Nursing home staff face bleak future

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Hamid Basil, 54, is a father of two and an ex-factory worker. He has recently quit his job and become an aged care worker. He speaks to The Independent Singapore about his work now.

Hamid whispers something in the fast-asleep silver-haired man’s ears. He opens his eyes but dozes off immediately. Hamid whispers again. Slowly he raises his eyebrows, awake. Hamid seizes the chance to guide the silver-haired man’s hands to move in a circular motion in the air.

Wash, rinse and repeat- Hamid Basil, 54, does these little sessions tens of time every day as an assistant physiotherapist in Green Avenue Nursing Home.

But Ray Chan, Head Nurse of Green Avenue, paints a picture of bleak career progression and ill recognition for people like Hamid, despite Singapore’s urgent need for aged care workers.

By 2030, Singapore is looking at 900,000 elderly citizens, with one elderly to 2.1 working adult ratio. And the industry potentially faces a disastrous manpower crunch when the elderly population in Singapore hits its peak.

“The Ministry of Health acknowledges that the aged population is getting bigger and with that, the percentage of sickness is getting bigger. Naturally the hospitals will filter their aged residents down to community hospitals and the community hospitals to nursing homes,” Chan says.

Currently NTUC Eldercare and Touch Community Services intend to add tens to hundreds of aged care workers to their organisations. Both have emphasised on home care, rather than nursing homes.

“And we desperately need more Hamids in Singapore’s nursing homes.

“His work does feel very mundane and laborious. But many of our residents fall asleep whenever there is even a small window of quietness.

“Nursing homes are not like hospitals. Hospitals can give awards and plentiful career progressions for the aged care workers to specialise. But in a nursing home, it is the same thing over and over again. Career progression is a big problem.

“Are fellow Singaporeans willing to come down to this level of work or not?” Chan says.

Hamid is Green Avenue’s only local caregiver. The 20 others are from Myanmar and Philippines.

Hamid and many others in the caregiving industry earn less than $2,000 a month according to CSM Academy that provides courses for aged caregivers and assistant therapists.

Chan adds that there is some stigma attached to being an aged care worker among locals.

“What some people would call ‘jade hands’. They see many of the things we do here from feeding to cleaning as our duty, not theirs,” he says.

“The real test comes when the family of the resident files a complaint against the aged care worker. If the nursing leadership does not stand up for their staffs but jump the gun and blame everything on the staffs, how would they feel?

“I do believe that everyone who walks into this industry, there is an element of care in them. Many of them have given their all like Hamid.

“If we do not recognise their work and industry leadership does not provide support, they will throw in the towel.”

Chan also mentions current problems with the ‘Categories’ system in nursing home. Fees paid are based on the severity of the residents from Category 1 for least assistance needed to Category 4, most assistance needed.

“For instance, I can have a dementia patient who is physically independent. He does not qualify for Category 4 but he runs everywhere and requires my staff to watch him all the time. We are putting in Category 4 resources but charging Category 2 or Category 3 fee.

“When we charge more, many of them cannot afford to pay,” he says. As a result, the physical fatigue of overworked staffs further deters many from the industry.

Chan describes a daily scene of how manpower crunch and stress can easily ruin their staffs’ morale.

“If we do not have enough staffs to help with physical therapy, many of them will become very stiff and will need hundred per cent care, including feeding.

“During feeding them, some residents will complain, ‘why am I served last?’ and kick up a fuss. If I got an extra pair of hands, then all of them can be served at the same time, I will see less of these problems.

“And if I can see this in my nursing home, I am sure it is repeated elsewhere as well.”

The head of Gerontology Programme, School of Human Development and Social Services, Kalyani Mehta suggests that Singapore should tapped into segments of society that have difficulties in finding jobs.

“For instance, single mothers and retired nurses. Also, glamorise courses such as NITIC and HITEC – the attitudes of these ITE students have to be molded while they are under training, so they can become responsible employees [aged caregivers],” the associate professor says.

Kalyani also calls for a change of attitude towards ageism among Singaporeans.

“In Japan, many youth are successfully employed at nursing homes. Societal attitudes can change and youth should be praised for their devotion to their grandparents or “adopted grandparents.”