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12 Aug 2011, The Straits Times
Home care: Focus on patient's convenience
HAVING had my father discharged from hospital after a bout of pneumonia, and acting as his main caregiver at home, I have discovered that not much has been done to care for home-bound elderly patients.
The current health-care system is inflexible in assisting home-bound patients, which may be one reason why such seniors do not attend follow-up visits.
The Ministry of Health should adopt the policy of going to such patients, rather than making them go to the hospital. Instead of forcing home-bound elderly patients to call for an ambulance to take them to a hospital's accident and emergency department, there should be a team of specialised doctors and nurses who can call on them, especially for illnesses that tend to recur.
Even if there is such a team, is the cost affordable enough? A house call costs anything between $150 and $300, while the fee for a nurse is $100.
Home-bound patients, especially if they are on wheelchairs, must call for special transport to ferry them to and from the hospital for specialist follow-ups, which is costly. A home-based approach can be affordable if it is managed well. The same applies for post-recovery help such as physiotherapy, which is also costly.
How many patients avoid such therapy because of the high cost?
I am also surprised that consulting family doctors at polyclinics is not subsidised for patients aged 65 and above.
Caring for the elderly is long term and families should be allowed to use their Medisave, regardless of whether their loved ones are hospitalised or not.
David Soh
Reply From MOH
MR DAVID Soh highlighted the challenges he encountered in caring for his elderly father ('Home care: Focus on patient's convenience'; Aug 2).
Mr Soh's experience reflects the challenges that our ageing population will increasingly confront. In particular, how we can help our seniors age in place even as their health declines over time.
Home care and assisted living are possible options but as Mr Soh pointed out, these can be costly as they are very resource-intensive.
The Ministry of Health (MOH) is working with various partners to help needy families care for their infirm, elderly members through more cost-effective and coordinated care services, including the provision of non-emergency transportation for rehabilitation patients.
We are also looking at training caregivers among family members who will be closely supported by a network of health-care professionals.
Mr Soh had commented that there is no subsidy for elderly patients above 65 years old in polyclinics. This is not true.
All polyclinic services are heavily subsidised for Singaporeans, with elderly patients receiving higher subsidies in most cases.
We thank Mr Soh for his letter and if he requires more specific information and assistance, he can contact the Agency for Integrated Care on 6603-6800 or via e-mail at enquiries@aic.sg.
Bey Mui Leng (Ms)
Director, Corporate Communications
Ministry of Health