Caregiving for someone with dementia is a huge undertaking, particularly when one is not adequately equipped to do so. M.E’s challenges in caring for the author’s mother are definitely not unique (Putting mum in a nursing home will be the last resort, Aug 16).

Many families in Singapore hire migrant domestic workers (MDWs) to help care for their elderly relatives. However, a joint study by AWARE and HOME in 2020 found that not all MDWs hired for caregiving receive relevant training beforehand. Existing training programmes are also not standardised.

Without proper training, MDWs are ill-equipped to manage the high care needs of care recipients with dementia. They also have to adapt to their care recipients’ evolving care needs and increasing dependency as the latter’s condition deteriorates. For those who lack the skill to manage the physical and mental strain of caregiving, this is extremely challenging.

At the same time, many MDWs refrain from voicing their concerns for fear of jeopardising their employment. Ultimately, MDWs’ fatigue and inability to cope can compromise their provision of care.

More needs to be done to better prepare and support MDWs in taking on caregiving responsibilities.

Establishing an accreditation system to certify MDWs’ skills can ensure greater standardisation of caregiving training. A standardised care matrix should be used to assess the skill levels of MDWs intending to take on caregiving jobs.

Dementia-specific caregiving training should be made mandatory for MDWs prior to deployment. This would improve the matching process between employers and MDWs by aligning the latter’s skills and the care recipients’ needs. Also, employers intending to hire an MDW for caregiving should be required to declare if the care recipients have dementia and/or behavioural issues.

Our research also found that respite care services are under-utilised, primarily due their high cost. This translates into over-dependance on MDWs to provide round-the-clock care, leaving them overworked and often unable to take rest days. Our eldercare infrastructure should include a national respite care programme to guarantee access to MDW caregivers, and all who need it. Care services should be publicly provided to keep costs affordable.

In 2018, around 82,000 persons above 60 were suffering from dementia in Singapore. This figure is projected to reach 152,000 by 2030. We need to develop more sustainable long-term care plans that do not overly rely on MDWs, and are supportive of all caregivers.

Jaya Anil Kumar, Research and Advocacy Manager at the Humanitarian Organization for Migration Economics (HOME)

Kimberly Wong, Research Executive, AWARE