This is especially true for elderly where their home is a place of comfort and precious memories.

 
Singapore is facing the growing concern of the aging population as the number of elderly citizens is expected to rise to about 900,000 in 2030 from 300,000 in 2013.  As they age, their health tends to deteriorate and they will need to be cared for.

 
Going in and out of the hospital or other institutional care can be very daunting to our elderly receiving intermediate care or long term care.  This is especially true for those with mobility difficulties and/or suffer from conditions like stroke, dementia or cancer.

 
With more elderly citizens retiring and having longer life expectancy, the ratio of working adults to support each elderly decrease significantly.  According to Department of Statistics (2014), the old-age support ratio is down to 5.2 in 2014 as compared to 13.5 in 1970.  As such, the economic and social burden on the working adults are increasing.  The pressure is also hard on the healthcare sectors as there is increasing load on institutional care.

 
Lonely and Depressed Elderly
 

A study by National University Health System (NUHS) in 2012 showed that about 21% of Singaporean elderly over 80 and about 16% of those in mid to late 70s are suffering from loneliness and depression. Depression is a serious issue and have a detrimental effect on the recovery ability of the elderly receiving care.  This effect is more worrying for elderly in hospital or other care facilities, where they tend to feel lonely and see themselves as a financial burden to their families.

 
Receiving care at the hospital may mean a faster emergency response and better monitoring.  If not for the limited means of access to medical services or lack of adequate caregiver support, most elderly and their family will choose to receive care at home.

 
By allowing elderly to receive care at home, they are not only closer to their families, but also feel calm, comfortable and are likely to retain the feeling of independence.  This contributes to the happiness of the elderly which eventually aids their recovery.  Find out more about what the elderly wants.

 
Home Care: A Lesson from Japan
 

Japan is the world’s ‘oldest’ society, with its over-65 population exceeds its population of children.  Being the first in Asia to experience the threats that come along with the rapid increase in the aging population, Japan had to come up with more innovative solutions to provide for the elderly.  This is when the importance of Home Care System kicks in by meeting the growing demand of the long-term care services while allowing the elderly to stay in their homes for as long as possible.  According to a survey by Japan’s Ministry of Health, Labour and Welfare in 2008, about 99,000 patients receiving Home Medical Care services everyday.

You Home Clinic is one such home care provider in Japan

 
What is Home Care actually?
 

Home Care is a holistic and integrated approach in delivering high quality nursing and medical services at home while addressing the social and emotional needs of the elderly.  With care teams consisting of skilled and passionate healthcare professionals, families can rest assured that their elderly will receive the best possible care treatment.  The family members and caregivers will experience less caregiver stress as they will be empowered with the knowledge on how to care for their elderly.
 
It is evident that Home Care can be a bridge to the aged-care gaps experienced by Singapore.  From the early 2000s, the Ministry of Health (MOH) has been encouraging the expansion of Home Care services by public hospitals and voluntary groups as well as the involvement of private players as Home Care providers, aiming to provide and better serve the elderly of Singapore.  Through Home Care we can assure them that we understand what they need.  That home is where their hearts are.
 

 
Increasing Load on the Institutional Care
 

	Home Care	Centre-based Care	Nursing Home Care	Home Palliative Care
Capacity in 2011	3,800 home places	2,100 day places	8,800 beds	3,800 places
Current Capacity	6,500 home places	3,100 day places	9,800 beds	5,000 places
Targeted Capacity in 2020	10,000 home places	6,200 day places	17,000 beds	6,000 places

Figure 1: Numbers of beds in various care places
Source: Ministry of Health, 2015
 

The Ministry of Health (MOH) has aimed to increase the bed capacity of various institutional care (Figure 1) over the past few years.  This is to accommodate the rising number of elderly needing the inpatient care as their conditions deteriorate with age and are more prone to diseases.  But will it be enough?
 
The demand for institutional care admission is increasing rapidly with increasing aging population, much beyond the upscaling rate of bed capacity.  Patients may have to wait a long time, six months or potentially one year, to be moved to nursing homes after inpatient hospital treatment.  Those waiting times result in unnecessary hospital expenses as well as redundancy in time and care efforts of the doctors, nurses and caregivers while the patients are healthy enough to be discharged.

 
Caregiver Stress
 

Though it makes life easier for the children to keep a look out on their elderly parents at home, provision of care at home comes with some heavy responsibilities and huge amount of stress on the caregivers.  Feeling of ‘I should constantly be available”, little confidence due to lack of care knowledge, lack of personal space and time and tiredness from multitasking can take a heavy toll on caregivers physically and emotionally. Caregiver burnout can be dangerous to both elderly patient and the caregivers themselves.  There is a higher chance of patients’ re-admission.