirement is that it’s not a surety because property values may fluctuate, depending on the location you are in and the property cycle. That’s something we have to keep in mind,” said Ong.

Conclusion

Having listened to all the possible financial solutions, Dr Safurah said she feels hopeful about the future of the elderly in our country. However, obviously a lot more needs to be done and inclusivity should be a priority.

“We say the product is not the main focus but I think at the end of the day, it still is because insurance companies do focus on very defined items that you can reimburse. We may lose a big portion of some groups of the aged who are not supported. Unless they are very ill, then only the insurance companies come in.

“How about those who are no longer earning but need insurance support to keep them well and prevent them from falling sick? I hope that that kind of product is something that financial companies can look at,” she said.

While Malaysia needs to find the right products and model to help its citizens save up for their retirement years, there’s no denying that awareness and education are equally important.

According to Balqais, the root cause of people not having sufficient savings is financial literacy. “The financial literacy rate in Malaysia is still very low. People do not understand about insurance – why do I need to pay when I’m not sure I’m going to get the money back?

“So, when we speak at public briefings, members of the public say they don’t want insurance because they would have more money without it, but in the event of financial shock or distress because of medical illness, they do not have sufficient savings,” she said.

She talked about EPF’s Retirement Advisory Services which offers free financial planning to the public. She hopes that this will help raise the financial literacy rate in the country.

It is hoped that with financial planning, the public will be more aware of the need to save.

As Ong pointed out, “There is no shortcut to saving for retirement. While you put money into EPF, you will still have to top up. Save more. The idea of saving more for retirement is that the money is earmarked for retirement. It’s not buying property for investment for retirement. Whether it really is earmarked for retirement is debatable. While the concept is good, you really need to have a earmarked retirement fund so that it is sufficient and it will sustain your retirement life.”

Main photo: ACG CEO Carol Yip (left) moderated the panel discussion. She was joined by panellists Toh Puan Dr Safurah Jaafar and Dato’ Steve Ong.

Stakeholders discuss building a retirement industry

RETIREMENT is not just about how much you have when you stop working. It is about your next phase of life,” said Ismitz Matthew De Alwis, executive director and chief executive officer of Kenanga Investors.

“What will you do for the next 20 years after retirement?” he asked the packed ballroom at the Sustainable Retirement & Aged Care Conference (SRACC).

Organised by Kenanga in partnership with Aged Care Group (ACG), the conference, held at the Majestic Hotel in Kuala Lumpur last week, saw representatives from the government, private sector and non-governmental organisations (NGOs) coming together for a day of discussions, networking and seeking solutions.

“Retirement is not something dull. It is not about the time when you stop working, go to day care and nursing home, while waiting to die. Retirement is the best phase of your life. It’s when you enjoy. Let’s get some colour into retirement,” he said.

He explained that even in retirement there are different stages with the last stage being when you would need more care.

There are many topics that can be discussed regarding retirement – from the financial side of things to where to live, what to do, and how to manage everything.

“This is a big topic to cover. We have a lot of questions. We hope from today we can start sharing that retirement is beyond numbers. Retirement is an industry that we need to take seriously, along with the whole ecosystem that comes with it,” said De Alwis.

The one-day conference featured three panel discussions.

The first discussion saw representatives from the civil service, private sector and government agencies talking about Malaysia’s financial options for retirement and aged care to ensure lifelong sustainability.

Can Malaysians afford to retire and how will they pay for their aged care? Will it come from the government, their pension, Employees Provident Fund (EPF), insurance, Private Retirement Scheme (PRS), savings, or all of these? Is it possible to have an integrated management system for all these, so that it is easier for Malaysians to pay for services?

The panellists explored this subject and even took questions from the floor.

The second panel consisted of foreign representatives who shared their experiences in retirement and aged care in Singapore and Australia.

The third panel discussed private sectors and NGOs getting involved in the retirement and aged care ecosystem in Malaysia.

While the conference did not conjure answers for all questions, it did start a lot of conversations and provided much food for thought.

Set the ball rolling

Panellist Tan Sri Datuk Dr Abu Bakar Suleiman, president of International Medical University, said, “In the 1960s and 1970s, no business wanted to build hospitals. So, who built hospitals? The doctors. Nobody else wanted to invest. They showed that it’s a viable business. After that, others came in.

“We are now in that stage of the game.”

While there are parties who are keen to get into the industry, many seem to be adopting a wait-and-see attitude and trying to find the best business model first.

“If we don’t build, we don’t have an industry and it becomes exclusive. When there are participants in the industry, then things will come to a palatable price. That’s what is important.

“At this moment the industry is in its infancy. We need to develop the whole ecosystem,” explained Kenanga’s De Alwis.

According to him, SRACC was held to get people from the private sector, public sector and NGOs to come together to look at the industry from a macro level and to look at building an integrated ecosystem, rather than working in silos.

“That’s why this conference is called Sustainable Retirement & Aged Care Conference and not a retirement conference. We are talking about the third phase of life, the things that we need to do to make it a colourful retirement.

“This is the next thing to come. It is going to be an industry. When the time comes, there are things that need to be catered for in this industry and we need the support of all stakeholders.

“As you can see it’s a huge ecosystem that we need to work on. We talk about government policy makers, private healthcare institutions, the entrepreneurs, the financial institutions like Kenanga, and the educational and training institutions. I think this basically will make up a sustainable aged care infrastructure,” said De Alwis.

Projects moving forward

In his keynote address, Fabian Bigar, Director (NKEA Healthcare) of Pemandu (Performance Management & Delivery Unit), spoke on “Delivering Transformation for Retirement and Senior Living in Malaysia”.

He provided the background of retirement and senior living in the Pemandu NKEA (National Key Economic Area) lab.

According to him, it is estimated that the retirement industry would create about 10,000 new jobs and RM1.7 billion in terms of GNI (gross national income) in the year 2020, when Malaysia becomes an ageing society.

After the completion of the lab, Pemandu presented its findings to the Malaysian Cabinet. Apart from the Entry Point Projects, Pemandu also requested for:

  • New act for aged care;
  • Reverse mortgages;
  • Transformation of existing old folks homes;
  • Insurance coverage for long term care and mobile services;
  • Financial incentives for the industry;
  • Trustee to manage finances for the senior citizens who are in homes; and
  • New skills standards.

“We received agreement in principle for all of this, of course subject to further discussions with the various agencies. Not everybody is moving at the same speed, so we have to leverage on those who can work faster,” said Bigar.

According to him, the Private Aged Healthcare Facilities and Services Bill will be ready for tabling at Parliament by the end of the year. However, as there are many other items waiting to be tabled as well, the Bill might only see the light of day next year.

While waiting for the Bill to be tabled, Pemandu has been working on the regulations.

“We started this year, so that when the Bill comes on stream we can enforce it in a short time,” explained Bigar.

In addition, the Department of Skill and Development has come up with the National Occupational Skills Standard (training syllabus) for the training of caregivers.

The Malaysian Investment Development Authority (MIDA) has been looking at incentives for the industry to be gazetted as a promoted industry.

While the Department of Town and Country Planning has developed “Physical Planning Guidelines for the Elderly Facilities” which will serve as a guide for the planning and designing of a senior living facility.

“These four agencies are already moving. As for the others, for example, finances and insurance, we will make sure that these things are put in place next year.

“Obviously, there is a lot more to be done. I hope at this conference we will find some clues, if not answers, on how we can move this agenda forward,” he added.

Innovation

De Alwis said the takeaway from the conference is that if you are a business owner, an NGO or individuals needing helping or who have questions related to the elderly, you would now know who to contact. ACG is positioning itself as a platform for all parties to work together towards elevating the retirement industry.

CareTRUST was derived to provide an avenue for those in the financial line to help clients manage the accumulation of their money and then the decumulation after retirement when they need to pay for services and facilities.

This collaborative effort sees more than 12 unit trust companies, four insurance companies and seven PRS providers on the bandwagon so far.

With ACG as the Care Administrator, CareTRUST would also see to it that the client’s wishes are fulfilled in terms of how they want to be cared for and where they want to live, when they are no longer able to execute these decisions for themselves.

This is just one of the new products targeted at retirees. De Alwis added that the retirement industry will spur product innovation. “It is something that we will continue to search for at Kenanga, be it within our group or working with various partners. It doesn’t matter if the money goes here or there. At the end of the day, we are enlarging the pie.

“We just need people who are brave enough to join in to build the industry. It’s not difficult and it’s not just to cater to one part of it. It’s a big part of the economy. It also can be very profitable if it’s done correctly. It’s an industry by itself.

“We need to create a retirement industry, then everything will come into play. There are various programmes now like Malaysia My Second Home, but everything needs to link together. We have to look at the whole ecosystem of retirement.

“On top of that, when we have more retirement products and services, of course, the cost will come down. It becomes a commodity. But, at this moment, no one dares dabble into it. If you look at it, five years down the road is a very short time, but in 10, 15 years, this will be a booming industry.

“We are quite excited. It creates more dynamism in terms of how we treat this product-wise and services-wise,” said De Alwis.

ACG chief executive officer Carol Yip pointed out that some parties in the country are already building facilities and offering services for retirees. However, demand is still more than supply. To speed things up in time for 2020, more players need to enter the market place. This would reduce the cost, and these facilities and services would then be more affordable to the masses.

Conclusion

Speaking to reporters, De Alwis said that this year’s conference was more of an introduction to the infant industry, and next year should see a drill down to more intense topics.

“We hope to see that there is growth and development, and we will be able to share more, get more speakers and expertise coming in to provide more advice.

“Once retirement becomes an industry, Malaysians will take it more seriously and the whole ecosystem will fall into place. Our theme today is ‘A shared synergy towards an integrated ecosystem’. For an integrated ecosystem all the stakeholders have to come together in their own way. Like a jigsaw puzzle, all the pieces must fit together,” concluded De Alwis.

Main photo: Ismitz Matthew De Alwis, executive director and chief executive officer of Kenanga Investors, presenting his keynote address at the Sustainable Retirement & Aged Care Conference.

Providing a platform for aged care services

THE time for creating awareness is past. Now is the time for us to educate families on the type of quality care needed for their elderly parents and where they can go when they need help.

“No matter how much we want to advocate holistic care services for the elderly, one of our biggest challenges is education. We are no longer talking about awareness because I think a lot of us know what type of services are available here compared to the western countries and that we are about 30-40 years behind them.

“It’s about time we educate the adult children because they are the pillars of the aged care for their elderly parents.

“Is having a helper to take care of your aged parents good enough? Does it help to give your parents quality of life?” asked Carol Yip, Aged Care Group (ACG) chief executive officer.

She was speaking at the 11th National Geriatric Conference organised by the Malaysian Society of Geriatric Medicine at the Grand Seasons Hotel in Kuala Lumpur, where the theme was
“Grey Matters: Sifting the Evidence to Optimise Care”.

According to Yip, her first priority is to educate families, in particular adult children, on what needs to be done and what is quality care. From there, they need to know where to go to get such quality care.

She emphasised that government, private sector and non-governmental organisations (NGOs) should work together to provide such services as well as inform families where they can obtain the necessary assistance and care in each state.

She informed that getting help for the elderly is not so straightforward because sometimes the elderly themselves do not want to come forward to get the care and help that they need. It might be that they don’t want to pay for the care, they can’t afford it, or they don’t want to inconvenience their family members who might have to pay for it.

So, what happens? They suffer in silence.

Senior living

Yip, who was involved in a senior living laboratory facilitated by the Performance Management & Delivery Unit (Pemandu) in 2012, said that while there is a very small number of licensed homes for the elderly, there are many unlicensed ones.

This is not helped by the fact that there is no one legislation to regulate the care centres and nursing homes in the country. Currently, there are two Acts governing the care centres and nursing homes in Malaysia – the Care Centre Act 1993 (Act 506) which regulates the care centres and is under the purview of the Welfare Department; and the Private Healthcare Facilities and Services Act 2006 (Act 586) which regulates the private nursing homes.

According to her, one of the most important outcomes of the Pemandu lab is the impending Aged Healthcare Act which the Ministry of Health (MoH) is now working on.

With one Act to govern all the elderly care centres and nursing homes, there will be better adherence to regulations and a rise in standard of living in such homes.

According to her, there is still much to be done as the aged care industry is in its infancy here. Business investors know that the aged care industry is now ripe for picking. It is just a matter of finding the right model that gives them the return on investment.

While property development has been a booming market in Malaysia over the past 50 years, the area of senior living has sadly been neglected until now.

“In any township you must have a school and a hospital, but how about a registered nursing home? The problem is that it’s not in our township regulation guidelines. So, it’s really up to the property developers if they think they want to provide that type of facility in the township,” said Yip.

She revealed that in the pipeline are town planning guidelines that look into the inclusion of nursing home facilities.

But, nursing homes are not the only type of senior living facilities needed. The other models that need to be looked at are home care, day care and retirement villages.

“And there is the integrated residential care centre (IRCC) instead of the nursing home. Nursing homes make people think of old folks homes.

“The IRCC would be purpose-built homes for the elderly which can look as good as a hotel. It can also be rated two, three, four or five-star, depending on what facilities and amenities you provide.

Then we have step down care, rehabilitation care, palliative care, and more importantly, dementia care.

“If you look at Malaysia now, how many dementia care centres can you find? Sad to say, we have less than five. Whereas in Singapore, I was told, there are at least 15,” said Yip, noting that dementia care is another area that the country needs to look into.

She revealed that during a recent meeting with the MoH, there was mention of dementia care centres. However, such a centre would need specialised medical practitioners and a special licence.

“If I were to build a four-storey building with about 200 beds for the elderly, focusing on dementia care, can you imagine the manpower I would need … the skills, the doctors, the therapists, and where would I look for them?” she asked.

Staffing is not a matter of just hiring foreign workers or even new graduates. In the area of elderly care, it is key to have experienced personnel and skilled workers.

This is why ACG is also working with hospitals, universities and NGOs to find, train and develop the necessary skills for aged care.

“We want to be a platform where we can collaborate with all the medical practitioners, hospitals and geriatric doctors,” she said.

Day care

As for those who prefer home care, Yip questioned how qualified helpers are to take care of the elderly, not just physically but medically, socially and emotionally as well.

“Perhaps a day care centre might be an option. Just like a child care centre, but for old folks. A place where you can drop off your parents when you go to work, and take your parents home after work,” she said, highlighting the need for day care centres.

Of all the senior living facilities, the day care centre would be the easiest to set up as you can have it in an existing neighbourhood clubhouse or a shoplot, unlike building a brand new retirement village or an IRCC.

Yip explained that ACG focuses on the mental, social, physical, emotional and financial aspects in all its programmes.

“Why do we want to do this? We want to transform the perception of ageing in Malaysia. We want to be the preferred choice in enriching the lives of the elderly in the space of continuum care, that means from home care right up till end of life care.

“Our philosophy is that whatever care plan we come up with must always feature these five areas.”

According to Yip, the financial aspect is the biggest challenge in the aged care industry.

“In Malaysia, sad to say, our retirement planning depends on ourselves. We have to save enough money for our retirement and aged care,” said Yip.

Having been in financial planning in the early years of her career, Yip has noted that many Malaysians don’t think about their old age care and how much money is really required for it.

In her doctorate thesis, on how senior citizens pay for their aged care, Yip has found that 100% of those surveyed don’t have EPF savings, while more than 90% depend on their family members.

She informed that insurance products in Malaysia currently do not allow any claims for old age care.

“We are now working with financial institutions to help our clients, and for all of us, so that we know when we have to go to a nursing home, we will have money to pay for it,” said Yip.

She emphasised that ACG wants to work with everyone in the healthcare and aged care industries to come up with a structure, a system and a platform to improve the aged care services in the country.

“Let’s move forward by putting in a system for our elderly parents,” she said.

DF Pharmacy helps monitor food intake, weight

SENIOR citizens don’t just need to take the right medications and dietary supplements for optimal health. They also need to get the right nutrients, especially if they are recovering from ailments.

With this in mind, Aged Care Group (ACG) and DF Pharmacy recently signed a Memorandum of Understanding (MoU) to provide easy accessibility of healthcare services to the community.

The MoU was signed by Jeff Kong Jiang Foong, DF Pharmacy managing director, and Carol Yip, ACG chief executive officer.

The collaboration aims to provide a holistic approach to elderly care in terms of dietary needs. At the signing ceremony, Kong explained that DF Pharmacy Dietetics Services will help the public, especially the elderly, monitor their food intake and weight. This service will ensure they have the necessary nutrients to recover from ailments.

“People are growing older in Malaysia, but we do not have enough aged care services for them. ACG offers a good platform for professionals to come together to provide a better lifestyle for the elderly in Malaysia,” said Kong, adding that DF Pharmacy hopes to play a more active role within the aged care sphere.

DF Pharmacy’s website can be found at http://www.dfpharmacy.com/.

Get healthy with ACG’s Silver Fitness Programme

AGED Care Group’s 12-week Silver Fitness Programme kicked off successfully with an introduction and demonstration at the Super Pharmacy Megastore recently.

Shoppers were introduced to the programme which promotes physical health and fitness among the ageing population.

The collaboration between ACG and the pharmacy saw Super Pharmacy giving away tins of oat milk to shoppers who registered for the programme during the promotion.

The introduction at Super Pharmacy allowed elderly shoppers to experience a variety of exercises. They even had a chance to learn how to use a resistance band, medicine ball and other exercise items.

Among the more challenging exercises they tried out was running on the spot with dumbbells, balancing on a wobble board and co-ordination exercises.

“I think all the exercises are good for body fitness, but we have to continue doing these exercises in order to make ourselves fit,” said Richard Tan, 63.

He believes the programme is good for health, especially for those who are ageing and living a sedentary life.

Interested in the “12-Week Silver Fitness Programme”? Call (03) 2142-1666 or (010) 213-5023 for more information, or surf to http://agedcare.com.my/products/12-weeks-silver-fitness-programme/.

  • Page 1 of 2
  • 1
  • 2
WP-Backgrounds by InoPlugs Web Design and Juwelier Schönmann