OVER the next 10 years, Singapore is expecting to be hit with a double whammy of an ageing population and an increase in mental ailments.
The Ministry of Health (MOH) is taking active steps to cope with this.
In an addendum to President S R Nathan's opening address to Parliament on Monday, MOH said it would strengthen the long-term care sector to help meet the needs of older citizens.
Said Health Minister Khaw Boon Wan: 'We need to ensure that intermediate and long-term care - which includes community hospitals, nursing homes, hospices, home care - is adequately funded and provided well.'
MOH will build five new nursing homes in the next two years, including one for the special needs of psychiatric patients.
There are now three nursing homes run by voluntary welfare organisation (VWOs), dedicated to caring for psychiatric patients.
Planning for the 300-bed home has started and it is likely to be completed in 2012, said a MOH spokesman.
It will be run by a VWO, to be chosen later.
MOH will also build two new nursing homes which can take in elderly with dementia. Together, these two homes will house about 500 patients and will be ready in four years' time.
Medisave will be extended beyond the six chronic diseases, to include outpatient treatment of schizophrenia and major depression.
Doctors who look after the mentally ill welcomed the changes.
There are more nuclear families now and they will need help to look after their mentally ill family members - especially if an aged parent or child has a mental illness and both husband and wife work.
Difficult task
Said Dr Tommy Tan, a psychiatrist in private practice: 'Such families definitely need more help from the state. It's very difficult for them to take care of someone who is mentally unwell.'
If a family member has severe dementia, that person may even need 24-hour nursing.
'You want to stop them from falling or walking out and wandering around, getting lost,' he said.
There are also other behavioural problems, such as paranoia, where they think that people are trying to harm them.
Said Dr Tan: 'Even if families can afford a maid, this is something that a maid cannot handle.'
Because most cannot afford to send family members to a commercially run nursing home, more such homes run by VWOs would be welcome.
Said Dr Ang Yong Guan, a psychiatrist in private practice: 'These homes allow an avenue for families to place their affected family member in a safe environment for short periods of time such as when they go for a holiday or on weekends.'
He thinks more such nursing homes, run on a smaller scale all over Singapore, is the way to go.
'With big institutions, personalised service may be lost. What Singapore needs going forward will be more such homes, on a smaller scale, so that it will be more convenient for people to get to them,' he said.
Even if such patients have maids looking after them, it is not enough.
'Such patients need mental stimulation and physical exercise, which a step-down care facility can offer,' he said.
To Mr Raymond Anthony Fernando, who has looked after his schizophrenic wife for 33 years, more needs to be done for the mentally ill and caregivers.
'Taking care of a mentally ill person is hard,' said Mr Fernando, a 59-year-old writer and motivational speaker.
'This illness is terrifying because it is unpredictable. It requires 24-hour, minute-to-minute care. It's like walking in a minefield and not knowing when it will explode.'
He has tried putting his wife in a home for a few hours, just to get some respite for himself.
But what he saw changed his mind.
'Imagine being served sausage curry one day, then ikan bilis curry the next day and then sausage curry again. It's not only repetitive but it's also unhealthy.
'And I've been in homes where I have seen staff bickering with each other. This is not a good environment for patients, especially the mentally ill,' he said.
Feeling safe
What he would love is a home where he feels his wife would be cared for as well as he would care for her.
'Then I can feel good leaving her there for a few hours while I go and sell my books,' he said.
According to an Institute of Mental Health spokesman, there were about 33,000 outpatients last year and 32,000 outpatients in 2007.
'In the next five years, it is likely that as the population ages, the prevalence of dementia and depression will show an increase,' she said.
