Contextual Challenges and the Mosaic of Support: Understanding the Vulnerabilities of Low-Income Informal Caregivers of Dependent Elders in Singapore

Abstract

Informal caregivers play an increasingly important and demanding role in providing and ensuring long-term care for elders. To date, few studies have qualitatively explored the challenges and coping strategies adopted by informal caregivers of dependent elders from lower-income households in Singapore. Based on data from in-depth interviews with 19 respondents, this study provides detailed and nuanced accounts of the lived experiences of low-income informal caregivers. The strains associated with the scarcity of resources among low-income caregivers are compounded by contextual challenges such as fractured familial relationships, role conflicts, and perceived barriers in their institutional environment. To overcome these challenges, low-income caregivers resort to a mix of informal and formal sources of support. Suggested improvements for policies and service provision to address the vulnerabilities of low-income caregivers will also be discussed in light of current gaps.

Long-Term Care for Older Adults in ASEAN Plus Three: The Roles of Family, Community, and the State in Addressing Unmet Eldercare Needs

“…The phenomenon of feminization of aging noted in many of these studies warrants special policy attention. This denotes the need to look out for this group of vulnerable older adults as well as their caregivers in the same disadvantaged position (Suen & Thang, 2018), both of whom will be at greater risk of falling through the cracks in a family-centered system. Countries such as Singapore have focused on increasing employment activities and enhancing skills for older adults as a strategy to meet their own income needs.…”

How Social Participation Benefits the Chronically Ill: Self-Management as a Mediating Pathway

“…The direct negative effect of formal social participation on health-related quality of life (although only on the EQ-5D index score but not the EQ VAS) contradicts the findings of other studies conducted in Asia, where most have found positive effects instead (e.g., He et al, 2016; Li et al, 2011). One possible explanation for this is that given strong ideals of meritocracy in Singapore, low-income individuals are often faced with a challenging institutional environment where they are met with bureaucratic complications and a general lack of empathy toward their plight (Suen & Thang, 2018). Even though social assistance for various needs is available, Suen and Thang (2018) noted that for individuals from low-income groups, “the experience of obtaining social support from formal sources was described [by potential recipients] as being almost tantamount to a violation of their dignity and sense of self-worth.” (p. 12) The general frustration and/or dissatisfaction toward formal organizations may extend to social activities that occur within formal contexts, negating any potential benefits that may be obtained from participating in them.…”

“…Insights gleaned from such studies are likely to highlight how best to optimize the benefits from formal social participation (and reduce any of its possible negatives), especially where chronic care is concerned. This is pertinent for members from low-income groups, who are more likely to face both estrangement from family members (Aw et al, 2017) and hostility from formal organizations (Suen & Thang, 2018).…”

Productive Activities and Risk of Cognitive Impairment and Depression: Does the Association Vary by Gender?

“…A recent study conducted among Singaporean older adults found a detrimental effect of formal social participation on health outcomes (Ang 2016, 2018), suggesting that formal social participation may exhibit different associations with older adult health within Asian contexts. One possible explanation for this is that institutions in Korea (and Singapore) may tend to be overly hierarchical and/or legalistic, often making it unpleasant to deal with formal organizations (or organizers) who may not empathize with older adults (Suen and Thang 2018). It is also possible that volunteering in Korea, for instance, may simply be an arena for the “young-old” to provide care for the “old-old” in the absence of sufficient support from children, in contrast to Western settings where volunteering usually connotes positive experiences such as skill training and formal group activity (Carr 2018; Thoits and Hewitt 2001).…”