Nursing home project for dementia patients shelved – MOH refused funding

Nursing Home project which would have given dignity for patients with dementia aborted because MOH has refused funding.

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A project for dementia patients, Jade Circle, which was to be jointly-developed by Peacehaven, Lien Foundation and Khoo Chwee Neo Foundation has been aborted after it failed in its attempt to secure government funding for its clients.

Jade Circle was to be a four-storey building constructed next to the current Salvation Army’s Peacehaven nursing home at Changi and built to the tune of $15 million. It hoped to pioneer a different model for dementia care by providing single or twin rooms with en-suite toilets. There would also be a dining area and kitchen for each small group of 12 residents.

Peacehaven reportedly said that such a design is meant to create a home-like environment and provide its clients with more privacy, autonomy and well-being. MOH has decided that it cannot provide subsidies to residents staying in such rooms.

The plans for Jade Circle are markedly different from the more common model of care for dementia patients here, which adopts a hospital-ward layout of six to eight beds per ward.

Fees at Jade Circle were estimated to be $2,800 to $3,500 per month before means-tested subsidies and the two Foundations had committed $10 million towards the project. The project envisioned for clients who are eligible or ineligible for subsidies and would have benefited dementia patients who are mobile, with moderate to severe dementia was announced by the funders in February this year.

In explaining why it cannot provide ongoing subsidies for clients in a nursing home setting like Jade Circle’s, MOH reportedly said that the project will be hard to scale or to be financially sustainable if applied to the rest of the aged care sector, as it does not have the class-distinction of our current healthcare system and so will proxy private or A class ward configurations such as single or double-bedded rooms.

In several first-world countries like Japan, Australia and Britain the maximum number of persons per ward in public hospitals is two. Singapore Democratic Party in their Healthcare Policy Proposal recommended that the Singapore Government do away with class-distinction and convert all wards in our public hospitals to two-bedded ones.

Commenting to a local newspaper on the shelving of plans for the nursing home Chief Executive Officer of the Lien Foundation, Mr Lee Poh Wah said, “unfortunately, we are aborting the project because reconfiguring the number of beds to a ward-like setting goes entirely against our ethos and vision of a future nursing home that helps persons with dementia age with dignity regardless of their socio-economic standing”.

“We can’t use the same funding model for different care settings as patients only stay for days or weeks in hospitals but those in nursing homes typically spend the remaining years of their lives there. With the policy rules in place, innovation has suffered a setback and there is a limit to filling in gaps,” he added.

A spokesperson from MOH has said that she will be meeting Peacehaven and its funders to better discuss collaboration with the different stakeholders with the intention of enabling the project to proceed.

The Ministry has said that it will support innovation on new models of care which can enhance care outcomes for patients provided this can be balanced against sustainability over the longer term.

MOH which is seeking to make the environment of its purpose-built nursing homes more familiar and friendlier to the elderly is ready to extend its portable subsidy scheme to the project, but Jade Circle would have to convert more than half of the 60-bed facility to four-bedded wards.

The Executive Director of Peacehaven, Ms Low Mui Lang, said that this would add just four more beds for the beneficiaries of the project. Ms Low also explained that in a room where there are many identical beds dementia patients may get disoriented. Fights too do break out due to lack of space.

In the year 2006 Peacehaven converted some of its existing wards to single and double bedded rooms. Ms Low said that after the change the clients began to take pride in dressing up and in initiating their own activities.

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