Category Archives: Think Piece

We deliver insights on trends, practices and ideas about senior living and aged care.

Healthy Ageing in ViTa Facility

Healthy Ageing: Turning Conviction In Care Into Reality

Aged Care Group (ACG) achieved a new milestone with ACH Group – Australia’s leading aged care organisation – to provide innovative care for diverse markets and healthy ageing.

In conjunction with the collaboration, the ACG team had an opportunity to tour some of their aged care facilities. In an interview regarding their experience, members of the visiting team shared aspects of ACH Group’s care delivery that were adaptable in Malaysia and unique to them individually.

Branding Aged Care Articulately – Reeca Lim

For Reeca Lim, ACG’s marketing professional who conceptualises design and development, the tour was a chance to study the success model of care in a developed country, how it articulates their delivery of care and the distinctive approaches in cultivating aged care branding and prominence, as well as its impact on people.

The brand isn’t just about the building, it is about the continuous endeavours in developing and improving a comprehensive innovation framework (from software to hardware) and ensuring the message is effectively relayed to the public. This garners their stakeholders’ involvement to create changes that add value to the ecosystem.

What stood out was how aged care is expressed and communicated to people. There is a dedication to the philosophy of healthy ageing and that care comes first, which is deeply internalised within the organisation from the grass roots to top management.

That philosophy; conveyed via service design and product innovation that is supported with evidence-based research is the pillar to success.

Care Is About People – Paramjit & Tze Lin

Malaysia’s approach in healthcare has typically revolved around being illness-centric, but there is a paradigm shift of living better and not just longer. Nurse Manager, Paramjit Kaur stated that the approach in aged care has to focus on restoration, rehabilitation and supports healthy aging.

According to her, the best practices revolve around a person’s right to make choices for themselves. While healthcare providers give support by providing the necessary services, there must also be an emphasise on the care recipients’ participation to put effort into being healthy.

At ACH, residents are encouraged to view ageing as a journey, not a destination. This cultivates a mindset to be healthier and as independent as possible which is reflective in their involvement in social activities etc.

Additionally, the homes didn’t seem institutionalised. There are signs of the personal touch everywhere in the way the rooms were done up. No two rooms are the same and there is a homely atmosphere all around. The residents are well dressed and groomed, and had varying meal times to suit their needs.

This practice emphasises the care recipient’s restoration, not institutionalising them.

Registered nurse and care administrator, Tze Lin echoed her agreement with this sentiment, stating that parties who are interested in the aged care business need to perceive the elderly as unique individuals with their own goals in life – not as statistics – and then provide the conditions that will allow them to maintain their dignity.

Is important to embed such a culture in your team and organisation as it will be reflected in the service provided and the care that people receive. For example, developers need to be mindful when designing the space and layout of a facility centre. If you’re building a facility for dementia patients, space needs to be taken into consideration as dementia patients value space.

She also stated that inter-professional learning – between medical and non-medical disciplines – need to be cultivated to ensure there is a continuity or integration of care. This would also lead to aged care offerings that are disruptive to the norm, spurring innovative solutions that improves the quality of care for the elderly.

Adapting Operational Practices & Culture Specific Care – Derrick Chan

Quality standards are fundamental in the provision of service. Having shadowed and observed the day-to-day operations in a residential aged care facility, Derrick Chan – who conducts Research & Development in aged care affairs – stated that some of ACH’s standard operating procedures could be adapted in local practices.

This includes activity planning, meal preparation, care provision, health and safety, equipment usage, front and back office management, staff planning and so on.

The similarity in what ACH practices and what we want to achieve overlaps in terms of the services, procedures and the administration required to ease a care recipient’s transition from the home to an aged care facility. For example, the utilisation of financial planners and downsizing consultants.

Another aspect of ACH’s endeavours that struck a chord with Derrick was the provision of care to diverse cultures and how talents are developed to ensure sustainable human resource.

There were programmes created as part of the good practice in aged care. For example, ACH Group has cultural-specific programmes that engages groups of participants from varied cultures to promote diversity in aged care, such as the Cambodian and Muslim community programmes. I believe this is relevant to Malaysia’s cultural experiences.

There are also tailored programmes designed to equip staff and volunteers from across the organisation with skills and specialised knowledge to carry out their duties. ACH Group has a Dementia learning programme which trains providers to enable people living with dementia to live a good life.

Moving forward in Malaysia, a dementia specialist advisory service can be setup as there is a lack of expertise and services in this area.”

Melinda U: Conviction In Care, Not Convenience

Given the similarities of the care delivery models and practices, General Manager of Managedcare Sdn Bhd, Melinda U shared her interest in understanding how ACH Group has come to refined their model over the course of their 65-year experience.

Similar to Managedcare has done, ACH Group has made partnerships with universities for initiatives such as their ViTA project. I wanted to know in detail what did these partnerships entail, what is the business model and what were each party’s role in it. I also wanted to know the operational details of running an aged care facility on a day-to-day basis, what went well and what pitfalls to avoid. So when we operate our own facility, we’ll know how to do it right.

She further stated that the basis for any operational designs and their subsequent modifications comes down to embodying the concept of person-centred care.

For example, ACH assists people to retain their previous lifestyle and take steps – such as providing transport – to achieve it. They don’t turn life upside down just because its more convenient. Operations flow according to the care receiver’s rhythm.

There are challenges for organisations and businesses to balance operational and cost efficiency, but it can be done while maintaining sustainability. So for us it’s important that no matter how we balance these factors, we must stay true to what we believe in and keep our priority in line with our beliefs.”

In conclusion, we can look forward to the outcomes of this partnership as the synergy between the ACG and ACH Group’s care model and practices will open Malaysians to new possibilities of quality care.

Dementia

Paying For Dementia Care – How to Plan Ahead

In 2015, the Alzheimer Disease International’s world report had estimated that 46.8 million ageing people worldwide were affected with dementia, Alzheimer’s disease, and other related memory disorders, with the majority of 22.9 million people affected residing in Asia.

The numbers were estimated to double every 20 years, with the number reaching 131.5 million by 2050. That is one new dementia case in every 3 seconds. In Malaysia, the last estimated number of dementia cases is projected to reach 261,000 in 2030 and 509, 000 in 2050. The estimated cost for dementia care is said to reach 705 million in USD.

Depending on the stage of these diseases, dementia individuals may require 24-hour supervision or care. With medical inflation being 10 – 15%, the cost for care is growing steeper. For the vast majority, family members – and sometimes friends – are the main providers of care is provided by friends. However, what happens when there isn’t enough money to pay for care?

As September 21st is World Alzheimer’s Day, it is prudent that we consider our potential encounter with dementia and make appropriate counter-measures. Hence, it is helpful to understand the different types of dementia, its varied stages and what to expect in order to make feasible financial plans if/when one faces dementia – be it for yourself or a loved one.

 

Dementia Types
Dementia is an umbrella term that describes a group of symptoms caused by many diseases associated with an on-going decline of the brain and its abilities. Dementia is an irreversible loss of cognitive capacity and memory, such that there is a decline in a person’s ability to function socially, physically and emotionally over time. While it usually appears in ages above 65, it should not be mistaken for simple forgetfulness due to old age as dementia is not a natural part of ageing.

As a brief overview, there are several types of dementia. However, the most common are listed below in descending order:

1. Alzheimer’s Disease (AD) – The most common type of dementia which looks at the accumulation and depositions of abnormal proteins) inside the brain cells that disrupts messages from the brain to body.

2. Vascular Dementia (VaD) – Also common, this dementia type is formed by the accumulated effects of multiple Cerebrovascular accident (CVA) on brain function. It is commonly associated with hypertension, atherosclerosis and inadequate blood flow to brain.

3. Dementia with Lewy Bodies (LBD) – This is a progressive type of dementia in which Lewy bodies (abnormal deposits of a protein called alpha-synuclein) build up in areas of the brain that regulate behaviour, cognition, and movement. LBD is usually difficult to distinguish from Alzheimer’s, VaD or Parkinson’s. Some symptoms of LBD include visual hallucinations and Parkinson-like symptoms such as a hunched posture, balance problems and rigid muscles.

4. Dementia associated with Parkinson’s Disease – This is a progressive disorder of the Central Nervous System (CNS) that affects the body’s motor functioning. Some people with Parkinson’s disease may develop dementia in later stages of the illness through the accumulation of Lewy Bodies.

 

The Stages Of Dementia
There are several stages that one should anticipate when preparing to create an outline of what is needed for one’s care in terms of finances, services and products. The list below will help you understand what to expect in the following stages:

Stage 1: The Early onset
During this stage, an individual can live a reasonably normal life. The dementia individual may experience short-term memory loss and he/she may misplace, forget and lose things from time to time. During this stage, dementia is not easily diagnosed.

Stage 2: Mild
The individual starts experiencing significant short-term memory and impairment of self-care tasks that require more complex thinking skills, including organisational skills such as managing finances – e.g. paying bills and managing financial assets. Another symptom to take note of are personality changes such as a sudden lack of motivation.

Stage 3: Moderate
Apart from prior symptoms, the individual will experience difficulty with basic Activities of Daily Living (ADL) routines that people tend do every day without needing assistance such as eating, bathing, dressing, toileting, transferring (walking) and continence. At this stage, the individual is extremely dependent and require close supervision.

Stage 4: Severe
By this stage, the individual requires constant 24-hour care in ADL routines. They are unable to use or understand words, recognize family member, find their way home. They are unable to walk.

Care & Estimated Costs
Estimating the amount of financial resources required for dementia care is difficult as the cost varies depending according to dependency and needs. However, it helps to know what are the resources available and their estimate cost to better gauge dementia care expenditure.

1. Day Care Centres
Adult Day Care Centres are a viable option to seek assistance that helps the dementia individual maintain their mental health via programmes and activities, while the working adult caregiver is away from the home.

Adult Day Care Centres can charge an estimate of RM100 per day. This works out to approximately RM24,000 annually if the individual attends day care for 20 days per month. However, it should be recognised that day care centres are not able to accommodate individuals in the later stages of the dementia.

2. Caregivers
Unlike a domestic worker, a professional caregiver is fully trained to handle matters regarding caregiving. Hiring a trained caregiver would typically cost between RM15 – RM25 an hour on a daily basis. This adds up to caregiving expenses ranging from RM2,000 to RM2,800 per month.

3. Nursing Homes
Almost all nursing homes are not equipped for those stricken with Alzheimer’s or dementia. Most would not charge additionally since dementia individuals do not require more care than other nursing home residents.

According to research conducted by Care Matters in 2014, the cost for staying in a nursing home could range from RM1,200 – RM2,600 a month for basic care services in a semi-private room, while a private room is about RM2,650 to RM3,500 a month. Bear in mind that sharing a room is not always an option for individuals with an aggressive nature due to dementia.

4. Daily Expenses, Consumables & Medical Check-Ups
Effective in 2017, the EPF has revised their figures regarding daily expenses an individual should be able to afford for 20 years. The EPF website stated the new minimum threshold provided is now RM950 per month. Furthermore, on-going medication and medical check-ups is at least RM235 per session with a Specialist Consultant. Additionally, expenditure on consumables such as adult diapers is at least RM400 per month.

 

Future Prospects
The potential of encountering dementia in our latter years is a real possibility as Alzheimer’s Disease and other types of dementia is said to be one of the most rapidly growing healthcare issue facing the healthcare industry. As ‘baby-boomers’ age and our population continues to live longer, care and supervision of those with a cognitive impairment is predicted to overwhelm our health care system and budget. While there is little in the way of early detection, it is known that dementia doesn’t occur overnight and there is a grace period for us to prepare for its possible occurrence.

Families and those who find themselves facing this predicament can do two things to help relieve the stress so often experienced through the caregiving years – EDUCATE yourselves on the resources for care and the progression of the disease, and PLAN AHEAD.

As a starting point, Malaysians could seek out the Alzheimer’s Disease Foundation of Malaysia (ADFM) at www.adfm.org.my to find educational resources, support groups, events and workshops that would help provide insight on the condition.

 


First Published: Smart Investor, October 2017

Written By: Aged Care Group

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)

Care

Paying for Care: Can Malaysians Afford it?

The retirement lifestyle is all the rage these days. Based on The Star’s “Yes to villages, no if it’s expensive” report on 9th July 2017, people are beginning to view the idea of moving into retirement villages and communities that have aged care facilities – such as senior day care centres – as an acceptable lifestyle option, so long as it is affordable.

While choosing either to age in your own home or move into a retirement village is a matter of lifestyle choices – the fact is: receiving care isn’t a lifestyle, it is a need and it becomes greater as we move further along in age.

In the same report, many Malaysians express concern about whether these facilities and services are affordable as not all Malaysians will have enough savings for their old age. The general consensus being to forgo these facilities and services if they are too expensive.

However, the need for care still remains despite the lack of finances. A person with a debilitating condition – either with no family members or ones that aren’t able to care for him/her – would need to check into a nursing home.

Hence, while the retirement lifestyle is nice to have, ensuring you can receive care is a must. So the real question is: how can Malaysians afford to pay for their long-term care when they need it.

In the previous issue on “Paying for Aged Care: The Trends & Challenges”, it was identified that the major hindrance of care delivery is the existing payment options within Malaysia’s infrastructure. In defining that, we now examine the opposite spectrum that looks into the factors that impede Malaysians from being able to pay for long-term care. This is specifically in the context of nursing homes where one’s need for long-term care is at its greatest.

Financial Capability & Long Term-Care
While the infrastructure to pay for long-term care has its challenges, Malaysians also need to be proactive. We need to review our financial capability, learn to save and invest our money for old, and identify the factors that could hinder our ability to pay for long-term care.

In a recent study on “Provision of Long-Term Care and Payment Options for Elderly People Living in Kuala Lumpur and Selangor, Malaysia” (*Yip, 2017), a research on the financial capabilities of Malaysian seniors to pay for long-term care was conducted.

With a sample size of 419 seniors whose age ranged between 65 – 84 years old and living in nursing homes, care centres and at home, the outcome of the study indicated:

• 75.5% were unable to pay for their care needs,
• 10.6% have just enough money to pay for care if their needs are prolonged,
• 7.2% have savings but need financial assistance if care needs are prolonged, whilst
• 6.5% indicated they have more than enough money to last for as long as necessary.

The 75.5% were unable to pay for their care is because they did not have savings in the bank to pay for the required services. Regardless of ethnicity, there are 4 factors that contribute to the inability of this significant percentage of the senior participants to finance their long-term care needs on their own. These factors are namely:

1. The Gender Factor
Gender is one of the variables that may affect one’s ability to save and pay for care. It is possible that women – be it for traditional reasons or otherwise – may be more financially dependent on their spouses and family members. For example, if a woman undertakes motherhood they may stay at home to take care of their children instead of retaining employment. Thus, affecting their future ability to pay for care in their golden years.

Further evidence to substantiate the gender factor was in terms of percentage more senior males seem to have more than enough money to pay for care needs as compared to female elderly. The ratio being 10.14% versus 5.33%.

2. Age Defining Factor that Affects Payment Ability
There is a strong correlation between the senior’s age and their ability to pay for their long-term care needs. The study revealed that as a person ages, their ability to pay for their care decreases. The number of seniors who don’t have savings at all increases significantly to more than 80% after age 75.

Furthermore, the small number of seniors who have more than sufficient funds to pay for care needs decreases as the age group rises. These results affirm the fact that longer life spans does increase financial risks due to age.

3. Previous Occupation
The third factor lies in the senior’s previous occupation – depending on whether they worked in the public sector, private sector, or are self-employed. Where the individual worked or what was his/her previous employment prior to retirement matters as it determines the senior’s ability to save and make money in preparation for their golden years. This will undermine the impact on how long can their funds last to pay for their long-term care needs.

According to the findings, seniors who used to be employees (73.87%), self-employed (80.95%) and housewives (80.19%) are found to have the greatest risk of not having any savings at all to pay for their care needs. Meanwhile, those who owned a business (10.71%) and worked for the government as civil servants (11.76%) have a relatively better ability to pay for their care needs.

4. Children
Within a typical traditional family setting, having many children is a blessing. As such, parents need to have a high financial capability to accumulate and grow their wealth in order to provide for their children during their developmental years.

The study’s results showed that more than 90% of seniors in need of care depend on family members for financial support. Filial piety is a deeply rooted value in Malaysian culture, so some would expect children to eventually take care of their parents in old age. However, there is no guarantee that they would or could do so – financially or otherwise – for various reasons.

Out of the group of seniors without children, 91.30% still needed financial support from family members. Only 34.78% of this grouping has their own savings to pay for care, while 32.61% possess other income sources to pay it. Hence, the assumption that people without children are more financially well-off to pay for their long-term care doesn’t appear to be true either.

Regardless if you have children or none, it is imperative for you to plan and accumulate enough wealth for your long-term care.

Conclusion
Whilst there are reports and research findings which are complementary to the idea and development of retirement villages, the income security of seniors needs to be addressed given the higher cost of living coupled with the increased number of seniors left to fend for themselves due to an ageing demographic.

Hence, industry players must be pragmatic and proactive in their approach when undertaking the task to develop a financially affordable aged care ecosystem in Malaysia. Meanwhile, Malaysians must reflect on the factors that hinder their financial capability to pay for long-term care and then arm themselves with the necessary financial knowledge and money management skills to save money and invest in assets that generate income for their long-term care.

 


 

Source: Smart Investor, August 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)

Payment Options

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

Written By: Aged Care Group

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

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”.

  • Page 1 of 3
  • 1
  • 2
  • 3
WP-Backgrounds by InoPlugs Web Design and Juwelier Schönmann