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Duke-NUS Study: Informal caregiving for Singapore’s seniors valued at $1.28B annually

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SINGAPORE: A recent study by Duke-NUS Medical School has revealed that the monetary value of time spent by informal caregivers in Singapore, who care for seniors aged 75 and above, amounts to approximately S$1.28 billion annually.

This figure represents about 11% of the government’s expenditure on healthcare and highlights the crucial yet often overlooked role of informal caregivers in the country’s eldercare system.

The study, published in the Aging And Health Research journal in June, noted that as Singapore’s population rapidly ages, with the proportion of residents aged 65 and above rising from 7.2% in 2000 to 16% in 2021, the role of informal caregivers is expected to become increasingly vital.

By 2030, nearly one in four citizens will be aged 65 and above, further emphasizing the importance of supporting these caregivers.

The Duke-NUS study, which is the first of its kind to estimate the monetary value of informal caregiving for seniors requiring day-to-day care in Singapore, provides essential insights for policymakers.

The researchers collected data from the ‘Caregiving Transitions among Family Caregivers of Elderly Singaporeans’ (TraCE) study, which surveyed 278 pairs of primary informal caregivers and senior care recipients from 2019 to 2020.

Primary informal caregivers—defined as family members or friends aged 21 and older who provide unpaid help for at least two out of three caregiving tasks—reported spending an average of 33 hours per week caring for their senior recipients.

This time was mainly dedicated to activities such as communication assistance, managing care needs, and offering emotional support.

The researchers estimated that the monetary value of this caregiving time equated to S$15,959 annually for each primary caregiver.

Secondary caregivers, who also contributed to caregiving, reported spending 8.4 hours per week, amounting to an estimated S$4,062 annually.

Nur Diyana Azman, Senior Research Assistant at Duke-NUS’ Centre for Ageing Research & Education (CARE) and the study’s lead author, emphasized the importance of shared caregiving responsibilities, noting that the involvement of secondary caregivers can significantly reduce the burden on primary caregivers.

The study also highlighted the significant role of migrant domestic workers in eldercare, with these workers spending an average of 42 hours per week assisting seniors with daily activities such as walking, bathing, dressing, and feeding. Combined, senior care recipients received an average of 60.5 hours of care per week.

Primary caregivers: Mostly female family members with decade-long commitment

In addition to estimating the monetary value of caregiving, the study also profiled both caregivers and care recipients.

Most care recipients were around 85 years old, predominantly female, widowed, and had no formal education.

Primary informal caregivers were typically around 61 years old, mostly female, and often the child or child-in-law of the care recipient. Many had been providing care for around a decade.

Associate Professor Rahul Malhotra, Deputy Director of Duke-NUS’ CARE and Principal Investigator of the TraCE study, stated that the study’s findings could help inform economic evaluations of care models for seniors and guide policies to better support caregivers in Singapore.

Professor Patrick Tan, Senior Vice-Dean for Research at Duke-NUS, underscored the importance of recognizing the contribution of informal caregivers, noting that without their support, formal care services would face a significantly higher burden, potentially straining social services and healthcare budgets.

“We hope that more efforts can be made to encourage and empower informal caregivers with practical tools and supportive communities so that no caregiver is alone.”

Netizens call for mandatory elder care leave

Commenting on the study’s findings in a Facebook post by The Straits Times, several netizens underscored the insufficient support for informal caregivers, particularly concerning elder care leave.

One comment pointed out that not everyone has access to caregiver leave, making it challenging to take time off for medical appointments for elderly family members.

She suggested that elder care leave should be made mandatory, as it is rarely provided by companies.

Another user argued that elder care leave should be separate from other types of leave, such as the 3 days of family care leave (FCL), asserting that combining them is inadequate for those balancing responsibilities for both elderly parents and children, creating a sense of unfairness.

Additionally, a comment noted that the recent National Day Rally did not address the issue of caregiver support, highlighting that most companies do not offer elder care leave.

This forces caregivers to use their annual leave for medical appointments, limiting their ability to spend time with their own families.

The post Duke-NUS Study: Informal caregiving for Singapore’s seniors valued at $1.28B annually appeared first on Gutzy Asia.

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Redditors question support for PAP over perceived arrogance and authoritarian attitude

Despite Senior Minister Lee Hsien Loong’s warning that slimmer electoral margins would limit the government’s political space “to do the right things”, many Redditors questioned their support for the ruling PAP, criticising its perceived arrogance. They argued that SM Lee’s remarks show the party has ‘lost its ways’ and acts as if it alone can determine what is right. Others noted that the PAP’s supermajority allows for the passage of unfavourable policies without adequate scrutiny.

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In a recent speech, Senior Minister Lee Hsien Loong warned that “if electoral margins get slimmer, the government will have less political space to do the right things.”

Mr Lee, who served as Prime Minister for 20 years, highlighted the risks associated with increasingly competitive politics.

“It will become harder to disregard short-term considerations in decision-making. The political dynamics will become very different,” he stated during his speech at the Annual Public Service Leadership Ceremony 2024 on 17 September.

“Singaporeans must understand the dangers this creates, and so must the public service,” SM Lee stressed.

SM Lee pointed out that Singapore faces formidable internal and external challenges in the years ahead, with rising expectations and demands from citizens.

As growth becomes harder to achieve and politics becomes more fiercely contested, he warned, “Things can go wrong for Singapore too.”

He urged vigilance in preparing for an uncertain future, noting, “As the world changes, and as the generations change, we must do our best to renew our system – to ensure that it continues to work well for us, even as things change.”

Critique of PAP’s Arrogance and Disconnect from Singaporeans

The People’s Action Party (PAP) experienced a notable decline in its vote share during the 2020 General Election, securing 61.24% of the votes and winning 83 out of 93 seats, a drop from 69.9% in 2015.

A significant loss was in Sengkang GRC, where the PAP team, led by former Minister Ng Chee Meng, was defeated by the Workers’ Party (WP).

In discussions on Reddit, some users questioned why they should support the ruling PAP, criticising the party’s perceived arrogance.

They pointed out that SM Lee’s recent remarks illustrate that the party has strayed from effectively serving Singaporeans and seems to believe it has the sole authority to decide what is right.

Others highlighted that the PAP’s super-majority in Parliament enables the passage of unfavourable policies without sufficient scrutiny.

One comment acknowledged that while many older Singaporeans remain loyal to the PAP due to its past achievements, younger generations feel the party has failed to deliver similar results.

There is significant frustration that essentials like housing and the cost of living have become less affordable compared to previous generations.

The comment emphasised the importance of the 2011 election results, which they believe compelled the PAP to reassess its policies, especially concerning foreign labor and job security.

He suggested that to retain voter support, the PAP must continue to ensure a good material standard of living.

“Then, I ask you, vote PAP for what? They deserve to lose a supermajority. Or else why would they continue to deliver the same promises they delivered to our parents? What else would get a bunch of clueless bureaucrats to recognise their problems?”

Emphasising Government Accountability to the Public

Another Redditor argued that it is the government’s responsibility to be accountable to the people.

He further challenged SM Lee’s assertion about having less political space to do the right things, questioning his authority to define what is “right” for Singapore.

The comment criticised initiatives like the Founder’s Memorial and the NS Square, suggesting they may serve to boost the egos of a few rather than benefit the broader population. The Redditor also questioned the justification for GST hikes amid rising living costs.

“Policies should always be enacted to the benefit of the people, and it should always be the people who decide what is the best course of action for our country. No one should decide that other than us.”

The comment called for an end to narratives that present the PAP as the only party capable of rescuing Singapore from crises, stating that the country has moved past the existential challenges of its founding era and that innovative ideas can come from beyond a single political party.

Another comment echoed this sentiment, noting that by stating this, SM Lee seemingly expects Singaporeans to accept the PAP’s assumption that they—and by extension, the government and public service—will generally do the “right things.”

“What is conveniently overlooked is that the point of having elections is to have us examine for ourselves if we accept that very premise, and vote accordingly.”

A comment further argued that simply losing a supermajority does not equate to a lack of political space for the government to make the right decisions.

The Redditor express frustration with SM Lee’s rhetoric, suggesting that he is manipulating public perception to justify arbitrary changes to the constitution.

Concerns Over PAP’s Supermajority in Parliament

Another comment pointed out that the PAP’s supermajority in Parliament enables the passage of questionable and controversial policies, bypassing robust debate and discussion.

The comment highlighted the contentious constitutional amendments made in late 2016, which reserved the elected presidency for candidates from a specific racial group if no president from that group had served in the previous five terms.

A comment highlighted the contrast: in the past, the PAP enjoyed a wide electoral margin because citizens believed they governed effectively. Now, the PAP claims that without a substantial electoral margin, they cannot govern well.

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Reforming Singapore’s defamation laws: Preventing legal weapons against free speech

Opinion: The tragic suicide of Geno Ong, linked to the financial stress from a defamation lawsuit, raises a critical issue: Singapore’s defamation laws need reform. These laws must not be weaponized to silence individuals.

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by Alexandar Chia

This week, we hear the tragic story of the suicide of Geno Ong, with Ong citing the financial stress from the defamation lawsuit against her by Raymond Ng and Iris Koh.

Regardless of who’s right and who’s wrong, this Koh/Ng vs Ong affair raises a wider question at play – the issue of Singapore’s defamation laws and how it needs to be tightened.

Why is this needed? This is because defamation suits cannot be weaponised the way they have been in Singapore law. It cannot be used to threaten people into “shutting up”.

Article 14(2)(a) of the Constitution may permit laws to be passed to restrict free speech in the area of defamation, but it does not remove the fact that Article 14(1)(a) is still law, and it permits freedom of speech.

As such, although Article 14(2)(a) allows restrictions to be placed on freedom of speech with regard to the issue of defamation, it must not be to the extent where Article 14(1)(a)’s rights and liberties are not curtailed completely or heavily infringed on.

Sadly, that is the case with regard to precedence in defamation suits.

Let’s have a look at the defamation suit then-PM Goh Chok Tong filed against Dr Chee Soon Juan after GE 2001 for questions Dr Chee asked publicly about a $17 billion loan made to Suharto.

If we look at point 12 of the above link, in the “lawyer’s letter” sent to Dr Chee, Goh’s case of himself being defamed centred on lines Dr Chee used in his question, such as “you can run but you can’t hide”, and “did he not tell you about the $17 billion loan”?

In the West, such lines of questioning are easily understood at worse as hyperbolically figurative expressions with the gist of the meaning behind such questioning on why the loan to Suharto was made.

Unfortunately, Singapore’s defamation laws saw Dr Chee’s actions of imputing ill motives on Goh, when in the West, it is expected of incumbents to take the kind of questions Dr Chee asked, and such questions asked of incumbent office holders are not uncommon.

And the law permits pretty flimsy reasons such as “withdrawal of allegations” to be used as a deciding factor if a statement is defamatory or not – this is as per points 66-69 of the judgement.

This is not to imply or impute ill intent on Singapore courts. Rather, it shows how defamation laws in Singapore needs to be tightened, to ensure that a possible future scenario where it is weaponised as a “shut-up tool”, occurs.

These are how I suggest it is to be done –

  1. The law has to make mandatory, that for a case to go into a full lawsuit, there has to be a 3-round exchange of talking points and two attempts at legal mediation.
  2. Summary judgment should be banned from defamation suits, unless if one party fails to adduce evidence or a defence.
  3. A statement is to be proven false, hence, defamatory, if there is strictly material along with circumstantial evidence showing that the statement is false. Apologies and related should not be used as main determinants, given how many of these statements are made in the heat of the moment, from the natural feelings of threat and intimidation from a defamation suit.
  4. A question should only be considered defamatory if it has been repeated, after material facts of evidence are produced showing, beyond reasonable doubt, that the message behind the question, is “not so”, and if there is a directly mentioned subject in the question. For example, if an Opposition MP, Mr A, was found to be poisoned with a banned substance, and I ask openly on how Mr A got access to that substance, given that its banned, I can’t be found to have “defamed the government” with the question as 1) the government was not mentioned directly and 2) if the government has not produced material evidence that they indeed had no role in the poisoning affair, if they were directly mentioned.
  5. Damages should be tiered, with these tiers coded into the Defamation Act – the highest quantum of damages (i.e. those of a six-figured nature) is only to be reserved if the subject of defamation lost any form of office, revenue or position, or directly quantifiable public standing, or was subjected to criminal action, because of the act of defamation. If none of such occur, the maximum amount of damages a plaintiff in a defamation can claim is a 4-figure amount capped at $2000. This will prevent rich and powerful figures from using defamation suits and 6-figure damages to intimidate their questioners and detractors.
  6. All defendants of defamation suit should be allowed full access to legal aid schemes.

Again, this piece does not suggest bad-faith malpractice by the courts in Singapore. Rather, it is to suggest how to tighten up defamation laws to avoid it being used as the silencing hatchet.

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