MALAYSIA will become an ageing population by 2021. We’ve heard it over and over again. But is the country prepared, especially in terms of housing and aged care services?
According to the National Statistics Department’s Population Projections 2010-2040, by the year 2021, Malaysians aged 65 and older will make up 11.4% of the population. That adds up to 4.4 million people, three million more than in 2010.
Carol Yip, CEO of Aged Care Group (ACG), says that while this impending development brings with it some economic opportunities, it also reveals the current lack of infrastructure, facilities and services in the country.
“Currently in Selangor and Kuala Lumpur, the care needed by older people is delivered by government welfare homes, private nursing homes and care centres and charitable aged care centres and by families at home. Within this diverse mix of services delivered by different agencies, each option has different funding bases.
“When help is needed, we as consumers, encounter frustrations and disappointments. In terms of nursing homes with quality aged care services and skilled staff, there is an increasing demand but a lack of supply. Such a situation warrants immediate attention from the business community to ensure the evolution of a viable aged care system as we progress towards a high-income society.
“In recognition of the growing need for aged care, the Government has created Healthcare National Key Economic Area (NKEA) entry point projects for seniors within the Economic Transformation Programme (ETP),” she says.
The three entry point projects are Mobile Healthcare Services, Institutionalised Aged Care and Retirement Villages.
Care centres and nursing homes
According to research conducted by ACG, there are currently 244 registered care centres and 16 registered nursing homes, and thousands of unregistered homes and centres.
There are many challenges in the industry. At the top of the list is the fact that there is no one legislation to monitor the care centres and nursing homes, as well as ensure these businesses adhere to the laws.
Currently, the Care Centre Act 1993 covers the care centres, meant for residents who need low level care. And, the Private Healthcare Facilities & Services Act 1998 regulates the nursing homes, which are supposed to be for those who need a high level of care.
The care centres and nursing homes face various challenges:
- Difficulty in finding suitable staff.
- Operators are unable to include frequent therapy for the residents.
- Lack of proper training for foreign staff.
- No assessment tools to assess the condition of the residents before admitting them.
- Lack of manpower for activities.
- Need for infrastructure modifications to suit the needs of the elderly.
According to Yip, there is also inappropriate placement of residents according to the level of care needs in nursing homes and care centres.
“The care centres which are meant for low care needs residents have more high care needs residents than low care needs residents. Whereas, nursing homes which are meant for high care needs residents also have low care needs residents living there. And some of the homes do not have certified staff to take care of the residents,” she says.
Despite the current shortcomings, the elderly are still going to care centres and nursing homes.
In an ACG survey of 240 people staying in nursing homes and care centres in Selangor and Kuala Lumpur, and 50 participants staying in their own home receiving care from spouse, family member or maid, it was found that the top reason for why the elderly chose to stay in a nursing home or care centre is the lack of family support at home and family members not having the relevant caregiving skills to take care of them.
It was also attributed to a lack of companionship in their own home and that some of their homes were said to be not elderly friendly.
On the other hand, to stay in a nursing home or care centre requires funds.
“Based on the survey responses, the percentage of residents not able to pay for their stay in nursing homes and care centres due to a lack of own savings is very high, almost 95% in both nursing homes and care centres.
“Families have become the central welfare provider, both in monetary terms as well as in the provision of social support to the elderly. It is not surprising that the most common source of support for the elderly is money from adult children. Although intergenerational relationships may presently be in flux, both co-residence and reliance on family assistance are outcomes for most elderly Malaysians,” says Yip.
Needs of the elderly
Moving forward, Yip foresees there will be the options of day care services as well as multi-generational housing and integrated residential care centres (IRCCs).
The day care centre would provide a variety of planned activities designed to promote wellbeing through social and health-related services.
Multi-generational housing is one where several generations of the family live in the same home. This way, the older generation and younger generation can help take care of each other.
The IRCC would combine the nursing home and old folks’ home into a single standard.
Day care centres
The purpose of the day care centre for the elderly is primarily three-fold:
- To provide senior citizens with an opportunity to get out of the house and receive both mental and social stimulation.
- To give carers a much-needed break so that they are able to attend to personal needs, or simply rest and relax.
- To supplement the lack of domestic help at home in relation to taking care of the elderly when the spouse and/or family members go to work.
In another survey, with 127 Malaysian respondents, ACG explored the needs of the elderly and retirees in day care centres.
Among the services ranked as very important at day care centres for the elderly are:
- Medical checks on blood pressure and blood glucose levels – 69.3%
- Health-related checkups – 66.1%
- Meals – 63.8%
- Pill and medication management – 59.1%
- Transport to and from day care centre – 55.9%
- Internet connection – 54.3%
- Entertainment – 52%
- Therapy services – 52%
The needs of men and women varied. The survey found that pill and medication management was very important to 73.1% of women and only 37.8% of men.
Therapy services (speech, physio and occupational therapy) was very important to 65.4% of women and only 33.3% of men.
While, 28.2% of women listed religious activities as very important. For the men, 22.2% listed religious activities as not important.
Gardening made it as one of the very important activities for the men, with 24.4% of them giving it a nod, while 38.5% of women listed gardening as merely somewhat important.
Both the men and women in the survey thought that activities with pets were not important – 28.2% of women and 35.6% of men.
According to the survey, a majority of the caregivers said there is an urgency for stroke care (62.2%), Alzheimer’s care (61.5%), high care needs (61.5%), assistance in personal care (58.8%), dementia (57.4%), physiotherapy (55.9%), special needs (50.8%), physical disabilities (50.8%) and Parkinson’s care (50%) at day care centres.
“The growing pressures of the ageing population in Malaysia will provide entrepreneurs an opportunity to set up day care centres offering activities and programmes desired by active retirees and the elderly who need care. A well-run care centre’s goals should focus on enriching lives, building upon their skills, knowledge and unique abilities and strengths.
“The day care centre is also a place for caregivers to network with other carers and trained professionals. The provision of care services for the elderly will also help adult children and spouses to overcome the domestic help problem when they go to work.
“In order for such an operation to be financially sustainable and to ensure that the quality of the services is not compromised, the day care centre operator must prioritise and organise care programmes and activities that are relevant to the elders, caregivers and families because these services are self-funded by the users as they use the services,” says Yip.
According to Yip, the immediate goal is to create flexible and seamless aged care services: a purpose-built integrated residential care centre that provides elderly Malaysians with more choice, more control and easier access to a full range of services, where they want it and when they need it.
All these have to be at an affordable price so that Malaysians are able to pay for their aged care needs without having to burden their families, society and the government.
It’s already 2015. The year 2021 is just six years away. Malaysia is running out of time.