Spotlights on caregiving, palliative care, and youth mental health (September/October 2024)
"It is important to acknowledge that without informal caregivers, formal care services might strain social services and healthcare budgets."
Caregiving and caregiving support, palliative care and end-of-life concerns, as well as youth mental health were the focus of Singaporean research studies and publications in September and October.
With caregiving and caregiving support, a Duke-NUS study estimated informal caregiving time and its annual monetary value, while an Institute of Mental Health study examined caregivers of individuals with dementia. A Lien Foundation and Kantar survey studied Singaporeans’ awareness and knowledge of palliative care, and another report underlined preferences of older adults to age in place. And with youth mental health, given that the struggles of those who are depressed, anxious, and stressed are well-understood, what are we actually going to do about the problems?
Finally, I share percentages or proportions related to financial freedom, workplace discrimination, and perceptions of democracy. And, as always, we conclude with your monthly global news roundup (September and October).
Spotlights on caregiving, palliative care, and youth mental health
Caregiving support and support to caregivers
Caregivers in Singapore provide important support – practically and monetarily – yet support to caregivers warrants further attention. A Duke-NUS study estimated that caregivers provided an average of 33.0 hours of weekly care, and seniors, in turn, received 60.5 hours of care from their primary and secondary caregivers. Cumulatively, the caregivers’ labour was valued at S$1.28 billion annually.
However, it is noteworthy that migrant domestic workers (MDWs) – as live-in full-time employees – provided even more caregiving labour (42.0 hours a week) than the caregivers, reflecting our persistent reliance on them. Their labour is especially significant, considering the other household duties for which they are responsible as well as their meagre compensation. In fact, during his visit to Singapore, Pope Francis called on our political leaders to seek fair wages for migrant workers (including the 290,000 MDWs and 440,000 workers in the construction, marine, and process sectors).
Caregivers, including the MDWs, will also have dementia in their sights. Although dementia prevalence among older adults aged 60 and above – resulting from higher employment and education and lower stroke prevalence – has decreased from 10 to 8.8 per cent between 2013 and 2023, the absolute number of Singaporeans with dementia will continue to grow. Consequently, given the increased demand for care needs, care burden and psychological distress among caregivers are expected to rise.
More precisely, this second Well-being of the Singapore Elderly (Wise) study by the Institute of Mental Health (IMH), involving 2,010 respondents, also found that caregivers of individuals with dementia reported significantly higher care burden and psychological distress, compared to caregivers who care for those without dementia.
Palliative care and end-of-life concerns
Palliative care seeks to improve the quality of life for those facing life-threatening illnesses, and the family of these individuals. Among Singaporeans aware of palliative care, while most understood its goals to maximise one’s quality of life and help the whole family cope with a serious illness, “many still mistake it as primarily care of the dying.” The Pulse on Palliative Care survey involving 1,005 Singaporeans – commissioned by family foundation Lien Foundation and conducted by market research company Kantar – was also conducted in 11 other Asia-Pacific regions or countries. Other critical themes included attitudes towards and experience with palliative care (evaluated by respondents to be mostly positive and accessible), as well as priorities and concerns towards death (with a majority wishing to be cared for and to die at home).
Similarly, a study by Ren Ci Hospital and Forbes Research with 500 respondents echoed these findings, concluding that palliative care knowledge appears limited to those who are already in the system and using healthcare services. Ren Ci clinical director David Ng said this to “The Straits Times”, that the aforementioned Pulse on Palliative Care survey:
“… Validated that many in the general population do not understand the full scope of palliative care, overlooking its broader scope to relieve symptoms and enhance quality of life throughout an illness trajectory.”
At the very end of their lives, approximately eight in 10 older adults (aged 53 to 79) prefer to age in their current homes, ideally in communities which housed eldercare or active ageing centres, transportation services, medical facilities, and nearby shops and eateries. This focus on ageing-in-place was included in a study of 6,020 respondents by the Centre for Research on Successful Ageing.
What’s next for youth mental health strategies?
So much has been made of the mental health struggles among young Singaporeans. Findings from the IMH’s first nationwide survey on youth mental health – primarily centred on high depression, anxiety, and stress prevalence – echo what we probably already know, yet discussions on policy changes or evidence-based practice implications feel scant. For instance, proposals to improve school mental health curriculum and help-seeking behaviours have been previously mooted, but our progress and evaluation of programme effectiveness are still unclear. Similarly, we’ve known about excessive social media use and cyberbullying’s ramifications too… What are we actually going to do about them?
Perhaps the mental health advocacy group, SG Mental Health Matters, comes closest. While its latest white paper is principally concerned with articulating a national suicide prevention strategy – which includes a national coordinating office, data-driven surveillance system, and national public awareness campaign – its systematic approach to implementing solutions is refreshing. Because, fundamentally, we want to understand the reasons for young Singaporeans experiencing depression, anxiety, and stress (as well as suicide ideation), such that efforts remedy causes in the earlier stages, and that interventions are not too piecemeal and do not come too late.
Socio-political percentages and proportions
44 per cent of Singaporeans said financial freedom is out of reach. The same proportion (44 per cent) also believed that having children will slow them down in being financially free, according to composite insurer Singlife’s second financial freedom index, which surveyed 3,000 individuals online.
Approximately 33 per cent of young Singaporeans have witnessed or experienced workplace discrimination, according to a poll of 1,006 18- to 43-year-olds conducted by market research company Kantar. This is despite a majority observing their workplaces to be inclusive, where discrimination is ostensibly minimised and diversity embraced.
72.2 per cent of Singaporeans strongly agreed or agreed with the statement, “Democracy may have its problems, but it is still the best form of government.” This was documented from the Singapore edition of the Asian Barometer survey, involving 1,000 participants aged 21 and older. Researchers at the Institute of Policy Studies also classified respondents into three archetypes “based on their contentment with democracy and the current system of government,” including those most content (22.1 per cent), in the middle (53.9 per cent), and those “ambivalent” (24.1 per cent).
Global news roundup
Across Lebanon, hundreds of coordinated pager explosions, for which Israel is said to be involved, killed dozens and injured many more. Reports alleged that Israel rigged the pagers with tiny explosive material and a switch before they were delivered to Lebanon. Days later, hundreds of walkie-talkies and solar devices detonated in a second round of explosions. Hezbollah vowed retribution, as the exploding devices marked a significant escalation in 11 months of conflict.
This was followed by hundreds of Israeli airstrikes against alleged Hezbollah targets – in the area’s deadliest day of attacks since Israel’s war with Hezbollah militants in 2006 – and culminated in the assassination of Hezbollah leader Sayyed Hassan Nasrallah. In response, Iran fired about 180 ballistic missiles at Israel. Weeks later, Hamas leader Yahya Sinwar, also the architect of the October 7 attack on Israel, was identified and killed in Gaza.
Also read about the following in this month’s roundup:
Global geopolitical conflicts;
Laws and judicial conflict; as well as
Electoral and political developments.