More help for mentally incapacitated elderly with no family support

More help for mentally incapacitated elderly with no family support

Seniors who have lost their mental capacity and lack family support will have the option of turning to Voluntary Welfare Organisations (VWOs) to make important decisions for them under a new Government initiative to be launched in early 2018.

SINGAPORE: Seniors who have lost their mental capacity and lack family support will have the option of turning to Voluntary Welfare Organisations (VWOs) to make important decisions for them under a new Government initiative to be launched in early 2018.

The pilot scheme was announced by the Minister for Social and Family Development Desmond Lee on Wednesday (Nov 29) at the inaugural Asian Family Conference, held at Orchard Hotel.

The scheme, called Community Kin Service, will allow VWOs to apply for a court order to manage a fixed sum of their clients’ finances. The court will require a doctor to certify that the client is mentally incapable of making financial-related decisions.

The VWOs will also be granted the right to administer payment to service providers for their charges’ personal, healthcare and household needs.

“Today, VWOs provide practical support to our seniors, such as coordinating home care services for seniors, arranging regular home visits and even helping them monitor their medical appointments and medication,” Mr Lee said.

However, he noted, they face challenges when supporting a senior whose mental capacity is on a "gradual decline".

"Currently, our VWOs are unable to help them with such financial matters," he added.

"This hinders the seniors from being able to support themselves at home, and could inadvertently result in premature institutionalisation."

The Ministry of Social and Family Development (MSF) will pilot the initiative with two VWOs, TOUCH Community Services and AMKFSC Community Services.

Ms Julia Lee, senior director of social work and programme development at TOUCH Community Services, said the initiative will give her clients peace of mind should they decide to continue living at home.

"I think they always have a concern that there's no one to manage their finances in the event that they lose their mental capacity," she added.

"So, with a service provider like us who’s familiar with them, it will very helpful for them to know that their needs will be well taken care of.”

Mr Ng Koon Sing, head of community network senior services at AMKFSC said the initiative will make it easier to use clients' personal finances for their well-being.

"Most of the time, we will have to look for charity dollars, so more processes need to be done to get other service providers to waive their service fees," he added.

"But we know that they have their own savings, and we try as much as possible to tap on their own resources to help them."


The new initiative comes amid an increasing number of elderly singles or couples without children in Singapore who wish to nominate a proxy but lack a strong family network.

In addition, Singapore is home to a rapidly ageing population. By 2030, a quarter of all Singaporeans will be at least 65 years of age.

To be eligible for the initiative, the seniors must be aged 60 and above, have no family support and show signs of declining mental capacity. As a safeguard, VWOs must provide annual reports to the Public Guardian’s office to account for the use of finances.

When asked about a possible conflict of interest arising from the fact that some VWOs double up as service providers, Ms Lee said the court will ensure that expenses are kept to a stipulated limit.

"The court will do their due process to see that the amount we request based on the care plan is reasonable," Mr Ng said, adding that he will introduce standard operating procedures to prevent abuse.

Mr Ng estimates that  about one per cent of AMKFSC's community network's 1,000 clients might have dementia and no next-of-kin, making them eligible for the new initiative.

He cited an example of a man in his 60s who lives in a rental flat. Mr Ng said the man will always use up the S$400 he gets monthly from financial assistance schemes within a few days, yet not knowing what he spent the money on.

"He always comes to the centre saying he has no money for rent or food," Mr Ng said.

"So, this (initiative) will actually cover the gap in terms of the financial portion," he added. "It’s strictly just a few more steps to help the seniors."

On the ground, Mr Ng noted, the new initiative will not change what social workers do, although they might need administrative support when it comes to applying for a court order.

"I understand that MSF is also talking to the court to see how this process can be more streamlined," Mr Ng added. "At the end, our objective is really to help the seniors."

Minister Lee said the Community Kin Service allows VWOs to "fill the role that a next-of-kin would typically play in supporting a senior".

“We will monitor the pilot for a year or two, see what needs to be improved, before considering whether to extend and scale it up as a permanent scheme," he added.


Mr Lee also announced that the qualifying criteria for the Professional Deputies and Donees Scheme will be made more stringent.

The scheme was introduced last year with the amendment of the Mental Capacity Act, allowing individuals to appoint professional donees or deputies, before or after these individuals lose their mental ability to make decisions. 

These professionals, who might be doctors, lawyers or accountants, are paid to make decisions on behalf of individuals they are entrusted to, if and when such individuals lose mental capacity.

To qualify for the scheme, the professionals must now have relevant experience with mental capacity cases, or at least five years of experience in their respective fields of work.

Second, they must not be financially embarrassed, including being an undischarged bankrupt or having a poor credit rating.

Third, they must not have been convicted of property offences or crimes against a person or public order, or be the subject of a civil judgement involving a breach of trust.

Previously, the only requirement was that they cannot be related to the person whom they are appointed to act for. Professional deputies must also register with the Public Guardian.

In addition to the new criteria, MSF is working with the Singapore University of Social Sciences to develop a certification course to train such professionals.

The course will cover topics like the duties and powers of a deputy, creating a care plan for someone who has lost mental capacity and prudent management of financial assets.

“We look forward to working with our stakeholders to roll out the scheme in Singapore in time to come, and strengthen our legal framework to protect individuals who have lost mental capacity,” Mr Lee said. 

Source: CNA/kc