Across the Causeway: Home away from home
Oct 13, 2016 06.23PM |
WHEN Madam K C Neo, 72, was referred to a nursing home in early 2014, she had just one request.
She pleaded with her husband that she would prefer a single or twin room, as she did not want to spend her remaining days in the company of “many, many strangers”.
“I have had my own room ever since I was married,” said the retired administrative assistant who used to live with her husband in a three-room HDB flat in Toa Payoh.
Single or twin rooms are only available for private-paying patients in Singapore and these can cost upwards of $3,500 per month.
Rather than stay in a government-subsidised open ward, which she is eligible for, Madam Neo moved to a twin room at City Heart Care Nursing Home in Johor Bahru, Malaysia, a 30-minute drive from the Causeway. She pays only $750 a month, about a quarter the amount.
“It’s peaceful here, I have my privacy – and it’s cheap, compared to Singapore.”
Like Madam Neo, a small number of Singaporeans are trekking across the border to live out their last years in nursing homes and old folks’ homes in JB.
“It’s peaceful here, I have my privacy – and it’s cheap, compared to S’pore.”
Exact figures are not available, but checks with three of the state’s largest nursing homes – City Heart Care, Spring Valley and ECON Medicare Centre — showed that 15 to 30 per cent of residents there are Singaporean.
The three homes have more than 600 beds. City Heart has a cluster of seven single-storey and three double-storey bungalows in a private housing estate, some with high ceilings, with a garden outside.
The home, which has been in operation since 1993, has 200 beds, up from 39 when it started, said its Malaysian founder, Mr Yeo Thiang Huei. Close to 20 per cent of its 180 residents are Singaporeans. Fees went up this year and currently start at $850 for Singaporeans, up from $750 earlier. Some rooms and wards are air-conditioned at no extra charge.
While Mr Yeo said he had no immediate plans for expansion, Spring Valley Homecare, which with 210 beds is believed to be one of the largest care homes in JB, plans to expand further, said Mr Frankie Ker, a Singapore permanent resident, who set up the home in 2006.
The majority of the beds at Spring Valley are in open wards with no air-conditioning and cost $600 a month for Singaporeans, way less than the $2,000 or so they would need to pay before subsidies back home.
Unlike the norm in Singapore or JB, all charges, including “hidden costs” – such as consumables – are displayed on its website.
“Since we are competing on cost, I think it is important to be transparent,” said Mr Ker.
The home also offers the cheapest “single rooms” at just $700 a month. These are 30 cubicles created by partitioning one of the bigger dormitories. At 6.6 sq m each, they are barely big enough to fit a single bed, cabinet and chair.
“They filled up quite fast, so I am planning a new home which will be fully air-conditioned and offer only single rooms,” said Mr Ker. The new three-storey 84-bed home is expected to be ready in early 2017.
Around 30 per cent of Spring Valley’s 180 residents are Singaporeans. Both homes have only a small number of beds with a nursing home licence, which requires stricter oversight from local health authorities.
Most beds are licenced as “old folks’ homes” by the Malaysian Social Welfare Department. The operators explained that, according to Malaysian law, at least 40 per cent of care staff in nursing homes must be nurses, just like in hospitals.
That, they feel, is expensive and unnecessary, as nursing home residents generally do not need the same intensive care provided by hospitals. By licensing only some beds as nursing homes, they can keep costs affordable.
A refuge for the sandwich middle-class
Meanwhile, cheaper prices are the biggest pull-factor, especially for middle-class Singaporeans ineligible for subsidised nursing home care back home.
These include families with per capita incomes above $2,600 per month – around a third of the resident population in Singapore. Those with per capita incomes of $1,800 to $2,600 get only 20 per cent subsidy, meaning they would still need to fork out $1,600 per month for a nursing home bill of $2,000.
“The rich can afford one or two maids, the poor are well-looked after, it’s the sandwich class that comes to us,” said Mr Ker.
“The rich can afford 1 or 2 maids, the poor are well-looked after. It’s the sandwich class that comes to us.”
Both City Heart and Spring Valley cater to a similar demographic of Singaporeans – most are single men; many have dementia and other mental illnesses. “Even after the new nursing homes were built in Singapore, we are still getting many dementia cases,” said Mr Ker.
Some Singaporean residents interviewed said they agreed to move to JB because they do not qualify for subsidies in Singapore.
A 44-year-old accident victim, paralysed from neck down, said his air-conditioned twin room at City Heart costs less than a third of what it would cost in Singapore.
“I have learnt to love myself, since I am usually on my own.”
“It’s not fair to burden my siblings even though they are doing well. This place is comfortable and home-like, and I have learnt to love myself, since I am usually on my own.”
Former lorry-driver, Mr Maurice Ong, 60, who is single, claimed he moved to JB after being told by medical social workers that he was “not sick enough or old enough” to qualify for a subsidised nursing home in Singapore.
He had a stroke in his late 40s and was living at home with his mother and a domestic helper.
When his mother died a few years ago, he applied for a nursing home. “I was told I should continue staying at home with a maid,” he said.
But he was not comfortable with this arrangement and, after a stint at a private nursing home in Singapore where he paid $2,000 a month with the help of a nephew, he moved to Spring Valley.
“Here I can get care round the clock, physiotherapy and four meals for only $600,” he said. He rented out his Tiong Bahru HDB flat to pay for his fees in JB.
“Here I can get care round the clock, physiotherapy and 4 meals for only $600.”
Ms Alison Hoo, 78, is another Singaporean at Spring Valley. She left the Lion City for Bordeaux after marrying a Frenchman decades ago. After he died, she sold the holiday resort they ran together and decided to move back home.
“But Singapore had changed and was so much more expensive,” said the soft-spoken former nurse who has friends and family on both sides of the Causeway. She decided to move to the JB home “to stretch my dollars more.”
She has transformed a sunny corner of a cavernous general ward at Spring Valley into a cosy personal space with pretty potted plants, multi-coloured pillows and a small writing desk with her wifi-enabled laptop – her vital connection to the wider world.
Three windows by her bedside offer views of tranquil, lush foliage. The bed next to hers was empty, so the home allowed her to use it to store her books and potted plants for free.
“They know I am a permanent resident here and they’re being kind,” laughed Ms Hoo.
Counsellor Martha Teo, who spent a week staying at Spring Valley in 2015 while researching her Master’s thesis, said some Singaporean families she met were upset at not qualifying for any nursing home subsidies back home.
A woman in her 50s and her adult daughter who would visit the husband frequently at Spring Valley “were both bitter that they did not get any subsidies because they still worked,” said Ms Teo. Their combined pay – at just under $8,000 – was less than the $8,666 median income for working households in Singapore.
“They were worried about long-term costs and tired of making the long journey to JB,” she said.
