Across Vendors
5.2 Familial Support
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54 contribution by the family physicians as crucial to allow better empowerment of the patients, and thus increase the efficiency and effectiveness of elderly care. As mentioned via the governing personnels and through official ministerial speeches and press releases:
Governing personnel A: We need a person who is coordinating the care and this person has to be a well-trained family physician. Because the aliment health problems of an elderly patient can be broadbased and wide, you will need a doctor who has the breadth and knowledge. One of the key thrust is to strengthen primary care sector. in order for the family physician to take good care of the patients‟ health, financing have to be done right too because today seeing a GP don‟t have incentive to look at more complex diseases compared to cough and cold in the profit-maximization point of view.‟
Article 5: Most of the elderly will have health conditions that require long-term chronic care, rather than short-term acute hospital care. GPs (general practitioners) and polyclinics (government-funded clinics) will play important roles in the care of the elderly sick.
Primary care sector, in the keystone members‟ point of view, has to be strengthened so as to provide assistance to elderly patients, especially those with chronic illnesses.
Medical professionals interviewed also indicated that the role of family physicians should be one that is „first contact with the patients‟, and will be escalated to the hospital care level only when there are insufficient facilities and capabilities to handle the treatments. While it may not be an obvious concern towards the potential patients on the capability of their family physicians, Singaporeans interviewed have indicated the distrust towards neighborhood general practitioners in handling any serious medical treatments other than common cough and cold symptoms – „If I cut my finger, where can I go other than A&E? I don‟t trust GP to give the right care.‟
5.2 Familial Support
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55 Another key aspect that is deemed important with the study of the datasets collated is the role of familial support in the eldercare system. The term „homecare‟, coined by the governing agency and medical professionals, emerged as a term dubbed in the fillial piety that should exist in the society with ingrained Asian values. As such, homecare is multi-faceted, and is regarded as the support of the family members, though other stakeholders may play a part in ensuring its wholesomeness.
Governing sectors see homecare as an avenue to take care of the emotional aspect of the elderly on the intangible side, while improving the efficiency of healthcare for elders. As mentioned by governing personnels, „If home care can be developed, it can actually lessen the burden and support aging in place which is essentially what people aspire to – nobody wants to age and die in a place away from home. Additional healthcare support to be delivered in homes will go a long way.‟, and based on a ministerial speech which mentioned that „the priority of our healthcare institutions should be to get patients well again so that they can go home.‟, it can be evident that homecare is one big sector in which the governing agency will develop as a strategy to counter the issues of aging population. Singaporeans who are either caregivers or elderly also indicated the knowledge of achieving efficiency through homecare. Interestingly, it was also mentioned rather frequently the preference to be home-based. Quoting from one of the Singaporeans interviewed:
Singaporean E: „Home care with chronic problem – best managed at home. Healthcare cost will be lesser. Healthcare is usually standard, no variation, will save time and money.
Patients will also prefer to be at home.‟
Taking into consideration the views of medical professionals, while they welcome the need for a more capable homecare system, as quoted from Nurse B in the dataset, commenting that
„family support is a huge direction towards elderly healthcare in the future‟ and „chronic problems are best managed at home as healthcare is usually standard without much
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56 variation, which will hence in turn save time and money.‟, issues were raised regarding the true medical knowledge that home caregivers possess, which in turn reflects its effectiveness.
Singaporeans interviewed too perceived the need for homecare as essential. They understand the culture within which the care of their parents should be the children‟s responsibility, as said by a middle-age Singaporean who „agrees that family support is crucial in eldercare.
Children of the elders have the responsibility.‟ Also, many see the need to be sensitive towards the emotional needs of the elders, since family ties are important in an Asian context.
Quotes from medical professional and Singaporeans are as follows:
Doctor C: Family support is important since we also have to take care of the emotional needs (of the elderly).
Singaporean I: Home is usually best preferred. Family ties are important (for the well-being of the sick elderly).
One unique feature in the Singaporean family is the engagement of domestic helpers in the homecare system. Indeed, with most of the support group having to work, domestic helpers are solutions towards the day care of elderly who are at home. Identifying such a trend, the governing agency is considering the development of homecare to include domestic helpers as part of the plan. „There is a possibility of training the domestic workers to support the care because Singapore is in a unique situation because Singapore is in a high density of housing and high dependency on domestic foreign helpers. Some of them are well-educated in home country. They can be trained to take care of the elderly more.‟, as indicated by governing personnel B. There is however an obvious divide between the views of the governing agency to that of the medical professionals. Doctors interviewed questioned the appropriateness of the high dependence on domestic helpers in homecare, as they are still lacking in the necessary medical knowledge especially in more complicated cases of health problems, Quoting from a Doctor B of a local public hospital when asked about the possibility of
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57 tapping onto domestic helpers in elderly healthcare, „Domestic helpers - not professional medical helpers. They are not trained. It is not appropriate in specific cases.‟