0:27

It is estimated that

0:27

there are over 210,000

0:38

caregivers in an ageing

0:38

Singapore with some 70% of them

0:42

aged 40 and above, they often

0:42

have to deal with the financial,

0:45

physical and psycho-social

0:45

responsibilities of caring for

0:49

the elderly and the young,

0:49

according to Ministry of Health.

0:52

With a rapidly ageing population

0:52

and shrinking family sizes, we

0:56

now see the emergence of the

0:56

"sandwiched generation

0:59

caregivers who care for both

0:59

their elderly parents and

1:02

children. Without doubt,

1:02

caregiving is for most, a

1:05

difficult journey. Caregivers

1:05

face greater obligation to care

1:09

for their family, with minimal

1:09

capacity to care for their own

1:12

mental health or even look into

1:12

their own financial needs.

1:15

Hi, I'm Yuzhen and you're

1:15

listening to Let's Talk CPF. In

1:19

today's episode, we will be

1:19

touching on the experiences that

1:22

caregivers face, various support

1:22

measures that caregivers can tap

1:25

on and how we can be prepared if

1:25

we ever find ourselves in a

1:28

position needing to care for a

1:28

loved one in future.

1:32

Today we have Angela Kwek,

1:32

Deputy Director, Healthcare

1:35

Claims and Payments, CPF and May

1:35

Heap, Senior Medical Social

1:39

Worker, SingHealth Community

1:39

Hospitals. Hi, Angela. Hi, May.

1:43

Hi, glad to be here.

1:44

Hello, thanks for having me here.

1:48

So May, tell me more

1:48

about what you do at SingHealth

1:51

Community Hospitals.

1:52

I am a senior medical social worker at Sengkang Community Hospital, which is

1:53

managed under SingHealth

1:55

Community Hospitals. I found my

1:55

calling in supporting patients

2:02

from various social backgrounds

2:02

and have been a medical social

2:05

worker for the past 13 years in

2:05

acute and community hospitals.

2:09

Being a mother of three, I see

2:09

the importance of family ties

2:12

and support and I understand how

2:12

family could help patients cope

2:16

better with their conditions.

2:18

How about you, Angela?

2:19

I've been with CPF

2:19

Healthcare Financing group for

2:22

eight years. It has been a

2:22

fulfilling journey. I was

2:25

involved in the successful

2:25

implementation of both

2:28

MediShield Life and CareShield

2:28

Life. In fact, last year, I even

2:31

had the opportunity to join the

2:31

caregiver taskforce set up to

2:35

help Singaporeans with

2:35

caregiving needs. Being part of

2:38

the taskforce gives me a better

2:38

understanding of the issues that

2:41

caregivers face. This has

2:41

definitely spurred us to explore

2:45

how we can help potential

2:45

beneficiaries to benefit from

2:49

CPF insurance schemes.

2:51

So May, having been a

2:51

medical social worker for 13

2:54

years, I'm sure you have met a

2:54

fair share of patients. Could

2:57

you share more about the

2:57

patients you have met?

3:00

In a community hospital

3:00

setting, we typically see

3:03

patients who are recovering from

3:03

stroke, hip fractures and knee

3:06

replacement operations. These

3:06

are the usual group of patients

3:10

who may need more care with

3:10

their day-to-day needs. They

3:13

usually require some form of

3:13

assistance with their activities

3:16

of daily living such as

3:16

toileting, and dressing,

3:19

especially for patients with

3:19

dementia. Our healthcare team

3:23

provide sub-acute medical care

3:23

and rehabilitation to support

3:27

the patient's transition back

3:27

home. We also have patients who

3:30

are receiving inpatient hospice

3:30

palliative care services at

3:34

Sengkang Community Hospital.

3:36

So as a medical social

3:36

worker, what is the typical day

3:39

like for you?

3:40

Well, I normally see

3:40

patients in the ward to help

3:43

them understand their conditions

3:43

and at times counselling them

3:47

about their medical conditions.

3:47

I will also work with patients

3:51

and their family members to

3:51

address their issues such as

3:54

care arrangements, financial

3:54

matters, and provide

3:57

psychosocial support throughout

3:57

their stay.

4:00

And from your

4:00

experience, what are some main

4:02

areas of assistance that

4:02

patients or caregivers might

4:05

need?

4:06

Some main areas of help

4:06

that they usually need can be

4:09

categorised into three

4:09

categories. First, it's care

4:12

planning. I will explore with

4:12

patients or family on the

4:15

options of day care or day rehab

4:15

services when the patient needs

4:19

to continue rehabilitation after

4:19

their community hospital stay.

4:23

Second, it's psychosocial

4:23

support. I will provide

4:27

counselling and emotional

4:27

support to caregivers who are

4:30

stressed with caregiving and to

4:30

be present when the caregivers

4:33

share about their emotional

4:33

stress. Thirdly, it's financial

4:37

resources. Patients may require

4:37

financial assistance for items

4:42

including assistive medical

4:42

equipment, dressing supplies,

4:45

and home modification to make it

4:45

easier for the patient to move

4:49

around. In addition, some

4:49

families may even opt to engage

4:53

a helper to relieve some burden

4:53

on the patient or caregiver.

4:57

So, by assistive

4:57

devices, do you mean like

4:59

wheelchairs and protheses?

5:01

Yes. And some home

5:01

modification can be as simple as

5:05

additional grab bars or to more

5:05

complicated ones like

5:09

installations of ramp, widening

5:09

of doorways for easy access into

5:13

rooms if a recipient uses a

5:13

wheelchair.

5:16

I can imagine all these

5:16

will add up to a substantial

5:19

amount.

5:20

Yeah.

5:21

If I may share, being a

5:21

caregiver is undoubtedly a

5:24

demanding role. Caregivers are

5:24

not only responsible for their

5:28

loved one's physical, emotional

5:28

and social needs, some may have

5:31

to look after the financial

5:31

needs of their loved ones. This

5:34

may pose a significant concern

5:34

to many. Fortunately,

5:38

Singaporeans with severe

5:38

disability can find some relief

5:42

through the CPF insurance

5:42

schemes that provide basic long

5:45

term financial support.

5:46

You're referring to

5:46

CareShield Life and ElderShield?

5:49

Yes. CareShield Life is

5:49

a long-term care insurance that

5:52

provides lifetime cash payouts

5:52

of at least $600 per month to

5:56

Singaporeans with severe

5:56

disability. For those not

6:00

covered by CareShield Life, but

6:00

are covered under ElderShield,

6:03

they can receive monthly payouts

6:03

of $300 or $400 for up to six

6:08

years. Both schemes aim to

6:08

reduce financial burden on

6:11

families. This allows patients

6:11

to focus on their recovery,

6:16

while ensuring that a caregiving

6:16

journey is sustainable.

6:19

And I understand to

6:19

qualify for the payouts under

6:22

CareShield Life or ElderShield,

6:22

there is a certain criterion to

6:25

meet.

6:25

Yes, policyholders who

6:25

are unable to perform three out

6:28

of the six activities of daily

6:28

living are eligible for

6:32

CareShield Life or ElderShield.

6:34

What are these

6:34

activities of daily living? And

6:36

what is this definition of mild,

6:36

moderate and severe disability?

6:41

Activities of daily living,

6:41

or what we call ADLs, refer to

6:45

basic activities that the

6:45

patient can perform on a daily

6:48

basis to take care of himself or

6:48

herself. This includes

6:52

activities like feeding,

6:52

bathing, toileting, and

6:55

dressing. Based on Agency for

6:55

Integrated Care (AIC) scheme

6:59

application, mild disability

6:59

means that the patient always

7:02

needs assistance with at least

7:02

one ADL; moderate disability

7:07

means patient needs assistance

7:07

with at least three ADLs and

7:11

severe disability means patient

7:11

is unable to perform at least

7:15

three ADLs.

7:17

I understand this has

7:17

to be certified by accredited

7:19

doctors. Where can patients or

7:19

caregivers find these doctors?

7:23

There are over 300

7:23

Ministry of Health accredited

7:26

assessors located in clinics

7:26

across various regions of

7:30

Singapore and around 250

7:30

assessors who can conduct house

7:34

calls. The full list of

7:34

assessors can be found on AIC

7:37

website. To share, the first

7:37

time assessment fee for

7:41

CareShield Life will be waived.

7:41

For ElderShield, the assessment

7:44

fee will be reimbursed to

7:44

members who are assessed to have

7:46

severe disability.

7:48

So my grandmother, she

7:48

fell and suffered a stroke. It

7:51

was devastating to see your

7:51

loved ones who was healthy

7:54

become someone who could not

7:54

take care of themselves. At that

7:56

time, we wanted to do what we

7:56

can to make things easier for

8:00

her. But in reality, lifestyle

8:00

changes and costs are both very

8:03

real. We were grateful that the

8:03

hospital connected us to

8:06

professional help that guided my

8:06

family on what my grandmother

8:09

would need and the financial

8:09

support that are available.

8:12

Those definitely help. So, with regards to claiming for

8:14

payouts, what are some things

8:17

that caregivers or patients may

8:17

not know about? And how would

8:20

CPF board help them?

8:22

We recognise it can be

8:22

frustrating when one becomes

8:24

disabled and could qualify for

8:24

some CPF insurance payouts, but

8:28

did not make a claim due to lack

8:28

of awareness, especially those

8:32

from the lower income group who

8:32

require more financial support.

8:36

From our interactions with CPF

8:36

members with caregiving needs

8:39

and those who become caregivers

8:39

to their loved ones, many were

8:42

lost when they had to scramble

8:42

to find resources and financial

8:46

assistance schemes to tap on.

8:46

With the caregiver taskforce, we

8:50

hope to proactively identify

8:50

Singaporeans with caregiving

8:53

needs, who could qualify for

8:53

some CPF insurance payouts to

8:57

help them elevate their

8:57

financial concerns.

9:00

So Angela, how do we do that?

9:02

To ensure that members

9:02

are aware of CPF insurance

9:05

schemes, we applied data

9:05

analytics to identify citizens

9:09

who need caregiving support due

9:09

to disability or terminal

9:12

illness. We then reached out and

9:12

invited them via letters to

9:16

claim from the various CPF

9:16

insurance schemes such as

9:19

CareShield Life, ElderShield,

9:19

and Home Protection Scheme. In

9:23

instances where potential

9:23

beneficiaries have yet to claim,

9:26

we will call them to understand

9:26

their difficulties so that we

9:29

can provide the necessary

9:29

support to help them kickstart

9:32

the claim process. Behind the

9:32

scenes, we also worked with AIC

9:37

to streamline the application,

9:37

assessment and disbursement

9:40

processes to help members

9:40

receive their payouts more

9:43

seamlessly.

9:44

How has this initiative

9:44

benefited patients and

9:47

caregivers, and how has it

9:47

improved things for them?

9:50

Since we started this

9:50

initiative last year, we have

9:54

identified and invited around

9:54

600 potential beneficiaries to

9:57

claim from CareShield Life,

9:57

Eldershield and Home Protection

10:01

Scheme. Close to half have

10:01

responded and among those who

10:04

claimed, 85% received

10:04

significant payouts. All of them

10:08

expressed appreciation towards

10:08

CPF Board for helping them with

10:12

their financial needs. CPF has

10:12

also partnered other agencies to

10:16

enhance the caregiving support

10:16

landscape. For example, we

10:20

collaborated with AIC so that we

10:20

can proactively identify and

10:24

reach out to help potential

10:24

beneficiaries to also benefit

10:28

from some AIC payouts, such as

10:28

the homecare giving grant.

10:32

And May, other than the

10:32

home caregiving grant, are there

10:35

other AIC schemes that patients

10:35

commonly apply at SCH?

10:39

Of course, yes. For AIC

10:39

schemes, we usually will check

10:43

with Agency for Integrated Care

10:43

if patients are eligible. Some

10:46

of the common schemes that

10:46

patients apply for are Pioneer

10:50

Generation Disability Assistance

10:50

Scheme, where eligible pioneers

10:54

with disabilities can receive

10:54

$100 a month. Another scheme is

10:58

the Interim Disability

10:58

Assistance Programme for the

11:02

Elderly, which we call IDAPE,

11:02

which will benefit seniors who

11:06

are not eligible for

11:06

ElderShield.

11:08

This is something that

11:08

we do not want to wish upon

11:10

ourselves or our loved ones. But

11:10

we need to be prepared for the

11:13

"what ifs". Angela, what are the

11:13

CPF schemes that we can tap on

11:17

to protect ourselves or our

11:17

loved ones financially if they

11:20

are terminally ill?

11:21

In addition to

11:21

CareShield Life and ElderShield,

11:24

the Board's Home Protection

11:24

Scheme helps CPF members pay off

11:27

their outstanding housing loans

11:27

in the event of unfortunate

11:30

death, terminal illness or total

11:30

permanent disability so that

11:34

everyone can have a roof over

11:34

their head.

11:37

Similar to the Home Protection

11:37

Scheme, the Dependents'

11:39

Protection Scheme provides up to

11:39

$70,000 to policyholders in

11:43

their unfortunate death,

11:43

terminal illness or total

11:46

permanent disability to ease

11:46

their burden during this

11:49

difficult time and relieve their

11:49

financial worries.

11:52

So, this might be on

11:52

some people's mind. For patients

11:55

who are terminally ill, can they

11:55

have the option of withdrawing

11:59

their CPF monies early? If so,

11:59

what is the process like?

12:02

Yes, they can. The patient

12:02

can withdraw their CPF savings

12:06

earlier if they are certified by

12:06

a accredited doctor to have met

12:10

any of the following conditions

12:10

like reduced life expectancy,

12:13

permanently unfit for work and a

12:13

permanent lack of mental

12:16

capacity. At the hospital, the

12:16

doctor will need to assess and

12:21

certify that the patient is

12:21

permanently incapacitated. The

12:25

report is then extended to

12:25

Medical Record Office and will

12:28

be released to a family for a

12:28

fees. Some misconceptions that I

12:33

come across is that patients who

12:33

undergo amputations of the limbs

12:36

will request for early

12:36

withdrawal of the CPF monies.

12:40

However, they will need to

12:40

fulfil the following condition

12:43

as I mentioned earlier.

12:44

In fact, members can

12:44

make a lump sum withdrawal of

12:48

$5000 or more from their CPF

12:48

accounts under the Reduced Life

12:51

Expectancy Scheme. To apply for

12:51

the scheme, they can mail the

12:55

completed medical certification

12:55

form to CPF Board and submit

12:59

their application online.

13:01

Caregiving is really

13:01

not an easy role. When my

13:04

grandmother suffered a stroke,

13:04

my aunt actually left her job to

13:07

take care of her. Her entire

13:07

life was disrupted. May, what

13:10

are some tips to help caregivers

13:10

like her to stay resilient?

13:13

The caregiving role is

13:13

definitely not easy. But

13:16

something that we often have to

13:16

look at is self-care. We cannot

13:20

take care of others unless we

13:20

take care of ourselves first.

13:24

And we need to ensure that

13:24

caregivers need to eat well,

13:27

exercise well, get enough rest

13:27

and also to have some me-time to

13:31

do the things that they like.

13:31

And also to be able to get help

13:35

from friends, family and

13:35

professional counselling, if

13:39

needed.

13:40

To encourage some of our members who may be caregivers, would you have any

13:42

heartwarming stories to share

13:45

with us?

13:46

I have seen caregivers who

13:46

are committed and resilient in

13:49

taking care of their loved ones

13:49

while braving through difficult

13:52

times together. I know of this

13:52

caregiver who really lived up to

13:55

the marriage vow of loving her

13:55

husband in sickness and in

13:59

health. She is so committed to

13:59

her husband's care and knows

14:02

about his likes and dislikes.

14:02

Though she's an elderly herself,

14:06

she strives to care for the

14:06

husband at home alone with

14:09

community support and will never

14:09

say "I'm tired" in front of him.

14:13

The husband is also resilient

14:13

and highly motivated with his

14:16

rehab sessions as he wants to

14:16

return home to his wife.

14:21

Thank you, May and

14:21

Angela for taking time off to

14:24

share the various support that

14:24

caregivers can tap on - whether

14:26

it's care planning like

14:26

exploring the various care

14:29

services available or

14:29

psycho-social support,

14:32

counselling and caregivers

14:32

communities or financial

14:36

resources such as all the grants

14:36

and policies that AIC and CPF

14:40

Board have. Before we go, May

14:40

Angela, any parting thoughts for

14:44

our members?

14:45

For caregivers, do not be

14:45

afraid to reach out when you

14:48

need help from families, friends

14:48

and professionals. You are not

14:52

alone.

14:53

While we will

14:53

proactively reach out and invite

14:56

potential beneficiaries to claim

14:56

from CPF insurance schemes, do

15:00

take action when you receive our

15:00

letters or calls so that you can

15:03

receive some payouts to tide you

15:03

through the difficult times.

15:08

If you would like to find out more about healthcare financing schemes, tune in to

15:10

our past podcasts on CPF

15:14

Explains - a guide to healthcare

15:14

financing with CPF. And if you

15:19

like our content, follow us and

15:19

give us a five star rating on

15:45

whichever podcast platform

15:45

you're listening from. I'm Yu

15:58

Zhen, and you're listening to

15:58

Let's Talk CPF.