The quiet and high cost of family caregiving

As we age, our parents age with us.

And so, there comes a time when we may be saddled with the cost of both looking after ourselves, and our elderly folk. Some costs are easy to predict (e.g., cost of food, transport, an allowance after they stop working, etc.)
 

However, there are some quiet costs that are both high, and difficult to spot:

●  Costs associated with accidents
●  Follow-up hospital treatments may go on for a long time
●  Cost of accidents and injuries
●  Even without an accident, there’s eventually a need for elder day care or live-in helpers
●  Parents’ CPF monies running out

Loss of Mobility and resulting transport costs

The most commonly overlooked cost arises from mobility issues.

When our parents are younger, they can get around by themselves, whether it’s via driving, public transport or even walking. All that changes when they get older – don’t forget conditions such as loss of vision, which can make self-travel difficult and risky.

This means that while senior citizens enjoy concession passes on public transport, in reality, these won’t solve the high prices that come with getting seniors around.

Why? Because without assistance, it’s often difficult for wheelchair users to get on and off public transport. Even seniors who are non-wheelchair users can suffer from falls – often with devastating consequences.

In these cases, you may have to consider options such as a personal helper to assist them in getting around (see below), setting aside a sum for Private Hire Vehicles or taxis when they go out, or even possibly renting or buying a car yourself.

One viable approach is to try and live closer to your parents; you’ll even get a Proximity Housing Grant (PHG) if you live within four kilometres of them. If you’re available to accompany them up buses and trains, you may be able to skip the cost of quite a few Grab rides for them.

Follow-up hospital treatments may go on for a long time

As our parents grow older, they grow increasingly fragile. This means hospitalisation tends to require follow-up treatment.

When you’re young and spry, you can just pick yourself up after falling down. It may hurt, but you’ll be fine by tomorrow. When you’re above 60 however, falling down is way more severe. Not only could it require hospitalisation because of fractured bones, but it might also mean a few months of physiotherapy afterward for proper recovery.

As such, consider something beyond just hospitalisation insurance for your parents.

Cost of accidents and injuries

In Singapore, around one in three people over the age of 60 experience a fall each year. Falling is much more injurious to the elderly than to younger persons: According to the American Academy of Orthopaedic Surgeons, around 50 per cent of elderly who experience a bad fall become dependent on a cane or walker (see mobility challenges in point 1), and about 40 per cent need to be admitted to a nursing home.

Fall injuries can cause the inability to perform Activities of Daily Living (ADLs), such as washing themselves, dressing themselves, going to the toilet on their own, etc. In these instances, personal accident insurance becomes vital.

The accident plan will be needed to cover costs such as getting a live-in helper to assist with daily living (if a nursing home is not preferred), or to offset some of the costs of an elder daycare. An accident plan can also cover the initial cost of medical transport, to and from any medical treatment.

What to do: Complement their healthcare with personal accident plans. These can help cover costs for mobility aids, physiotherapy, Traditional Chinese Medical (TCM) and even the to-and-fro transport costs for medical treatment – one such plan is our very own Great Golden Protector.

Even without an accident, there’s eventually a need for elder day care or live-in helpers

Ageing is inevitable; so even without an accident, our parents will eventually need live-in help or care centers. In these instances, insurance plans cannot cover the cost (insurance such as personal accident only kicks in if there’s an accident, not for natural causes like old age).

Don’t assume that a domestic helper is all you need. Consider, for instance, a case where an elderly man is unable to bathe himself or change his own clothes. You cannot be certain that a female domestic helper is comfortable or qualified in this scenario.

In addition, let’s not forget domestic helpers are meant to clean - most don’t have the specialised training needed to help seniors stay engaged (this means going out still, meeting new friends, simple physical exercises, etc.)

At some point, you’ll need more qualified and expensive services:

Elder day care services can vary widely in cost, from $400 to $1,600 per month; while having a professional come to your home could cost around $20 an hour. Staying in a retirement home is the most costly option, from $700 to $4,000 a month (you can see some sources here).

Also, for those that engage elder day care services, note that quoted fees often exclude transport.

Why? That’s because care providers can’t really quote the fees as it’s too variable - it will depend on how near or far your parents live. While this is usually the safest and most convenient way to get to elder day care (the drivers and helpers are trained), it also tends to be the priciest.

You’ll notice the range of costs is quite large. That’s because the costs will vary based on the care institution or helper you pick; and while the government does provide subsidies, this will vary based on your Household Means Testing results. Note that if your per capita household income is above $2,800 per month, however, there is no government subsidy.

Finally, even if you don’t intend to get any helpers and intend to become the primary caregiver to your parents, you need to take into serious consideration the effort and opportunity costs it entails.

In this scenario, getting yourself protected becomes all the more important – after all, what would happen to your elderly parents if something happened to you?

Parents’ CPF monies running out

Finally, Singaporeans living in the 2020s should remember that, in their parents’ day, CPF contributions were lower. And the longer our parents live, the higher their insurance premiums and the more their CPF gets used up.

Sometimes, it’s a good idea to check how much they have exactly; it might even be a good idea to help them top up their Retirement Account, as well as supplement their CPF with policy coverage to ensure they are adequately protected and insured.

You can do so with private annuity plans, endowment plans, as well as protection plans such as Integrated Shield Plans, and accident plans.

This may spare you from having to foot the bill, later in life.