Situation for female family caregivers has grown more dire during COVID-19, according to survey by SAWA

Family caregivers in Singapore shoulder a heavier care burden amid the COVID-19 pandemic, while their incomes decrease and out-of pocket expenditures rise.

These are the findings of a survey carried out in May by the Singapore Alliance for Women in Ageing (SAWA), which comprises four organisations: AWARE, Persatuan Pemudi Islam Singapura (PPIS), Singapore Council of Women’s Organisations (SCWO), and the Tsao Foundation.

The alliance, which focuses on the gendered nature of eldercare, has called the survey results “highly troubling”.

“Ink was spilled before COVID-19 about the psychological and financial pressures of family caregiving, such as their propensity for burnout and – in the case of women – their difficulty achieving retirement adequacy,” noted AWARE President Margaret Thomas, on behalf of SAWA.

“With the pandemic, it seems the situation has gone from bad to worse for many,” she added.

SAWA interviewed a total of 42 female family caregivers for the elderly to study their experiences during COVID-19. The average age of the women surveyed was 55.5 years. All except two lived with their care recipients; four in five were caring for their parents and/or parents-in-law.

At the time of the survey, 64 per cent of respondents (27 of 42) were employed; all of these were making less than S$5,000 a month from work. More than half (23) employed domestic workers.

As for the care recipients, their average age was 82 years, and they needed help with an average of 3.2 Activities of Daily Living (i.e. eating, bathing, getting dressed, toileting, transferring and continence). Almost half were suffering from dementia.

The SAWA survey found that with the COVID-19 outbreak, there was a marked increase in caregiving responsibilities for more than half of the respondents. With formal eldercare services closed, the onus was on caregivers to keep care recipients meaningfully engaged throughout the day, in addition to assisting them with physiotherapy and ensuring that their medical needs were met.

One respondent was in the process of employing a new foreign domestic worker, but due to COVID-19, the worker was unable to start.

Caregivers’ informal respite options were also greatly diminished. While relatives used to be able to visit regularly to take over some care duties, the circuit breaker made that impossible.

Work was another major source of stress for caregivers, with work-from-home arrangements proving incompatible with caregiving.

One respondent, a counsellor, reported trying to conduct counselling sessions from home, but with her father unable to go to daycare, having to deal with his difficult behaviour all day was extremely disruptive for her.

Names have been changed to protect confidentiality

Of the 27 working respondents, 52 per cent (14) experienced a change in employment, such as fewer clients, fewer working hours or having their projects put on hold. Many have seen a decrease in income.

One respondent said, “Aside from tutoring, I used to do some training in schools, but with school closures, that’s no longer available for me, resulting in tight expenses now.”

On the other hand, 3 in 4 respondents saw an increase in out-of-pocket expenses during COVID-19. Their weekly expenditure rose: family members required meals throughout the day, utility bills were up, and cleaning supplies needed to be regularly stocked.

Multiple respondents were concerned about exposing care recipients to the virus on public transportation, so they had to opt for taxis instead. Only 1 in 10 were receiving any financial assistance, and only 1 in 3 felt that they were “managing OK for the time-being” with finances.

Despite the challenges, 3 in 5 respondents were able to see some positives in their COVID-19 situation. Of these, nearly half reported that in spite of the additional work, they appreciated having more time to spend with their care recipients. And around a quarter reported that the experience had given them new conflict management skills.

“During the pandemic, there has been a lot of discussion about the challenges of childcare – and rightly so. But we haven’t spared as much thought to the other major group of caregivers in this country. And with the elderly at greatest risk of succumbing to COVID-19, what eldercarers do to protect their wards is more important than ever,” said Ms Thomas.

“We don’t think of family caregiving as ‘essential work’, because it is so invisible. That is why those who perform it remain sadly uncompensated. But the pandemic has thrown into relief all the ‘pain points’ of caregiving, highlighting what many of us have been advocating all along. Our caregivers deserve better, especially now,” she added.