Whether you are caring for a parent, spouse, or any elderly loved one, your role as a family caregiver is both a labour of love and a significant responsibility. To fulfil such a crucial role, it is essential that you are equipped with the knowledge and support necessary to extend the best care possible. In this article, we discuss 8 ways to provide better home care for a senior loved one, including how to keep your home safe for seniors, how to talk about financial and legal matters with an ageing parent, what to do to keep a loved one socially active if you don’t have time, and more.
Table of Contents
1. Make Your Home Senior-Safe
Falls are one of the leading causes of injury among seniors in Singapore. The top location these falls occur is at home, due to factors such as environmental hazards combined with compromised gait, balance, and vision – issues commonly experienced by elderly individuals.
Tripping and falls in the elderly can lead to debilitating consequences, including fractures – especially at the hip, immobility, dependency and disruption to daily activities. The risk is higher for those with osteopenia or osteoporosis.
Thus, the importance of keeping your home safe and friendly for the elderly cannot be overstated. What a younger person finds easy to navigate can pose challenges and risks for an older family member, so it is important to evaluate home hazards from the elderly’s point of view to take proactive measures. Here are a few essential aspects to ensure safety in a senior’s home:
- Anti-slip treatment for bathrooms and toilets: This is a common culprit in fall accidents. Make sure you install grab bars, apply anti-slip treatments to bathroom and toilet flooring, use non-skid mats and keep the floors dry as often as possible.
- Decluttering surfaces: Tuck away loose wires and cables, secure carpets and rugs, reduce excess furniture and decors, keep counters tidy with only necessary items within reach.
- Treatment to steps and entrances: Make sure entrances are wide enough and steps are easy to handle for seniors, consider installing ramps if necessary.
- Adequate lighting: Draw up curtains, install lights in low-light spaces. Motion-activated lighting can be beneficial for seniors when they move around the house.
- Chairs and beds with comfortable heights: Avoid those that are either too high or too low for seniors.
- Appropriately fitted footwear: Ill-fitted shoes can cause instability and increase the risk of slipping or tripping.
HDB’s Enhancement for Active Seniors (EASE) program provides up to 95% subsidy to retrofit your home for safety improvements. Learn more about eligibility and subsidy items that are offered under EASE from our article on financial schemes for caregivers.
In addition to the above general home safety concerns, people with Alzheimer’s disease and dementia often face unique challenges due to their progressive cognitive decline. Read our dedicated article addressing safety tools and aids for people with dementia for details of these challenges and how to prevent them at home.
2. Help Seniors get Screenings and Check-ups Regularly
Regular screenings and checkups are essential to maintain our health and prevent potential complications. Screenings help to detect common chronic conditions such as hypertension, high cholesterol, diabetes, as well as high-risk conditions such as colorectal cancer or breast cancers. If the senior has an existing chronic condition, follow-ups are crucial to prevent and mitigate the health and financial impact of exacerbations and complications.
Other important checkups for the elderly include dental, vision and bone density tests. Dental health contributes to better appetite, nutrition and thus overall health. Eye exams help to ensure seniors use the most appropriate eyewear, preventing fall and tripping risks as we discussed above. Bone density scans assess bone health to prevent fractures and osteoporosis, especially among women.
However, keeping track of all the necessary check-ups can be challenging for our elderly loved ones. As caregivers, you can help them with:
- Establishing a schedule: With Healthier SG, a personalised health plan including necessary screenings and check-ups is now accessible to all seniors in Singapore. If your loved one has not enrolled for the program or has troubles with the Healthy 365 mobile app, you can sign up as their caregiver and allay these challenges for them.
- Providing transportation or accompanying them to the check-ups: Seniors can now get screened conveniently at community care centres and clinics instead of making a trip to the hospital, for $5 or less under the Screen for Life program. Discuss with your loved ones the logistic support level they need and make arrangement accordingly. If they need to be physically escorted to the appointments but you are unable to do so, you can enlist medical escort services.
- Encouraging active involvement: Taking an active part in one’s health empowers our loved ones to age gracefully while maintaining a sense of control and autonomy. It can positively impact their attitude and motivation to cope with health challenges as well. As caregivers, you can be there for your family members while encouraging them to take charge through simple activities like leading the discussion with their doctor, setting up appointments, understanding prescribed medications, etc.
3. Encourage Seniors to Stay Active
If you find it challenging to stay active as the years go by, you are not alone. Age-related loss of muscle mass and strength, also known as sarcopenia, starts in our late 30s and accelerates over time. Beyond the age of 60, it is estimated that one in three people in Singapore is affected by sarcopenia, which compromises their muscle strength, function and mobility.
Some seniors have chronic illnesses like arthritis, cardiovascular disease, or COPD, which impact their joints, bones, heart, or lungs, thereby limiting their level and range of physical activities. Acute episodes like a hospitalisation can further disrupt the ability to engage in regular exercise. However, engaging in physical exercises is precisely what counters the effects of sarcopenia, inactivity, and their related consequences.
Numerous research links physical activities with less physical decline, better control of chronic diseases, improvements in heart health, mental health, cognitive function and overall well-being. Seniors are encouraged to aim for at least 150 minutes of moderate-intensity aerobic physical activity, in addition to strength training 2 days per week. The key to working out is to start small and be consistent. You can start exercising at any age and build the habit, even if you were not active in the past.
Here are some ways to encourage seniors to stay active in Singapore:
- Go brisk-walking or hiking as a family. You can also sign up to the National Steps Challenge™ and earn rewards as you walk!
- Join free workout classes or events at a nearby community venue through the Healthy 365 app. There is a wide range of exercises to get active while bonding with family and friends, many of which are tailored to seniors, including Zumba, kickboxing, masala bhangra and more. Help your loved one get the Healthy 365 app and familiarise with it to benefit from its various activities.
- Join MyActiveGYM™ to get access to equipped gyms and pools nationwide. The Merdeka Generation Package gives seniors unlimited gym access for just $30/year.
You can also exercise at home. Here are some useful and simple exercise ideas for seniors of different health status to stay active in Singapore. Be sure to consult doctors for the right types of physical exercise and assist the seniors when they exercise, if they are new to exercises or recovering from injury, operation or treatment.
4. Maintain Healthy and Adequate Nutrition
Contrary to common belief, seniors need more protein and nutrition to address muscle loss and decreased metabolism, compared to their younger counterparts. Yet, as many as half of the older adults in Singapore do not meet the recommended protein intake for their age.
People aged 50 and above need about 1.2g of protein/day for each kilogram of their body weight. They may also need higher intake of calcium and vitamin D to counter the loss of bone density. Elderlies may also experience loss of appetite and malabsorption due to medication or hormonal changes, requiring supplementation of certain essential vitamins and nutrients.
To maintain optimal nutrition for the elderly, it is important that caregivers pay attention to:
- Daily healthy, balanced diet: Encourage a diet rich in fruits, vegetables, whole grains, lean proteins, and dairy. Food is the best source of nutrition. However, stay away or minimise foods that are high in saturated fats and sodium such as preserved or processed meats (luncheon meat, sausages, hot dogs, etc).
- Hydration: Remind the elderly to stay adequately hydrated throughout the day, but do not drink too much liquid during mealtime. Dehydration can cause or exacerbate health issues.
- Address health issues affecting appetite and eating habit: Dental issues or medication side effects can result in reduced appetite and insufficient nutrition intake. Check with a doctor if it is the case for your elderly loved one. Read more about common causes of loss of appetite among the elderly and what to do about them from our blog article.
- Use supplements as guided by your doctor: Supplements can be helpful when specific dietary requirements are not met by food alone. Health check-ups and reviews with a doctor can reveal what you need. For instance, vitamin D and calcium supplements can aid in maintaining bone health, while omega-3 fatty acid supplements may help with absorption of other vitamins and nutrients.
If you do not have time to prepare meals for your loved one and they are unable to do it themselves, it can be a good idea to have food catered to home to ensure regular meals. There are private suppliers with customisable meal plans, as well as public service that provide Meals on Wheels with subsidies (means-testing required).
5. Keep Their Company
Companionship, family and social connections contribute to senior’s cognitive stimulation, helping them combat feelings of loneliness and isolation and prevent mental decline.
As family caregivers, you can help schedule social time for your loved ones in multiple ways, without sacrificing too much time of your own. Here are some suggestions:
- Invite a relative or a friend to come over and share a meal or teatime with the senior.
- Engage in activities together, such as cooking, baking, or crafting.
- Play a quick game with the elderly, such as chess, card game or board game. Scrabble or trivia games are great ways for children to learn and bond with the seniors.
- Head outdoors and do physical exercises together – working out together provides both bonding opportunities and health benefits.
- Encourage the elderly to join organised activities with their peers, such as at active ageing centres.
- Engage a professional caregiver – they are skilled at keeping the company of their clients while performing other caregiving tasks.
- Apply for Befriending Service – Trained volunteers can drop in to visit and provide companionship for seniors who are isolated, alone or bored. The service requires referral.
6. Equip Yourself with Health Knowledge and Caregiving Skills
Caregiving can be overwhelming. It requires not only understanding the specific conditions your loved one is facing but also mastering various caregiving techniques to provide proper care. But you don’t have to navigate the journey by yourself. Taking caregiver training courses can equip you with the relevant skills and knowledge, including:
- Personal care techniques, e.g., how to bathe, transfer, lift and carry, etc.
- Nursing skills, e.g., checking vital signs, handling tube feeding, catheter care, wound care, stoma care.
- Knowledge about specific conditions, e.g., how to recognise the warning signs of stroke or dementia, management of chronic diseases, etc.
- Caregiver coping skills and well-being.
These classes can be provided in class or at home and tailored to your home environment. Caregivers caring for a loved one aged 65 years or above, or in need of support with at least 1 activity of daily living (ADL) can get a subsidy of $200/year when taking one of the pre-approved courses, under the Caregivers Training Grant (CTG).
7. Talk about Finances and Legal Papers
Many people find it hard to approach the sensitive matters of finances and legal papers with their ageing parents. Yet, these topics are often better discussed earlier rather than later. You may consider having conversations with your elderly loved ones about:
- Financial planning – You may want to find out how they want their savings, insurance and financial resources to be used in the future, what legal arrangement needs to be in place if they ever need you to manage their finances or make financial decisions on their behalf, whether they need financial support from the family, etc.
- Advance care planning (ACP), also known as elder care planning – this is the process of planning care arrangements when you are healthy and capable for circumstances when you get severely ill or otherwise become unable to make such decisions, e.g., when dementia advances to a late stage. Learn more about the importance of ACP and the 8 steps involved in drawing up an ACP from our blog.
- Legal papers such as Lasting Power of Attorney (LPA), Advance Medical Directive (AMD) and other legal documents your parents might need you to be aware of or get involved in preparing. Note that ACP, LPA and AMD need to be done when one is of sound mind, however ACP is not legally binding while LPA and AMD are.
Tips to discuss finance and legal paper matters with your parents:
- Involve your siblings, agree on a plan and share information with one another.
- Bring up the topics naturally, at a comfortable time. For instance, when your loved ones are relaxed, you can share that you are doing your own financial planning or advance care planning to gauge your parents’ interest and comfort level with the topics.
- Empower them to make decisions: These are important matters to your parents, they may need help and support to go about making decisions, but ultimately they will want to take charge, unless they explicitly mention otherwise to you. In fact, with a lifetime of experience, our parents may have a lot of wisdom to share when it comes to financial management.
- Ask a trusted contact to initiate the discussion: It can be a good idea to ask a professional such as a family doctor or a long-time friend of your parents to break the ice and bring the issue to their attention. In Singapore, many doctors are trained to facilitate Advance Care Planning and can help you go through the process with your elderly loved ones. Take note that even with the initial help of a third person, you will still need to guide and discuss the specific questions with your parents.
- One small discussion at a time: Don’t expect to address all financial and legal matters with your parents in one seating. Be willing to have multiple conversations, on their terms.
- Keep some questions off the table: You may come purely from a desire to help your loved ones. Yet, some questions can appear prying or are just not appropriate to ask, like how much money they have, or the details of their will. Assess what is off-limits for your family and avoid bringing it up.
8. Know Where to Get Help When It Is Needed
In your caregiving journey, there can be situations where there is an emergency, or things do not go as planned. It is critical to know when to safely self-treat at home, when to visit a doctor and when to head straight down to A&E department. Keeping in touch with a regular doctor who is familiar with the elderly’s condition and medical history to call on in such situations can provide immense support and relief. We also wrote articles about 10 acute situations the elderly may face at home and what to do, which can be useful for you.
For emergency situations, keep after-hour and 24-hour medical contacts handy and share them with other family members.
Other useful contacts include respite care providers, for instance when you need a caregiver to stand in for you, house call nurse or house call doctor providers when you need consultation or nursing procedure at home.
9. Takeaway Message
Each facet of care above aims to contribute to the overall well-being of our senior beloved, allowing them to age with dignity and grace. As we embrace these practices, we foster a more compassionate and supportive care experience at home. Outside of home, you and your loved ones can seek assistance from professional medical and caregiving services, as well as explore volunteer services in times of need. Together, these efforts create a comprehensive network of support, ensuring your family members get the care they deserved in their golden years.
Ninkatec offers a comprehensive range of homecare services, ranging from home-based medical care, house call doctors, house call nurses, caregiving services to clinic-based GP care. Our accredited clinic – Charazoi Medical Clinic – is registered with Healthier SG, CHAS, MediSave and on the panels of major insurance providers. Call, chat with us or leave us a message to find out more.