Commentary: No amount of eldercare leave will be enough for the harsh reality of caring for aged parents
Amid an ageing society, will having more parental care or eldercare leave help? Community aged-care physician Dr Ng Wai Chong weighs in.

An elderly caregiver in Singapore. (Photo: Calvin Oh/CNA)
SINGAPORE: Some of us stumble into caregiving with little preparation or warning; for others, the awareness of our ageing parents’ needs creeps in slowly but surely. All it might take is a missed medication, a fall or an ominous diagnosis to set us frantically trying to organise care for our aged loved ones.
Many caregivers feel overwhelmed - juggling filial responsibilities, work duties, family commitments and squeezing out some “me time” for self-care. Will having more parental care or eldercare leave help?
Just 13.2 per cent of private companies, or 1,785 firms, offer their staff parental care leave, according to 2020 data provided by Manpower Minister Tan See Leng in March. Companies CNA spoke to mostly offered two or three days of family care leave.
THE CASE FOR ELDERCARE LEAVE
Aged care arrangements are by no means easy to organise, with families often facing tough choices. Eldercare leave, alongside flexible working arrangements, are necessary and should be universally offered by employers if we want to support the national vision of ageing-in-place.
Caregivers who cannot quit working would have to engage community services like home personal care or day care, or hire a domestic helper. Even when such arrangements are in place, caregivers may often need to coordinate care and manage any disruptions.
As a community aged-care physician, some scenarios I have encountered include the domestic helper who wants to quit after being repeatedly accused of stealing because mum’s dementia affects her memory; or when the day care centre becomes concerned when dad starts to cough as that could be a sign of a chest infection.
Such incidents interrupt the caregivers’ routine.
Frail elders are more likely to suffer from acute health crises. A caregiver once told me that each time her bedbound mum coughed, she would lose sleep because it is hard for her to tell what an emergency is and what is not.
She had been given conflicting information in the past for similar symptoms: On one occasion, she was told in the Emergency Department that her mum was critically ill; on another, she was told by the Emergency Department that she could have brought her mum to a general practitioner instead.
Even when the care recipient is not ill, medical appointments alone can take up a lot of time as frail elders typically have multiple chronic diseases requiring many medical appointments at different clinics.
GRANTING ELDERCARE LEAVE IS ONLY ONE PART OF THE SOLUTION
It’s not surprising that some in Singapore are calling for parental care leave to be on par with childcare leave, currently at six days. Just as parents need time off work to care for children who fall sick, so too will caregivers who accompany a senior for medical appointments or to resolve care matters.
While more eldercare leave would be helpful for many, it is only one part of the solution. No amount of eldercare leave will be sufficient alone to address the harsh realities of caring for an ageing population - not without broader support and assistance.
Caregiving is not just about having the time off to provide care, but also about being sufficiently informed and trained in giving care for the specific health condition.
Caring for someone with mild dementia is different from caring for one with a more advanced state of cognitive disability; caring for seniors with anxiety or depression is different from caring for seniors with heart failure requiring careful management of fluid intake and medications.
Indeed, the demands of caregiving often take a toll on the physical and mental well-being of caregivers, making self-care all the more critical. I’ve encountered a frail, frustrated and depressed 90-year-old woman who was her bedbound husband’s caregiver and would hit him whenever he spat at the visiting doctor.
Emotions associated with caregiving are complex - from constant worry over the senior’s deteriorating health, to guilt over whether one is doing enough, to resentment and frustration, particularly in families with fraught relationships.
Some caregivers also grapple emotionally about the responsibility that ends up upon them, when another sibling had been the favoured child for example. Aged care workers often have to facilitate family meetings to negotiate a consensus on roles and responsibilities among siblings and grandchildren.
Another important concern is the financial security of full-time caregivers. One case that illuminates this involves two daughters looking after their mother with severe dementia. When one daughter was diagnosed with advanced breast cancer, the other became caregiver for both her mum and sister. Their unmarried brother, who worked as a truck driver, became the sole breadwinner.
Under the weight of caregiving duties, many caregivers have neglected preparations for old age. It is therefore critical to help them make feasible plans for their own future. In this case, for example, supporting the caregiver also requires consideration for how the daughter will be able to reintegrate the workforce and lead a fulfilling life after her mother and sister pass on.
THE NEED FOR CAREGIVER-CENTRIC CARE PLANS
Different caregivers have diverse needs, which also vary according to the different phase of the caregiving journey. Among caregivers, some are more vulnerable or are experiencing particularly trying times and are in need of focused attention.
If caregivers occupy such a crucial role in the practice of aged care, then aged care must evolve to better acknowledge and recognise the caregivers’ personhood, their specific needs and aspirations in order to provide them with support that is targeted, timely and accessible. This is especially crucial for the support of at-risk caregivers.
We can achieve this through a person-centred and comprehensive caregivers’ needs assessment. Social workers experienced in frail care are well-placed to conduct such assessments and to develop a caregiver-centric care plan.
Singapore is ageing rapidly and caregivers are truly the bedrock of ageing-in-place. Caregiver-inclusive workplaces that offer eldercare leave and the various programmes and schemes that provide direct aged care services, respite care, caregiver training and financial support are all very important policy levers.
However, to really make an impact on the caregiver’s well-being, expert assessment of the multifaceted needs of caregivers is important too.
It is our hope that caregivers can grow and thrive in life as they themselves age. If we do not take care of our caregivers, we cannot take care of our seniors.
Dr Ng Wai Chong is CEO, NWC Longevity Practice, a social enterprise that provides aged care consultancy, training, research, and direct clinical services.