COMMENT Nursing homes are mushrooming in Malaysia. The money is good, for these nursing homes charge anything between RM1,000 and RM3,500 a person and are largely set up by entrepreneurs, mainly on rented premises.

It does not take much effort to find one of these nursing homes by just taking a leisurely drive along Jalan Templer or Jalan Kelang Lama.

I am impressed with a few of the homes, based on their set-up, but it is enough for one or two rotten apples to spoil the business.

Despite being known as nursing homes, some of these homes are managed by people who have no qualification in nursing. One would be fortunate to find a nursing home set up by a good Samaritan, but in some nursing homes that we know, the caregivers take on the role of both the nurse and doctor in prescribing medicines.

Some nursing homes are better off because they have retired nurses on board, but at least in the case of my relative’s previous nursing home, it was managed by only one man, and a foreign worker.  The owner himself had only two years of working experience in the previous nursing home where he worked, before opening one on his own.

 

The nursing home fees are charged based on the condition of the patient. If the patient is more challenging, then the price is usually higher. Understandably, it also depends on the level of service given, and the type of staff that the home employs.

If you can afford it, it is well and fine, but what about parents of children earning just a mid-range  salary? Filial piety is still strong in the Asian culture; therefore, even if we have to tighten our belts on other areas, as children, we want the best for our ageing parents. This is at least true in the case of my relative.

Medications, too, can be expensive

According to his daughter, apart from the pampers and the miscellaneous items such as toiletries, the medicines for her father alone can cost an average of RM1,100 a month. Based on the doctor’s prescription, by 7am, when her father awakes, he has to be given half a tablet of Seroquel one hour before food, followed by 1mg of Lorazepam and 40mg of Micardis.

After breakfast, there is the Vitamin B complex tablet and 20mg Ebiza Memantine. In the evening, before dinner, there is another half a tablet of 300mg Seroquel, followed by 30mg Remeron and half a tablet of Lerstric-Ranbaxy.

We are not talking about other complications such as a swollen leg or a fall. In the case of older women, this is always a major concern, especially when there is a bone fracture after a fall.

As it is, a study conducted by one Universiti Sains Malaysia lecturer, Dr Zaheeruddin Babar, shows that the prices of medicines in Malaysia are among the highest in the region.

Now, with the imminent inking of the Trans Pacific Partnership Agreement (TPPA) by the Malaysian government, there are still a lot of uncertainties over the the prices of medicine. The prices will only go up further, unless there is intervention.

Most average salaried persons may have an average of RM200,000 to RM300,000 in the Employee’s Provident Fund (EPF) after working for more than 20 years. Given that nursing care costs an average of RM30,000 a year, the fund for this alone can only last about 10 years.

That is fine, if you have RM300,000 in the EPF, and if the nursing care costs RM30,000 per annum. But what about those who may only have RM100,000 in the EPF, and the cost of nursing care is, on the average, RM25,000 a year? This means the fund can only last for four years.

In the case of my relative, he was working as a farmer. Now, his two children are having to fork out an average of RM1,500 every month. This on top of the cost of raising their own families. This does not only burden the family, but causes stress to the working children, causing their productivity to dip.

This is why some people prefer to hire maids to look after their elderly folk at home, but there are cases where good nursing care is necessary due to the poor health conditions of the senior citizen.

Government has to play a bigger role

It is time that the government, through the Ministry of Women, Family and Community Development, puts together good infrastructure to support the ageing population in our country.

State governments can also assist by providing community services to cater to the needs of senior citizens, set up affordable retirement homes by converting some of the unutilised buildings into day care centres for the senior citizens.

I have always wondered why there are so many idle community halls around, which can be used as day care centres for senior citizens.

 

The Ministry of Health should also visit nursing homes to monitor the conditions. This is not to penalise them, but to help raise the standards of nursing care in this country. For those who fail to comply with the basic care facilities, the provisions under other laws have to be enforced, until some sort of nursing care law is finally passed in Parliament.

                

National news agency Bernama quoted Health Minister Dr S Subramaniam as saying on Dec 12, 2013, that an Aged Healthcare Act would be tabled in the Malaysian Parliament in the following year to develop and improving regulations for the aged care sector. However, there seems to have been no further development in this.

The staff who are involved in nursing care should at least be trained and certified to do the job. At the moment, there are no basic standards set for the nursing homes. There are also no requirements to train the staff involved in the nursing homes.

Meanwhile, retired nurses should be engaged to take on some of the nursing homes to ensure that foreign maids are supervised. It can be implemented immediately, if there is sufficient political will at the ministry level.

In 2014, through the good efforts of one Dr Chong Lu Ann of Prince Court Medical Centre, a nurse experienced in dementia patients was brought in from the United Kingdom to train nursing care staff. However, we have found out that the response from these nursing homes was lukewarm.

Unless the relevant authorities put in place the basic training required of all staff and helpers of nursing homes, it is unlikely that the operators of these homes will allow their carers to attend the such training sessions.

It would be a shame for the ministries concerned if volunteers like a personal friend of mine, Christopher Kee, currently based in Melbourne,  is willing to give his time to train the nursing care staff on a small fee, just to cover his air fare.

As a trained psychologist, who wife has worked in nursing homes in Australia for the past 10 years, Kee has promised to be back to Malaysia in March to run a series of seminars and workshops.

 

Non-governmental organisations that are keen to host these training sessions and charge a minimal fee to cover costs, or caregivers who are interested to attend the sessions, can contact his local contact by writing directly to Florence Kwan at florence_7139@hotmail.com.

Part I: Malaysia not ready for ageing population

Part II: Miserable state of some nursing care homes

STEPHEN NG is an ordinary citizen with an avid interest in following political developments in the country since 2008.