When it comes to our loved ones, many of us will do all we can to ensure their well-being, especially during their silver years.
It is inevitable for elderly family members to have health-related issues as they age. There will come a time when they will start to lose the ability to complete day-to-day tasks such as showering or doing simple household chores. This is where elderly care becomes something of concern.
While nursing homes and elderly day care are valid options, there are also issues like vacancy, distance, and cost to consider. Many elderly people are also against the idea of staying in nursing homes. This is where the idea of options like hiring a private nurse or a live-in caregiver comes into play.
Differences between a private nurse and a live-in caregiver
Private nurses are trained and licensed healthcare professionals. They have experience in providing patient medical care and can administer home nursing care procedures like giving medication, changing feeding tubes, wound dressing, and general monitoring of health conditions.
Live-in caregivers, however, are not trained or licensed healthcare professionals but might have undergone nurse aid training or obtained certifications related to caregiving.
However, it’s important that live-in caregivers are not domestic helpers. Their primary responsibility is to monitor the health and medical conditions of those under their care, along with providing personal care duties such as medication assistance and daily hygiene tasks.
Private nurses provide care on an hourly, half-daily, or full-day basis, and their services are typically only available during normal working hours (between 8am to 6pm). For live-in caregivers, they can provide care and monitoring round-the-clock as they live with the elderly person they are caring for.
When should I look into getting elderly care services?
While some prefer to look after their elderly family members themselves, it is not always possible due to time and resources.
For example, getting up in the middle of the night to assist them is not sustainable if you hold a day-job. It is also difficult to look after them yourself if you are away for work or have other commitments.
When your elderly family members start to have difficulty performing their activities of daily living (ADL), it is time to contemplate the need for caregiving services. The six basic ADLs comprise of: washing, toileting, dressing, feeding, mobility, and transferring.
What’s more, it can also be challenging to take care of elderly family members with chronic illnesses and who require more close monitoring. Besides assisting with ADLs, private nurses or live-in caregivers can also provide long-term care to manage these chronic conditions.
Cost of hiring a private nurse
The cost of hiring a private nurse to take care of your elderly family member depends on how much elderly care support they require, and the government-funded subsidies that they qualify for.
Charges for a private nurse are usually calculated on an hourly basis, with the average cost ranging from S$25 to S$150. The price varies depending on the services needed, subsidies available and the agency you choose. Most agencies also have a one-time registration fee ranging from S$50 to S$100 when you first engage their eldercare services.
For example, NTUC Health separates its care services into medical, nursing, and therapy with prices per visit from as low as S$8.20 for home nursing to S$54.80 for medical services. Meanwhile, it will cost S$30 to S$35 per hour for a Homage private nurse to assist with ADLs and simple nursing on weekdays, and complex nursing starts from S$80, chargeable per procedure.
Should the elderly require daily assistance with simple nursing, the costs can easily add up to S$150 – S$450 a week.
Cost of hiring a live-in caregiver
When it comes to hiring a live-in caregiver, the monthly salary usually ranges from S$600 to S$1,000. However, compared to private nurses, there are a lot of additional one-time costs that come with a live-in caregiver.
For example, Active Global, which has its own fully-equipped Caregiver Training Centre, provides a detailed cost breakdown for live-in caregivers. On top of the monthly salary, there is also a monthly levy of S$300, a one-time service fee for caregivers from S$2,700 to S$3,500, and third-party costs such as air ticket costs, work permit application, and medical check-ups.
Source: Active Global
Just like hiring a helper, employers also have to make sure that they provide adequate food and accommodation for the live-in caregiver. Employers will also have to get them health insurance, similar to what is offered under maid insurance in Singapore.
For a live-in caregiver, the monthly cost can easily reach S$1,500, depending on the salary and if you receive a subsidy for the monthly levy. You will also need to factor approximately S$3,000 to S$4,000 on service fees and third-party costs when you first employ the caregiver.
Subsidies and grants available for elderly care services
There are various subsidies available to aid families in paying for elderly care services. According to the Ministry of Health (MOH) subsidy framework for Residential Long-Term Care (LTC) services, the subsidies available are as follows:
LTC services include Chronic Sick (High/Low) services, Nursing Home services, Inpatient Hospice Palliative Care Services, Psychiatric Rehabilitation Homes and Psychiatric Sheltered Homes. You will be able to use this subsidy on most of the private nurse’s services needed for elderly care.
The Home Caregiving Grant (HCG) is also available for families that require caregiving services for their loved ones with permanent moderate disability. This is categorised as a need for assistance in performing three or more ADLs. The S$250-S$400 monthly cash payout can be used to defray costs from caregiving expenses such as eldercare costs, or hiring live-in caregivers.
Instead of paying S$300 for the monthly levy, eligible families can also apply for the Migrant Domestic Worker Levy Concession for Aged Persons and Persons with Disabilities. Eligible households will pay a lower concessionary MDW levy of S$60 a month.
Additionally, for those who were born before 1950 and were Singapore citizens by 1987, the Pioneer Generation Disability Scheme (PioneerDAS) is part of the Pioneer Generation Package and honours the contributions of Singapore’s Pioneers. While this is not solely made for eldercare services, Pioneers who have disabilities can receive S$100 every month as additional support for everyday expenses.
Eldershield and Careshield Life to help with costs
Introduced in 2002, ElderShield is a basic long-term care insurance scheme targeted at severe disability, especially during old age. Upon severe disability, the scheme provides S$300 per month for up to 5 years or S$400 per month for up to six years, depending on the scheme enrolled.
From 2020, Singapore Citizens and Permanent Residents who turn age 40 are enrolled into CareShield Life, instead of Eldershield, on 1st Oct 2020 or when they turn 30, whichever is later.
CareShield Life is a long-term care insurance scheme that provides basic financial support should an insured develop severe disability, especially during old age, and need personal and medical care for a prolonged duration (i.e. long-term care). Careshield Life payout illustration is as follows:
The monthly S$600 payout can be insufficient in helping to defray the cost of getting adequate caregiving services for the elderly. Thankfully, there are supplements that can be added to one’s Careshield Life to receive additional benefits, such as higher monthly payout amounts.
There is no one-size-fits-all when it comes to eldercare. Depending on your elderly family member’s needs, you can look into hiring a private nurse, a live-in caregiver, or even a combination of both to take care of them.
Taking care of an elderly family member, especially one with nursing needs or one who is disabled, can consume a lot of your time, energy, and money. Feel free to reach out to the Planner Bee team at firstname.lastname@example.org to know more about supplements to add to Eldershield or Careshield Life to better prepare for life’s unpredictabilities.