Helping hand for long term care of seniors

IF you have not thought much about your possible long-term health
care and associated financial needs, now is a good time to start. Did
you know that one in five long-term care (LTC) users is younger than 65
years, while around half are aged over 80 years, with women counting for
over 60% in total? According to a recent Organisation for
Economic Co-operation and Development (OECD) report Help Wanted?
Providing and Paying for Long-Term Care', there are clear signs that our
chances as individuals of needing long-term care are increasing. With
people living to a greater age and more women working, traditional
family-delivered care is not keeping up. It is not surprising
that the needs of frail and disabled seniors are growing. In many
countries, LTC policies are being developed in a piece-meal manner, in
response to immediate political or financial problems, rather than being
constructed in a sustainable, transparent manner. Yet, the future of
LTC, is unquestionably more demand, more spending, more health workers,
and above all, higher expectations that the final few years of life must
have as much meaning, purpose and personal well-being as possible. In
nearly all OECD countries, between half and three quarters of all
formal LTC is provided in home-care settings with a substantial share
suffering from dementia-related problems. According to the
report, family caregivers are the backbone of any LTC system. Across the
OECD, more than one in 10 adults aged over 50 years provides help
(usually unpaid) with personal care to people with functional
limitations. Close to two-thirds of these providers are women. Support
for family caregivers is often minimal, provided as recognition that
they perform a socially useful and difficult task. Financial Planning for Long-Term Care In
Malaysia, the life expectancy is expected to rise from 72.6 years in
2010 to 74.2 in 2020 for men. For women specifically, the figure is
expected to rise from 77.5 years to 79.1 years during the same period.
“The figure is expected to rise in line with the improved health
standards of the population” according to a comment in a local
newspaper. These statistics, together with women's role in the
family, point to a need for a different approach to financial planning
for LTC. Women will need more LTC savings because of their longer life
expectancy. If a woman sacrifices her income earning opportunity to
become a caregiver for the family, she needs to be compensated for loss
of income unless her LTC will be taken care of by her family or the
government. Unless family support is strong, the government should have
special provisions for LTC funds for women. There are cases where
men become caregivers for family members and they make necessary
financial sacrifices too. Regardless, everyone needs to conduct a
thoughtful and in-depth LTC financial self-evaluation: and consider
including your family members in your thoughts. Upon launching Phase 3 of the World Health Organisation's Good Governance for Medicines Programme, Health director-general Datuk Dr. Hasan Rahman
stated the programme will “enable the public to buy good quality drugs
at a good price”. Malaysia was one of the first countries to adopt this
programme. The Ministry of Women, Family and Community
Development has announced that they have set up Rumah Seri Kenangan to
provide care and protection to the aged who are poor. There are now 22
day-care centres for senior citizens through a strategic initiative with
certain non-governmental organisations which has now benefited 16,331
senior citizens nationwide. How about middle to higher-income
earners who want to live a comfortable life with affordable LTC, if need
be? Do we have such amenities in an age-friendly community living
environment? A friend of mine commented, “Money, money, money is the
crucial point here. In most places it would cost at least RM2,000 per
month, plus drugs cost to maintain a decent living. An acceptable living
would cost RM3,000 plus drugs and a comfortable living RM4,000 plus
drugs. Luxury living, of the type we associate with advanced countries,
would cost RM10,000 or more. Clearly, this is not viable for most
people, knowing that some patients live 20 or more years in retirement.” LTC
requires significant financial commitment from individuals, families
and the government. It will take more than government initiatives to
support and encourage us to implement workable solutions. It requires a
significant paradigm shift and mindset change within the populace,
business community and policy makers to look beyond the current
situation when making decisions. Though making profit is
important for business sustainability, we need to adopt strong
humanitarian principles if we are to succeed in providing LTC within the
constraints of our socio-economic transition, culture and social
support system. Dr Phua Kai Hong,
Lee Kuan Yee School of Public Policy, Singapore, in one of his
presentations proposed the “many helping hands” approach to community
care. A collaborative approach of public, private and people
partnerships, joint responsibilities of the individual and family,
community and the government, and a shift to more cost-sharing is
required. On the financial side of things, Phua envisions the solution
as a diversified mix of methods including prepayment, savings, pension,
insurance, annuities and targeted subsidies. Progressing towards a higher-income society Because
of the uncertainty of if or when a person might need LTC services,
pooling of the financial risk associated with a sudden LTC need is
important. We must design an efficient financing solution instead of
relying on out-of-pocket payments. Otherwise, the cost of LTC services
and support will be unaffordable for most people, even if we achieve
higher-income society status. The OCED report suggested that
countries need to have a “toolkit of policies” to strike a balance
between access to LTC and financial sustainability, selecting from
several healthcare financial system options as needed. It seems LTC
insurance has a potential role to play but unless made compulsory, it
will likely remain a niche market. A vision and the right mindset Malaysia's
family units are in transition. Traditional care delivery is under
stress. The sustainability of LTC provision will likely become an issue
for us in the future. We won't be able to find ideal solutions
overnight. Unless we quickly see some concerted effort from the
important stakeholders and government ministries, it will remain a
multi-million ringgit problem. However, I believe there is light at the
end of the tunnel. It begins with a vision and the right mindset. From
both the financial services and healthcare perspectives, we must take a
sizeable first step in the right direction along our Economic Transformation Programme
pathway. This is to ensure that we implement the right collaborative
strategies and cohesive policies to make things work for our senior
citizens. It is also for our younger generation and those of us in our
middle years!