Families For Life | Family Units can’t be Strong if People don’t care for Elderly Parents

This Article was first published on The Straits Times.



A recent story in The Straits Times about a widow facing loneliness and depression after her adult son and his family moved out got me thinking about the organising principle Singapore society used to be based on, with the family unit at the centre, and how this is changing.

The story told of how the 84-year-old woman eventually learnt to recognise she still had a robust relationship with her married son, who visits her for dinner every day. It ended with her putting her son’s needs above her own. She accepted the reality of living on her own and the eventuality of checking into an aged care home so she doesn’t burden her son and his family.

And what choice did she have? It was a heartbreaking acceptance of a situation beyond her control. But shouldn’t family be the first port of call, not the last resort in old age?

Reconciling modern realities with long-held family values

It’s been more than a decade since my wife and I asked my parents, both in their 70s now, to move in with us in our four-room flat – a heavy decision taken with full view of the likely challenges and tensions living in a tight space will bring. But even with the best of intentions to care for them in their old age, the demands of a fast-paced modern life that includes three young kids and jobs involving dealing with rapid changes in the workplace can sometimes shorten tempers. Preventing situations where sparks fly and fighting the  temptation to exchange curt, sharp words is a near impossible

task.

 

Mum’s ailing memory sometimes led to potentially dangerous situations, like an unattended stove or a pair of large tailor’s scissors lying within the children’s reach. Such triggers can create family feuds that spiral out of control and have tested my marriage.

 

Issues like when the children go to bed and whether they should be allowed cold drinks can seem

like trivial matters, but until ground rules are respectfully set – our children, our responsibility – conflict with well-meaning grandparents can be hard to avoid.

 

Although difficult, my wife and I have come to recognise that family solidarity comes from a union of varied family members practising tolerance and valuing harmonious relationships. We always return to a sense of duty and reciprocity of responsibility to our elders. My parents both had little formal education and struggled to bring up me and my siblings. School fees, books and uniforms can be expensive, and we had to borrow from our relatives just to make ends meet on some occasions.

 

Despite the financial challenges, my parents never stint on their love for us and provided an emotionally stable environment to their best effort. Caring for them in their old age, just as they looked after us as helpless children, comes naturally to me. My conviction hardened after personally witnessing my father caring for my paternal grandfather as he lived with us until his last days. He would accompany my frail and cancer-stricken grandfather to his medical appointments and daily trips to the market.

 

Changing values

 

As Singapore ages, the brewing question over who should be the first line of defence for seniors

will require a hard answer. Looking after almost a million seniors in 2030 means every household would likely care for one to two elderly folks. Thus far, the national response has been supportive, with options catering to wide-ranging family circumstances and recognising different financial situations, needs and aspirations. Most recently, the Healthier SG initiative seeks to shift the emphasis of care to proactive preventive care, reshaping health-seeking behaviours and putting the onus on each of us to take charge of our health as we age. We have also been urged to get our own housing, retirement finances and healthcare in order – to start early and save enough to meet the Basic Retirement Sum in our Central Provident Fund and play our part to fund our premiums in the national hospital insurance scheme MediShieldLife.

The growth of assisted living facilities, like Kampung Admiralty, where seniors are surrounded by peers, professional help and community services, points to this alternative model of development planning to support individuals ageing in place.

At the same time, the shift towards greater state support is undeniable. Singapore has created stronger safety nets to look after the less abled and less well-off individuals over the past decade. A slew of schemes like Silver Support and agencies like the Silver Generation Office have been set up to provide financial support to the bottom 20th percentile of senior households and befriending services.

Much state support is also geared towards involving the community to support ageing. The Silver Generation Office recruits volunteers in the same residential district to befriend and introduce public service schemes to elderly households, while the Community Network for Seniors strengthens the model of ageing in place by creating group engagements and encouraging physical activity, with an emphasis on active ageing. The message is clear: The Government will offer some type of backstop if a senior cannot hold it together, due to estrangement from adult children or when the senior does not have family caregivers of his own. But is this coming at the expense of a long-held focus on the family unit to care for older members of their family?

The bedrock of social cohesion

Family as the basic unit of society contributes far more to the prosperity of an economy than individuals can on their own. “The stability and cohesiveness of communities and societies largely rest on the strength of the family,” then United Nations Secretary-General Ban Ki-Moon said in his 2010 annual report. “Singaporeans are well connected with their families and rely on them for a range of emotional, social and instrumental needs,” the Institute of Policy Studies’ Dr Mathew Mathews highlighted in 2013. This ethos focused on the family has served Singapore – one of the fastest-growing nations in the world – over the past 50 years, as working adults strive for excellence and higher standards of living, supported by an enabling and cohesive society.

 These are values shared among most Singaporeans. According to the 2020 World Values Survey, four in five Singaporeans agree that adult children have a duty to provide long-term care for their parents, regardless of educational background, income level and age – one of the highest across Asia.

But can we pay it back to the parents who gave us this lease of life?

Caring for elderly parents, especially those facing physical and cognitive decline in old age, can be physically and emotionally draining, with this responsibility becoming progressively more demanding as old folks develop complicated health conditions. Even if adult children live with their elderly parents, squaring away their needs will require a village. For many in their 50s, larger family sizes then have translated to more helping hands today, as siblings step up and help chaperone elderly parents to medical appointments. But as family sizes have shrunk since the 1980s, some difficult choices must soon be made, especially by those in their 30s and 40s: Do they abandon their parents in their time of need or hold on to their wrinkled hands down the road?

Loneliness, prevalent even among seniors who live with family, can also have a detrimental effect on mental and physical health. A third of older Singaporeans surveyed by the Centre for Ageing Research and Education (Care) over 2016 to 2017 said they were lonely, with the proportion increasing among those aged 80 and above. Care also found that people aged 60 who feel lonely can expect to live three to five years shorter on average. This trend of elderly reclusiveness has recently also received media attention, especially after an elderly man and his mother were found dead in a Tampines flat.

Commit to reciprocating love

Singapore society is evolving as the country focuses on helping our workforce compete in an increasingly globalised marketplace. Legislators in Singapore recognise that matters involving family are complicated matters. The Maintenance of Parents Act, passed in 1995, which seeks to provide seniors with recourse for financial support from their adult children, is now under review, recognising that difficult circumstances in cases of abusive and neglectful parents might warrant special dispensation.

For the rest of us, let’s commit ourselves to caring for our parents in their old age and reciprocate their love with meaningful actions. “Family is about relationship building across the life course. It is about inter-, intra- and alternate generational bonding through love and caring,” Fei Yue Family Service Centre president Thang Leng Leng highlighted in 2014. Living with elderly parents and children in a country where flats don’t have enough rooms except for the rare and expensive multi-generational home can be a practical challenge. But like the man in the story at the start of this op-ed, perhaps an easier ask is: Can you even commit to daily dinners? What simple gestures or consistent rituals that have meaning for our seniors can you commit to?



Learn more about Our FFL Contributor Tan Chin Hock:

Tan Chin Hock is a bit of an adrenaline junkie - a former commando, no less! He is dedicated to empowering and advocating for strong families. With his passion for self-care and healthy living, he leads by example and encourages others to prioritize their family relationships. Through his social enterprise, he aims to inspire and uplift the less resourced communities through photography. Join Chin Hock as he combines his unique experiences and unwavering commitment to promote the importance of strong families and making a positive impact in today's world.

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