Planning For Dementia Archives - DementiaHub.SG

Programmes and Services

Peter Cher — Thu, 09 Apr 2026 02:45:47 +0000

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There are numerous programmes and services available in the community, owing to the Integrated Mental Health Network. This network brings together health, social, and community care providers who serve various clients, including persons living with dementia and their care partners.

If you are just starting out on your journey with dementia and don’t quite know where to start, this article is for you. Read on to find out about the various programmes and services available, how they can help you, and requirements you might need to take note of before applying.

CARE & SUPPORT SERVICES

Care & Support services involve the provision of practical (i.e., support with daily activities, linking clients up to relevant care services), emotional and financial support for persons living with dementia and their caregivers. These services may be rendered at home, a day care centre, or a nursing home for clients who require care and support that cannot be provided at home.

Dementia Helpline

CREST

CREST-CSN

COMIT

CREST-PDS

Meals on Wheels

Medical Escort and Transport

Home Personal Care

Eldersit Services

Maintenance Day Care

Dementia Day Care

Weekend Day Care

Social Service Office

Integrated Home & Day Care

Nursing Home Respite Care

Family Service Centres (FSCs)

Dementia Helpline

CREST

CREST-CSN

COMIT

CREST-PDS

Meals on Wheels

Medical Escort and Transport

Home Personal Care

Eldersit Services

Maintenance Day Care

Dementia Day Care

Weekend Day Care

Social Service Office

Integrated Home & Day Care

Nursing Home Respite Care

Family Service Centres (FSCs)

SOCIAL ACTIVITIES/PROGRAMMES

Social activities and programmes create opportunities for interaction with others in the community, which is especially pertinent for persons living with dementia who may become more withdrawn over time as they socialise or communicate less. These activities and programmes are aimed at slowing down the progress of dementia, providing a structured schedule, and improving the mood of persons living with dementia.

Active Ageing Centres/Active Ageing Centres (Care)

Volunteer Centres/Programmes

Community Centres (CC)

Gym Tonic

Voices for Hope

Active Ageing Centres/Active Ageing Centres (Care)

Volunteer Centres/Programmes

Community Centres (CC)

Gym Tonic

Voices for Hope

MEDICAL AND HEALTHCARE SERVICES

Medical and healthcare services for persons living with dementia may include medical assessments, rehabilitation care, prescription of medications to aid with behaviour, memory and mood, as well as nutritional assessments. These services may be rendered in various settings, including the care recipient’s home, centres, hospitals or nursing homes.

Memory Clinics

Centre-based Nursing

Day Rehabilitation Centres

Home Therapy

Home Medical

Home Nursing

Nursing Home

Memory Clinics

Centre-based Nursing

Day Rehabilitation Centres

Home Therapy

Home Medical

Home Nursing

Nursing Home

ADDITIONAL RESOURCE

Directory Listing of Dementia Support and Services

This resource details a comprehensive list of the various programmes and services in the community, divided by the 4 main regions in Singapore so you can easily find a service provider near you.

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When to Consider Moving into a Nursing Home

aleene.chow — Mon, 11 Mar 2024 00:17:03 +0000

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Caregivers want their loved ones to live in the environment most comfortable to them, which is usually home. However, circumstances might call for a person living with dementia to move into a nursing home if their needs cannot be met at home. Find out more about when you might need to consider having your loved one move, and how you can support them throughout the process.

If the primary caregiver can no longer provide care that the person needs to live well
If the person with dementia lives alone, but requires additional care that is too costly or difficult to access from home because they are wheelchair or bed-bound
If community services are unable to meet their needs adequately
Safety concerns when the caregiver is unable to cope with severe behavioural and psychological symptoms of dementia (BPSDs) or sundowning experienced by the person living with dementia

Allied healthcare professionals may advise a change of living arrangement with the following considerations, in order of priority:

1. Medical health of the person living with dementia
2. Psychoemotional needs of the caregiver (whether the caregiver’s ability to cope with stress, maintain personal relationships and quality of life is impacted by the current caregiving arrangement)
3. Functional status (ability to carry out activities of daily living) and the safety of the person living with dementia
4. Socio-economic considerations

Sudden changes in the person with dementia or the caregiver’s health may require the person living with dementia to change living arrangements. It is hence best to prepare for these situations ahead of time and select the best nursing home for your loved one’s needs by discussing their long-term care plans with them while they still retain mental capacity.

Who makes the decision to move?

The decision should always be left to the person living with dementia, as long as they have been assessed to retain mental capacity. This means that they are judged to still be capable of making important decisions. They must be able to understand information and weigh options, as well as communicate their decision. However, if the person living with dementia has lost the mental capacity required to make this decision, the Lasting Power of Attorney (LPA) donee can make this decision on their behalf. If the person living with dementia has not appointed anyone as their LPA donee, health and social service professionals can advise their next-of-kin on this decision. If a person living with dementia no longer has mental capacity and has lost contact with their next-of-kin, then a professional body may be appointed as the donee. They are then referred to as a public trustee.

For more information about the Mental Capacity Act, please refer to the Code of Practice.

Code Of Practice – Mental Capacity Act
Source: Office of the Public Guardian

The code of practice elaborates on the Mental Capacity Act, especially in how it is applied to actual situations. It helps professionals, paid caregivers, informal caregivers, family and friends of the person understand their roles and responsibilities under the act to safeguard the interests of the person lacking mental capacity.

It is common for caregivers to feel worried about the changes that living with a loved one with dementia may bring. Many also feel guilt over the decision to move their loved one into a nursing home, even when it is in their loved one’s best interests.

How should the move to a nursing home be carried out?

Your loved one will go through a period of adjustment when they enter the nursing home. Nursing Home Respite Care is a service which offers short-term care for persons living with dementia, and can range in duration from several days up to a maximum duration of one month. Although this is mainly meant to provide respite for caregivers when they are temporarily unable to provide care, it may be a good way to see how your loved one responds to the care environment in a nursing home and for families to ease into the change. To be eligible for respite care options, your loved one must meet some minimum criteria:

- Has moderate to high nursing care needs
- Must have a discharge care plan after the end of the respite care period (they must have a permanent place of stay they can return to)
- Application requires medical records

Often, the application to a nursing home is done through communication with a social worker. As part of the application, a needs assessment will be conducted to assess your loved one’s fit for respite or nursing home programmes, as well as a family conference to hear the opinion of everyone involved. You can find out more about the application criteria here.

You or any authorised caregiver also needs to provide your loved one’s recent (dated no earlier than six months from submission of the application) medical report, which must include the following:

Diagnosis

Clinical History

Current functional status

Required nursing procedures

Drug allergy history (including list of currently prescribed medications)

Cognitive and behavioural symptoms (if applicable)

Results from a chest X-Ray (negative for infectious disease)

COVID-19 vaccination information (full vaccination status required)

You can also use your loved one’s hospital discharge summary if they were discharged within the past six months of application. All of these documents can be provided by your loved one’s primary physician.

Nursing homes will prioritise applications based on your loved one’s fit for criteria. Some nursing homes have specialised dementia wards for those who are mobile but may have behaviours that make them unsuitable for general wards. Priority is usually given to wheelchair- or bed-bound seniors for public nursing homes. For private nursing homes, anyone can apply.

You can speak to a care consultant at AIC Links to find more information about making the change in living arrangement. Alternatively, you can speak to a medical social worker at a polyclinic during your loved one’s scheduled doctor’s visits.

Addressing your loved one's needs during the move

Your loved one will be quite limited in the number of personal possessions they are able to bring into the nursing home when admitted. Often, they are only allotted one wardrobe, or even simply a drawer for personal clothing. They are also not able to bring pets with them, which is another consideration if your loved one is very attached to a family pet. Wherever possible, you should also consider whether the faith and language preferences of your loved one match the nursing home you are applying to. There are several nursing homes affiliated with faith-based organisations.

After the move, speak to the person living with dementia to find out how they feel about the move as early as possible. Many seniors experience relocation stress when moving into a nursing home, although the adjustment period is different for everyone. Some nursing homes also have support groups for family and friends of the home’s residents, which may help if you are feeling anxious over the decision. Talk to the care home nurses/staff about your loved one’s life history and interests. You can still remain actively involved in your loved one’s care even after they move into a nursing home.

Moving from the Nursing Home back to home
You or any authorised caregiver also needs to provide your loved one’s recent (dated no earlier than six months from submission of the application) medical report, which must include the following:It is uncommon for persons living with dementia to transfer from the nursing home back to the home setting. In the case that occurs, the caregiver/guardian should have a conversation with the care team at the nursing home as part of discharge care planning. You may also arrange for an occupational therapist to make a home visit and recommend necessary changes to make the home safer for your loved one. If you are considering moving your loved one back home, you may apply for home leave from the nursing home so they can adapt to the change. Under home leave, residents from a nursing home are temporarily discharged to stay at home.

For more information on the support services available, contact a Community Outreach Team (CREST).

Financial support for application to nursing homes

Nursing homes can be very expensive. Before subsidies, the average cost per month is $4,000 for public nursing homes. Singaporean citizens and Permanent Residents are eligible for between 10-75% subsidy for nursing homes depending on monthly household income per person. A table of subsidy levels can be found on the Ministry of Health’s website.

Other Financial Support

- Moderate/mild disability: Pioneer Generation Disability Scheme
- Severe disability: Interim Disability Assistance Programme for the Elderly/ElderFund, MediSave Care, Pioneer Generation Disability Scheme

You can find a more detailed list of financial schemes here.

Other options

It is always best for persons living with dementia to age in place whenever possible. If your loved one does not require nursing care but have high care needs, there are several services that can offer the support they need for daily activities of living, including:

If they have difficulty with a few ADLs, You can apply for an Integrated Home and Day Care (IHDC) package, which combines different home-based and centre-based care services suited to your loved one’s needs. If you provide care for your loved one at home with the aid of a domestic worker, you are also eligible for the Home Caregiving Grant and Migrant Domestic Worker (MDW) Levy Concession in addition to the schemes listed under Other Financial Support above.

You may also consider assisted living facilities, such as St. Bernadette’s Lifestyle Village or Red Crowns Assisted Living. These facilities are communal living spaces that offer the services mentioned above including housekeeping. It is intended for those who require assistance with ADLs but not nursing or medical care, and can offer residents more independence and privacy compared to a nursing home.

If your loved one is living alone and prefers to continue to do so, you can arrange for befriending services or for a community nurse to make regular visits. You can also get your loved one connected to a Community Case Management Service (CCMS) team for care coordination. The CCMS provider depends on the region of your loved one’s residence, so you can speak to an AIC care consultant to find out more or get a referral from your loved one’s GP.

You can also apply for the Home Monitoring System (HoME+) by the Singapore Red Cross, which is a non-invasive system that uses motion sensors and a panic button to monitor your loved one’s safety and assist them in cases of emergency. However, this service requires you to have a Wi-Fi network set up in your home. Wait time from the point of application for HoME+ can take up to six months.

Singapore Red Cross HoME+

HoME+ helps seniors living on their own, through a helpline and a monitoring, alert and response system for home safety. It offers 100% privacy (no CCTV), and empowers the elderly with greater freedom and security in their own homes. The system features 2 motion sensors, 1 door sensor, 1 gateway and 1 duress button, entirely supported by a call center, community responders and Red Cross’ ambulance services.

Additional Resources

FINDING A NURSING HOME | Connecting Caregiver Tips

For those caring for persons living with dementia, choosing a nursing home may become an eventual necessity.

Patsy Chia was a caregiver to her mother for more than 10 years. She narrows down the factors in finding a nursing home for your loved one, and how families can provide care and concern even if their loved one is not living at home.

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Nutrition & Hydration Needs for Persons Living with Dementia

Admin — Thu, 06 Oct 2022 09:24:54 +0000

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The type of food we eat will affect our health and quality of life. While there is no special diet required for persons living with dementia, the condition may bring about challenges to proper nutrition, hydration, and weight maintenance. Here are a few ways to ensure that your loved one has a well-balanced and nutritious diet, drinks sufficient amounts of liquid, and maintains physical and mental well-being.

The nutritional and hydration needs of persons living with dementia will be similar to other people of their age. People who are undernourished tend to get sick more often and recover from illness and injury more slowly. However, those who experience increased physical activity from restless behaviours (such as pacing up and down, wandering and fidgeting), may need a higher amount of nutrients to try to minimize weight loss.

For most persons living with dementia, maintaining good nutrition may be a challenge. Some of the changes they may experience include a loss of appetite, forgetting to eat and drink, forgetting how to chew or swallow, or developing an insatiable appetite.¹

People in the later stages of dementia may lose a considerable amount of weight. Learn about strategies to help promote oral intake and create a positive eating environment here. If there is persistent weight loss or poor appetite despite these strategies, it is recommended to seek advice from a dietitian.

Eating Well for Healthy Ageing

Eating a well-balanced nutritious diet is important for overall health. My Healthy Plate shows the portions required for a balanced and healthy diet, which is a guideline for one to aim for.

¼ Plate of Wholegrains

Wholegrains provide us with energy, fibre, vitamins (e.g. vitamin B and vitamin E) and minerals (e.g. zinc, magnesium). They are rich in nutrients as they are not overly processed, with their original form being kept. Eating more wholegrains have been shown to lower one’s risk of developing chronic diseases such as diabetes, heart diseases and certain cancers.

Wholegrains include brown rice, wholegrain bread and oatmeal. Wholegrains can also be used to make products such as brown rice vermicelli, chapati from wholemeal flour and wholegrain breakfast cereals.

It is recommended to consume at least 2-3 servings of carbohydrates/wholegrains per day

1 serving of protein equals to:
1 palm size of lean meat/poultry/fish	2 glasses of low-fat milk
4 slices of low-fat cheese	¾ cup of cooked beans/peas/lentils (120g)
4 pieces of tempeh (120g)	¾ block of tau kwa (150g)

Incorporating a variety of wholegrains will help to ensure one gets more nutrients and makes mealtime more interesting. Do keep a look out for “Higher in Wholegrains” Healthier Choice Symbol during grocery shopping.

Meeting the above protein requirements per day will help to ensure that one gets sufficient amounts of iron and vitamin B12 daily. Iron and vitamin B12 help in the formation of haemoglobin in our red blood cells, which are needed to carry oxygen to all parts of our body. There are two types of iron in foods. Haem iron comes from animal sources (such as meat, poultry, fish) and non-haem iron come from eggs and plant sources (such as beans, lentils, peas), nuts, fruits and vegetables. Our body absorbs haem iron better than non-haem iron. Eating foods rich in vitamin C (e.g. oranges, lemons, tomatoes, cabbage) together with foods containing non-haem iron, and drinking coffee/tea away from meals are some ways to help to increase iron absorption. Sources of vitamin B12 include meat, fish egg, yoghurt, fortified soymilk and fortified cereal.

Dairy products (low fat milk/cheese/yoghurt), high calcium soy milk, tofu and canned low sodium sardines are both good sources of protein and calcium. Calcium helps to strengthen our bones and teeth and reduces the risk of osteoporosis. Drinking 2 cups of high calcium low-fat milk or high calcium soy milk will allow one to meet their daily calcium requirements of 1000mg per day. Vitamin D helps our body to better absorb calcium into our body. Food sources of vitamin D include oily fish (e.g. salmon, mackerel, cod), eggs, margarine, fortified cereals, fortified dairy (milk, cheese, yoghurt) and fortified soy milk. Meeting above protein and calcium requirements will generally mean that one is meeting recommended amounts of vitamin D per day.

½ Plate of Vegetables and Fruits

Similar to wholegrains, vegetables and fruits are rich in fibre. They are also rich in vitamins, minerals, phytochemicals and antioxidants. Consumption of adequate fibre daily helps protect one against chronic diseases such as heart diseases, stroke and certain cancers. Fibre helps to regulate our bowel movement, control blood sugar and cholesterol levels, and manage weight gain.

It is recommended for women to take 20g of fibre per day and men to take 26g of fibre per day. This equates to 2 servings of vegetables and 2 servings of fruits per day. Starchy or root vegetables like corn, sweet potato and potato do not count towards the 2 serves of vegetables per day.

1 serving of fruit equals to:
1 small apple, orange, pear or mango (130g)	1 wedge of papaya, pineapple or watermelon (130g)
1 medium banana	10 grapes or longans

1 serving of vegetable equals to:
¼ round plate of cooked vegetables	150g of raw leafy vegetables
¾ cup of cooked leafy vegetables (100g)	100g of raw non-leafy vegetables
¾ cup of non-leafy vegetables (100g)

Overall, it is recommended to:

Enjoy a wide variety of nutritious foods across and within food groups
Eat at least 3 meals a day
Eat 2 servings of fruits and 2 servings of vegetables a day
Eat a diet low in saturated fats and salt
Include foods containing calcium, vitamin D, iron and vitamin B12
Use added sugars in moderation

Drinking Enough Fluids

Persons living with dementia who are older may be more susceptible to dehydration due to reasons such as a blunted sense of thirst, poor memory, immobility or medications interfering with their thirst mechanism.² Low hydration levels are associated with incidences of acute confusion/delirium, urinary tract infections, constipation and delayed wound healing.³

It is recommended to aim for 6-8 glasses of water per day.

Tips to increase fluid intake include:

Frequent encouragement of small amounts of fluids throughout the day
Keep a cup/bottle of water within reach of the elderly
If the senior is not keen on drinking plain fluids, other sources of fluids such as soup, juices, milk, honey water, barley water can be encouraged

Preservation of Cognitive Function

There is currently a move in research to consider the evidence for whole diets (particularly those which are plant-based, rich in good fats), rather than individual nutrients, to help with the prevention of cognitive and functional decline.⁴ This could probably be due to the synergistic beneficial effects of various nutrients in a diet.⁵

Research suggests that healthy dietary patterns with an emphasis on higher consumption of vegetables, fruits, wholegrains and healthy fats, while minimising red meat, refined sugars and processed foods intake may work as a preventative measure to cognitive decline by reducing cardiovascular risks.⁴

Some examples include the Mediterranean Diet, Dietary Approaches to Stop Hypertension (DASH) Diet, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diet and NU-AGE Diet.

Understanding Dementia: Part 7
Source: Agency for Integrated Care

Today, there has been no clear and consistent information on dietary factors that may increase or decrease the risk for the onset of dementia. However, adopting a Mediterranean diet may lower the risk of cognitive decline and dementia. This means eating higher proportions of grains, fruits, fish and vegetables.

These dietary patterns share similar recommendations with My Healthy Plate from the Health Promotion Board (Singapore), though with additional advice for specific food groups and portion sizes. In common, these dietary patterns recommend:

Selecting wholegrains (aim for at least 2 serves of wholegrains per day)
Choose lean meat and oily fish (aim for at least 1 serving of oily fish such as sardine, mackerel, and salmon per week)
Aim for at least 2-3 serves of vegetables per day
Aim for at least 2 servings of fruits per day, including 2 serves of berries per week
Incorporate healthy oils (e.g. olive oil)

However, current research has not yet been able to determine how long the exposure to these diets must be or during which ages is it more effective.⁴ Hence, individuals should be encouraged to follow the above recommendations if they are nutritionally well, as a preventative measure to cognitive decline. There should also be focus on meeting caloric and protein requirements for individuals who are undernourished as poor nutrition can lead to a myriad of health issues.

Additional Resources

Nutrition and Dementia
Source: Alzheimer’s Disease International

This report investigates how a healthy diet and the right nutrition can improve the lives of persons living with dementia. The publication features:

Dietary factors across the life course that might increase or decrease the risk of onset of dementia in later life;
Relationship between dietary nutrients and dementia prevention;
Recommendations on the actions to take in order to improve the nutrition of persons living with dementia; and
The need for more research on nutrition and dementia.

Eating Well with Dementia
Source: Alzheimer’s Society of Ireland

Provides caregivers with information on:
Understanding how dementia can affect a person’s appetite and experience with food;
Meeting the nutritional needs of a person with dementia;
Encouraging a person with dementia to enjoy and be involved in meal preparation and mealtimes; and
Dealing with weight loss, weight gain and other issues that can emerge.

Eating and Living With Dignity
Source: Ministry of Health of Israel

This guide for care professionals and family caregivers provides information, tips, and recommendations addressing the following in persons with dementia, such as:

Difficulties with eating and choosing food;
Constipation problems;
Changes in eating and swallowing as dementia progresses; and
Maintaining health nutrition.

AUTHOR BIO

Clarissa Tai, Senior Dietitian

After graduating from the University of Queensland with a Master in Dietetics degree, Clarissa has been working as a dietitian at Tan Tock Seng Hospital since 2019. Her interest lies in working with the geriatric population, to help improve their health, quality of life and awareness of nutrition related issues.

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Volkert D, Chourdakis M, Faxen-Irving G, et al. ESPEN guidelines on nutrition in dementia. Clinical Nutrition [Internet]. 2015 [cited 2022 Aug];34(6):1052-73. Available from https://nutritotal.com.br/pro/wp-content/uploads/sites/3/2016/03/ESPEN_demencia.pdf
El-Sharkawy AM, Watson P, Neal KR, et al. Hydration and outcome in older patients admitted to hospital (The HOOP prospective cohort study). Age Ageing [Internet]. 2015 [cited 2022 Sept];44(6):943-947. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621229/
Bruno C, Collier A, Holyday M, Lambert K. Interventions to improve hydration in older adults: A systematic review and meta-analysis. Nutrients [Internet]. 2021 [cited 2022 Sept];13(10):3640. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621229 DOI: 10.1093/ageing/afv119
Lavingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet [Internet]. 2020 [cited 2022 Aug];396(10248):413-446. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392084/
Scarmeas N, Anastasiou CA, Yannakoulia M. Nutrition and prevention of cognitive decline. The Lancet Neurology [Internet]. 2018 [cited 2022 Aug];17(11):1006-15. Available from http://old.school.med.uoa.gr/uploads/media/LancetNeurology2018.pdf

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Making a Will

Admin — Tue, 25 Oct 2022 09:25:16 +0000

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Planning a will is important to carry on the wishes of a person after they pass on. The will should contain clear instructions about what one wants to do with their money and the assets they own. It will also ensure that their legacy and future generations are taken care of accordingly

About a Will

A will takes effect after death. It is a legal document that describes a person’s estate, which includes their money, savings and assets. It also states how their estate will be distributed among their beneficiaries.

Wills differ from person to person. It can be a simple one-page document to a complex one, depending on the person’s estate. It also contains instructions about the care of young children, special needs children, gifts to charity, and so on.

A will normally enlists the following:

• A list of all of the person’s assets
• A list of all the person’s liabilities and debts, stating how the person wants to pay their debts off before assets are distributed to the beneficiaries
• The beneficiaries and guardians, and how much each one is to receive
• The executors carry out the person’s will. A beneficiary may also be the executor.
• The advisors (such as the person’s lawyers and accountants)
• A revocation clause: This is to cancel out any wills the person planned previously.
• A residuary clause: This gives the person a say in how they want to distribute the rest of their estate. For example, if a beneficiary dies before the person does, the intended assets will be a part of this remainder.

Why Make a Will?

If a person does not have a will, the Public Trustee, an office under the Ministry of Law, will decide who receives their property based on the law. This means that people to whom this person wants to pass on their money or belongings may not get them. If a person you know or care for has not made a will, help this person ensure that their money goes where they want it to go by planning a will.

They may appoint:

• An executor, someone trusted to make sure their wishes are carried out; or
• A guardian to take care of the property or money they are leaving for their children.

If you and/or a person you care for need legal advice, you may want to consider visiting a free legal clinic. Keep in mind free legal clinics are staffed by volunteer lawyers so not all of them may be experts in this area. You should call the clinic before you visit to make sure they can give you and/or the person you care for the necessary advice. Free legal clinics are also offered at some community clubs.

Additional Resources

My Legacy

A Singapore government website which contains information on end-of-life planning and writing a will.

MoneySense

A Singapore government website which contains information on estate planning.

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Advance Care Planning

Admin — Fri, 21 Oct 2022 09:49:34 +0000

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Advance Care Planning (ACP) is the process of planning for one’s future health and personal care. Having ACP conversations will allow your loved one with dementia to:

Share their personal values and beliefs with the family
Explore how his/her values and beliefs influence their healthcare preferences in difficult medical situations
Delegate a trusted member/relative to make healthcare decisions on their behalf, should he/she be unable to one day

Ideally, discussions about the person living with dementia should take place as early as possible, while your loved one with dementia still has the capacity to make informed choices and decisions.

Learn more about what ACP is. For more information, visit AIC.

Who Is Advance Care Planning For?

ACP is an important part of routine healthcare. Anyone can start their ACP today regardless of their age or health condition. Discussing and documenting healthcare preferences with loved ones and a healthcare team can give everyone peace of mind.

ACP is particularly important for people who have a chronic illness, an early cognitive impairment, frail, or are approaching the end of life.

ACP conversations: Mdm Jee
Source: Agency for Integrated Care

Mdm Jee chose her daughter as her voice. Through Advance Care Planning (ACP) conversations, her loved ones are informed about her personal values and how she wants to be cared for in the event that she is unable to think or speak for herself. This video shines a light on how ACP gave her loved ones peace of mind as they navigate the journey of caring for their mother.

Benefits of Advance Care Planning

Doing an ACP helps to promote more holistic healthcare:

• Patients receive healthcare that is tailored to their values and preferences. Many patients who have done their ACP avoided unnecessary or overly aggressive medical treatments.

• Families of people who have done their ACP experienced less anxiety, less stress, and were clearer about what decisions to make.

• The healthcare team has a better understanding of the quality of life you expect and can act in your best interests.

Importance of ACP conversation for dementia patient
Source: Agency for Integrated Care

A right conversation, at a right time, with the right people enable persons living with dementia and their loved ones to prepare for what lies ahead. This video explores a scenario where a family together works out the care plan of their loved one who has dementia.

Additional Resources

My Legacy

This is a Singapore government website which contains information on end-of-life planning. Their pages are available in English, Mandarin (中文), Malay (Melayu), and Tamil (தமிழ்).

• Find out more on making an Advance Care Plan.
• Find out more on planning ahead.

Are You Afraid Of Dying? | Can Ask Meh?
Source: Our Grandfather Story

In this video, interviewees share their journeys with their health conditions. They also discuss ACP and the Lasting Power of Attorney (LPA).

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Deputyship

Admin — Thu, 06 Oct 2022 11:46:55 +0000

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Appointing a deputy is important for persons with dementia. A deputy aids in making decisions on behalf of their client. This article shares information and resources for understanding the deputyship process.

What is a Deputy?

A deputy is appointed by the Court to make decisions on behalf of a person who lacks mental capacity when the person has not made a Lasting Power of Attorney (LPA) and does not have a donee to decide on his /her behalf in respect of those decisions.

A deputy can be an individual or a licensed trust company under the Trust Companies Act (Cap.336), as prescribed by the Mental Capacity Regulations.

Deputies must submit annual reports to the Office of the Public Guardian (OPG) to explain the decisions and expenses they made on the person’s behalf.

These websites have more information on how to apply for deputyship:

Here are two scenarios that differentiate between doneeship and deputyship:

Scenario A: Doneeship

Mdm Tan has recently been diagnosed with dementia. She learns that as her condition progresses, she may eventually lose mental capacity, and be unable to make key decisions, such as buying a property, or transferring ownership of her personal assets. She wants to appoint someone she trusts to manage her affairs when she no longer has mental capacity. Under the assessment of a geriatrician, she has been assessed to have mental capacity to make an LPA. She chooses to appoint her son and her sister as donees (persons who will manage her affairs on her behalf when she loses mental capacity) for her LPA.

Scenario B: Deputyship

Mr Lee was diagnosed with dementia two years ago. His only daughter, who has been living overseas and recently returned to Singapore, wants to ensure her father’s affairs are managed well. She learns that her father has not made an LPA. His regular physician assesses that Mr Lee is now at a moderate to late stage of dementia, and that he no longer has the mental capacity to make an LPA. Mr Lee’s daughter discusses his options with a social worker and learns that she can apply to the court to be a deputy of her father. After application, the Court will decide whether Mr Lee’s daughter can be a deputy and may appoint her to be Mr Lee’s deputy.

Professional Deputies

The Professional Deputies and Donees (PDD) scheme aims to serve individuals who may not have family members or close friends to rely on to be their proxy decision makers. This scheme came into effect in September 2018.

In the case where a person has lost his/her mental capacity, has not appointed a donee, and others (such as next-of-kin) do not apply to appoint a deputy for this person, the Family Justice Courts can appoint a professional deputy for this person.

Professional deputies and donees:

are paid for their services;
must not be related to the person they are appointed to act for;
must submit annual reports to the Office of the Public Guardian to explain the decisions and expenses they made on the person’s behalf; and
must be an eligible professional from a professional group specified by the Mental Capacity Act (lawyers, doctors, accountants, allied health professionals, nurses, or social workers).

For more information on the Professional Deputies and Donees scheme, visit this page by the Office of the Public Guardian. A list of registered professional deputies and donees can also be found here.

Additional Resources

My Legacy

This is a Singapore government website which contains information on end-of-life planning. Find out more on making a LPA. This page is also available in Mandarin (中文), Malay (Melayu), and Tamil (தமிழ்).

Ask the Experts – Planning Ahead: Finances & Legal

This video by AIC addresses some financial and legal concerns such as how to address frozen assets and how the LPA works.

Source: Agency for Integrated Care

Webinar on Deputyship Duties

This 50-minute webinar is a guide on the duties of a deputy. This webinar includes information about the deputy’s roles and responsibilities towards the person they act for, how they should understand and comply with their court order, and how to fill out the deputy report form.

Source: Ministry of Social & Family Development

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Financial Schemes

Admin — Thu, 06 Oct 2022 02:47:56 +0000

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Caring for a person living with dementia requires careful financial planning, and may sometimes require the family of the person living with dementia to tap on financial resources. There are a number of government financial schemes available.

The blocks below list the financial resources available in the following 5 areas:

• Mobility Assistance
• Daily Activities Assistance
• Caregiving Assistance
• Medical Fees Assistance
• For Low Income Individuals

Click the ‘+’ symbol to expand the list in each block.

List of Financial Resources

For Mobility Assistance

Seniors Mobility and Enabling Fund (SMF)

The SMF provides holistic support for seniors to age in place within the community by extending subsidies to Singaporean seniors:

• Requiring mobility and assistive devices for daily independent living and to remain ambulant in the community
• Receiving government funded home care and care within the community, needing home healthcare items for their care

Find out more.

For Daily Activities Assistance

Enhancement for Active Seniors (EASE)

The Housing and Development Board introduced EASE in 2012 to subsidise home modifications so that older residents can live at ease in their homes.

This is what can be installed in a flat through the EASE programme:

• Slip-resistant treatment to floor tiles in up to two bathrooms or toilets
• Grab bars in the flat (eight or 10 grab bars for the first toilet, and six grab bars for the second toilet)
• Up to five ramps in the flat, and/or at the main entrance – if it is doable

Find out more.

ElderShield

ElderShield is a basic long-term care insurance scheme designed to help Singaporeans meet expenses for severe disability, especially during old age.

The ElderShield scheme has been enhanced into the new CareShield Life scheme introduced from mid-2020.

• Until 2019, Singaporean Citizens and Permanent Residents with MediSave Accounts were automatically enrolled in the ElderShield scheme at 40 years of age, unless they opted out.
• From 2020 onwards, there were no new automatic enrolments into ElderShield at 40 years of age. Singapore Citizens and Permanent Residents born in 1980 and after are instead automatically covered by CareShield Life on 1 October 2020 or when they turn 30.

Depending on the plan the person has, ElderShield will pay a monthly cash benefit of $300 per month for up to 60 months, or $400 per month for up to 72 months if the person has a severe disability. The Ministry of Health has appointed three private insurers to administer ElderShield: Aviva, Great Eastern and NTUC Income.

Find out more from AIC and CareShield Life.

CareShield Life

CareShield Life is a long-term care insurance scheme for Singaporean Citizens and Permanent Residents launched on 1 October 2020 which provides basic financial protection should an individual become severely disabled, especially during old age, and need care for a prolonged duration.

CareShield Life policyholders who are/become severely disabled are eligible to make claims, and can receive payouts for as long as they remain severely disabled, and meet the terms and conditions needed to receive payouts. Payouts start at $600 cash per month in 2020, which increases annually until age 67 or when a successful claim is made, whichever is earlier.

Find out more from AIC and CareShield Life.

Interim Disability Assistance Programme for the Elderly (IDAPE)

The IDAPE is an assistance scheme that was set up in 2002 for a small group of seniors who were not eligible for ElderShield at the time, because they were too old or had pre-existing disabilities.

If these seniors develop severe disabilities, they can receive $150 or $250 monthly cash payout (depending on their financial circumstances) for up to 72 months. There is no restriction on how the payments should be used, as long as they are used for the care of the disabled IDAPE claimant.

For example, the payments can offset:

• Medical bills
• Nursing costs
• Hiring a foreign domestic worker (FDW) as a helper to care for the disabled IDAPE claimant

The senior may nominate himself/herself, a caregiver who is 21 years old and above, or a nursing home that the senior is residing in to receive the IDAPE payout.

Find out more.

ElderFund

ElderFund is a discretionary assistance scheme launched on 31 January 2020.

It is targeted at severely disabled lower-income Singapore Citizens aged 30 and older, who are not able to benefit from CareShield Life, ElderShield, and the Interim Disability Assistance Programme for the Elderly (IDAPE), and have low MediSave balances and inadequate personal savings to meet their long-term care needs.

Eligible Singapore Citizens can receive up to $250 cash per month for as long as they remain eligible, and meet the terms and conditions needed for receipt of payment.

Find out more.

MediSave Care

MediSave Care is a long-term care scheme that was launched on 1 October 2020. It allows Singapore Citizens or Permanent Residents aged 30 and above who are severely disabled to make monthly cash withdrawals up to a total of $200 per month from their own and/or their spouses MediSave Accounts for their long-term care needs.

Find out more from AIC and CareShield Life.

For Caregiving Assistance

Caregiving Training Grant (CTG)

The CTG is a $200 annual subsidy that lets caregivers attend approved courses to better care for their loved ones. The $200 subsidy is provided for each care recipient every financial year (from April to March the following year). If multiple caregivers of the same care recipient wish to attend training, the $200 would need to be shared among the family members.

Find out more.

Migrant Domestic Worker (MDW) Levy Concession

The MDW Levy Concession for Persons with Disabilities lets families pay the Migrant Domestic Worker levy at a concessionary rate of $60 a month, instead of $300. Each household is eligible for up to two MDW levy concessions, caring for two loved ones at any one time.

Find out more.

Home Caregiving Grant

The HCG is a $400 monthly cash payout to support loved ones with at least permanent moderate disability, i.e. always require some assistance to perform three or more Activities of Daily Living (ADLs).

This grant can be used to defray the costs of caregiving expenses, such as the costs of eldercare and caregiver support services in the community, or hiring of a Migrant Domestic Worker (MDW).

Find out more.

For Medical Fees Assistance

Community Health Assist Scheme (CHAS)

The CHAS enables all Singapore Citizens, including Pioneer Generation (PG) and Merdeka Generation (MG) cardholders, to receive subsidies for medical and/or dental care* at participating General Practitioner (GP) and dental clinics.

Visit CHAS for more information.

*Only for CHAS Blue/Orange, MG and PG cardholders

Medical Fee Exemption Card (MFEC)

The Medical Fee Exemption Card (MFEC) can cover expenses for standard medical and hospitalisation treatment at government or restructured hospitals, polyclinics, and approved intermediate and long-term care services for needy residents of MOH-funded nursing homes, or MSF-fundSed sheltered and disability homes.

Eligible applicants must have personal savings of $6000 or less, and a monthly per capita family income of $700 or less. They must be Singapore Citizens or Permanent Residents of Singapore, and either residents of MOH-funded nursing homes or MSF-funded sheltered and disability homes.

Find out more.

MediFund

The Medical Endowment Fund (MediFund) is an endowment fund set up by the Government. It is used to assist needy Singapore citizens who experience difficulties paying for remaining bills after receiving Government subsidies and other means of payment, which include MediShield Life, MediSave, and cash.

MediFund Silver, a scheme that is part of MediFund, provides assistance to persons aged 65 and older.

MediFund can be used to pay for restructured hospitals, national specialty centres, and intermediate and long-term care services.

Eligible applicants must be a Singapore citizen, a subsidised patient, have received or require treatment from a Medifund-approved institution, and be having difficulties with paying for their healthcare bills after Government subsidies and other means, including MediShield Life, MediSave, and cash.

Find out more from the Agency for Integrated Care and Ministry of Health.

MediShield Life

MediShield Life is medical insurance that provides life-time coverage for all Singaporeans. Unlike the previous scheme, MediShield, you cannot opt out of MediShield Life.

The premiums for MediShield Life can be paid using Medisave funds or cash. The Government has also provided subsidies for lower- and middle-income Singaporeans, as well as for Pioneer Generation members. There are also subsidies for the first four years of MediShield Life, as people move from MediShield to MediShield Life.

Find out more from the Agency for Integrated Care and Ministry of Health.

For Individuals with Low Income

Silver Support (SS) Scheme

The SS Scheme provides a quarterly cash supplement to seniors who had low incomes during their working years and now have less in their retirement.

There is no need to apply for the Silver Support (SS) Scheme. The CPF board automatically reviews eligibility for SS annually. Persons who qualify will receive a notification letter from CPF in December of the preceding year.

Find out more.

ComCare Schemes

The ComCare group of government financial schemes provide social assistance to low-income individuals and families, and is available at Social Service Offices (SSOs).

1. ComCare Interim Assistance

ComCare Interim Assistance may be provided to individuals and/or households that require urgent and immediate help of a duration of less than 3 months.

Find out more.

2. ComCare Short-to-Medium-Term Assistance

ComCare Short-To-Medium Assistance may be provided to individuals and/or households for persons or households that need temporary financial help due to an inability to find work for a period of time.

Find out more.

3. ComCare Long-Term Assistance (Public Assistance)

ComCare Long-Term Assistance may be provided to persons who are unable to work and need financial support.

Find out more.

Recipients of ComCare Public Assistance receive full subsidies for the treatment of conditions covered under CHAS. Find out more.

Workfare Income Supplement (WIS) Scheme

Introduced in 2007, the WIS Scheme is a broad-based measure for Singaporeans who meet certain requirements that tops up the salaries of our lower-income workers and helps them save for retirement. It supplements their income and retirement savings through cash payments and CPF contributions.

Find out more.

Click on the image below to view the eligibility criteria of financial resources:

How to Access Services for Financial Schemes

eServices for Financing Schemes Application Portal

As part of the Agency for Integrated Care (AIC)’s efforts to streamline the application process for long-term care schemes, AIC has launched the eServices for Financing Schemes (eFASS) application portal on 1 October 2020. Patients and caregivers can submit applications to and manage their long-term care schemes online using the platform.

More information about eFASS.

AIC Link

Need advice on care services and schemes? Caring for a loved one and need training or assistance? AIC Link advises caregivers and their loved ones on getting the right care at the right place. Care Consultants at AIC Link provide information on care at home, assistance schemes, and caregiver support.

Visit AIC Link for more information and how to access financial assistance schemes and other support at these locations.

Social Service Offices (SSOs)

For more general financial assistance, you may approach your nearest Social Service Office find out more about what assistance schemes may be available for you and family members. You may also apply for financial assistance at SSOs.

Find the nearest SSO to your residential address.

Medical Social Services

Some hospitals and healthcare institutions have medical social services. Amongst other responsibilities, medical social workers and officers can provide information on financial assistance. They can help patients and their caregivers to find or be referred to resources in the community to address financial needs, amongst other needs.

If a person living with dementia currently receives services at a hospital or healthcare institution, they and/or their caregivers and family members may approach the medical social services department regarding the financial issues related to the person living with dementia.

Additional Resources

Agency for Integrated Care (AIC): Financial Assistance

Information on financial assistance schemes.

Information on care and finance-related web tools and mobile apps.

LifeSG app

This one-stop mobile application, created by the Singapore government, features information on a list of schemes and other government programmes. Visit LifeSG and download the app from the links below.

SchemesSG

This website was created by a ground-up initiative as a platform for the public to easily search for financial schemes that fit specific sets of needs. Visit SchemesSG.

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Making Your Home Dementia-Friendly

Admin — Wed, 05 Oct 2022 09:24:46 +0000

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Persons living with dementia may face challenges navigating the physical environment, due to loss of orientation, sensory acuity, visual-spatial awareness, and mobility. Changes in their sensory system may reduce their tolerance towards environmental stimuli, such as sound levels, lighting, activity and people. For some persons living with dementia, the lack of sensory stimulation and occupational deprivation results in ill-being, leading to loss of self-worth and self-identity.

Experience Dementia in Singapore is a Virtual Reality (VR) application which provides you with the perspective of a person living with dementia. Step into the shoes of the person living with dementia to experience the challenges faced in a typical apartment in Singapore, and consider how we can modify the environment to support the well-being of the person living with dementia at home.

A dementia-friendly home aims to enable persons living with dementia to maintain their independence in performing everyday activities such as eating, going to the toilet, bathing, and continuing their hobbies in a meaningful way. Where possible the person living with dementia should be supported to engage in activities outdoors.

List of Resources for the Homes of Persons Living with Dementia

Local Resources

360° Virtual Reality Dementia-Friendly HDB Home Design Guide

The 360° Virtual Reality Dementia-Friendly HDB Home Design Guide is a resource developed by Agency for Integrated Care and Dementia Singapore, for persons living with dementia and their families, and care professionals in Singapore. It provides a range of proposed modifications to create a dementia-friendly home that is more accessible, comfortable and safer for persons living with dementia.

For the best viewing and user experience on this virtual reality guide, it is recommended to access it using a desktop.

Experience the Guide

Related Resource

360 Degree Virtual Reality Dementia-Friendly HDB Home Design Guide
Source: Agency for Integrated Care

Care partner Michelle talks about some modifications she has made to make her home more comfortable for her dad Thomas. This video introduces the localised virtual reality home design guide for caregivers, to make their home more dementia-friendly for their loved one, by design.

Watch Video

HACK CARE

HACK CARE by LIEN Foundation is a catalogue of more than 240 pages of ideas to make a home a friendlier environment for persons living with dementia and their families. It assembles practical hacks, surprising ideas, and simple tips and tricks to simplify a caregiver’s life as they cope with the daily challenges of caregiving, while transforming them into meaningful and enriching moments.

How to Design a Dementia-Friendly Home
As Told By An Expert

Source: Qanvast

Ms Koh Hwan Jing – Director of Community Enablement at Dementia Singapore – offers some practical tips on how caregivers can design a home that is safe and appropriate for your loved ones living with dementia in this excellent feature piece by Qanvast.

Image Source: Quanvast

Overseas Resources

Making Your Home Dementia-Friendly

The Alzheimer’s Society in the United Kingdom has developed a booklet which describes some of the ways to create a more dementia-inclusive home, to support persons living with dementia and their families.

The booklet comprises multiple sections, where each section covers a different aspect of living at home. Some of the tips offered by this booklet, may require help and support from care professionals as well. The sections include:

• Lighting
• Furniture and furnishings
• Flooring
• Eating and drinking
• Using the bathroom
• Knowing where things are
• Keeping things in order
• Keeping safe

The booklet contains a checklist that recommends some changes individuals can implement to make their homes more dementia-inclusive.

Safety In and Around the Home

This resource by Dementia Australia contains tips on how friends, family, and caregivers of persons living with dementia, can improve the safety of the physical environment in and around the home.

The page comprises a simple safety checklist for individuals to assess their homes for any safety hazards.

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Advance Medical Directive

Admin — Sun, 02 Oct 2022 10:16:16 +0000

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An Advance Medical Directive (AMD) is a legal document signed by a person in advance, informing their doctor that they do not want any extraordinary life-sustaining treatment to be used in the event that they become terminally ill and unconscious.

Making an AMD is a voluntary decision. As medical technology advances, there are increasingly many ways of extending a person’s life. This means that people can live longer even with a terminal illness. Extraordinary life-sustaining treatment is any medical treatment which serves only to prolong the lifespan of terminally ill patients but does not cure the illness. For example, a respirator connected to a patient to assist with breathing is not a treatment and does not bring about healing for the patient.

A person living with dementia may not be able to express their wishes to continue or stop treatment. Some people may prefer to pass away naturally in peace and not extend treatment. In the situation that a person living with dementia is not able to communicate their wishes to the doctor in the future, the doctor will be guided by their AMD.

How to Make an AMD

Patients must be above the age of 21 and of sound mind.
Three doctors (including the hospital doctor) must all certify that patients are terminally ill.* Two of the doctors must be specialists.
Patients need to complete and sign the AMD form in the presence of two witnesses – the doctor in-charge and someone who is above 21. Both witnesses cannot stand to gain anything from the patient’s passing.

If there is a disagreement between the doctors:

The doctor-in-charge will review the AMD
If there is still no agreement, the Ministry of Health will appoint three additional specialists to review the patient’s case.
If all the three appointed specialists are unable to certify that the patient is terminally ill, the AMD cannot take effect.
More information can be found on the Ministry of Health’s website.
An AMD can be cancelled at any time. The person who has made the AMD can do this by completing a form or writing a letter to the Registrar of AMDs, and having a witness who can testify to their cancellation. The caregiver themself may opt to be a witness.
If the person who has made the AMD is unable to write, they may communicate their wishes to cancel the AMD by speaking or using sign language. The witness will have to submit the notice and explain why they are unable to submit it themselves.
For more information on the Advance Medical Directive, please visit the Ministry of Health’s page on the AMD.

Additional Resources

Planning Ahead: Advance Directives in Singapore

This video provides information on how sharing your wishes and values in advance helps your loved ones understand what treatment decisions you would prefer in a medical crisis. In this talk, Dr Chua will explain the importance of Advance Care Planning (ACP), how it complements the Lasting Power of Attorney (LPA) and AMD and how you can get started on planning ahead.

Source: Council for Third Age (C3A)

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Service Provider	In Partnership With
Allkin Singapore Ltd	Sengkang General Hospital
Allkin Singapore Ltd	Ang Mo Kio Polyclinic Punggol Polyclinic
Dementia Singapore Ltd	Khoo Teck Puat Hospital National Neuroscience Institute Tan Tock Seng Hospital
Fei Yue Community Services	Ng Teng Fong General Hospital
Fei Yue Community Services	Bukit Batok Polyclinic Bukit Panjang Polyclinic Choa Chu Kang Polyclinic
Filos Community Services Ltd	Institute of Mental Health Woodlands Health
Filos Community Services Ltd	Geylang Polyclinic Tampines Polyclinic
Montfort Care	Changi General Hospital
Montfort Care	Eunos Polyclinic
NTUC Health Co-operative Ltd	Alexandra Hospital National University Hospital
NTUC Health Co-operative Ltd	Clementi Polyclinic Jurong Polyclinic Pioneer Polyclinic Queenstown Polyclinic
Thye Hua Kwan Moral Charities Limited	Singapore General Hospital
Thye Hua Kwan Moral Charities Limited	Outram Polyclinic

Planning For Dementia Archives - DementiaHub.SG

Programmes and Services

CARE & SUPPORT SERVICES

SOCIAL ACTIVITIES/PROGRAMMES

MEDICAL AND HEALTHCARE SERVICES

ADDITIONAL RESOURCE

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When to Consider Moving into a Nursing Home

In this Article

Why move into a nursing home?

Who makes the decision to move?

Code Of Practice – Mental Capacity Act Source: Office of the Public Guardian

How should the move to a nursing home be carried out?

Addressing your loved one's needs during the move

Financial support for application to nursing homes

Other options

Additional Resources

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Nutrition & Hydration Needs for Persons Living with Dementia

In this Article

Why is Proper Nutrition & Hydration Especially Important for Persons Living with Dementia?

Eating Well for Healthy Ageing

¼ Plate of Wholegrains

½ Plate of Vegetables and Fruits

Overall, it is recommended to:

Drinking Enough Fluids

Tips to increase fluid intake include:

Preservation of Cognitive Function

Additional Resources

Nutrition and Dementia Source: Alzheimer’s Disease International

Eating Well with Dementia Source: Alzheimer’s Society of Ireland

Eating and Living With Dignity Source: Ministry of Health of Israel

AUTHOR BIO

Clarissa Tai, Senior Dietitian

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Making a Will

About a Will

Why Make a Will?

Additional Resources

My Legacy

MoneySense

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Advance Care Planning

Who Is Advance Care Planning For?

Benefits of Advance Care Planning

Additional Resources

My Legacy

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Deputyship

What is a Deputy?

Professional Deputies

Additional Resources

My Legacy

Ask the Experts – Planning Ahead: Finances & Legal

Webinar on Deputyship Duties

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Code Of Practice – Mental Capacity Act
Source: Office of the Public Guardian

Nutrition and Dementia
Source: Alzheimer’s Disease International

Eating Well with Dementia
Source: Alzheimer’s Society of Ireland

Eating and Living With Dignity
Source: Ministry of Health of Israel

How to Design a Dementia-Friendly Home
As Told By An Expert