CONSUMER CHARTER

In Singapore, where family has long been seen as the first line of support in caring for the elderly, sending a loved one to a nursing home is still shrouded in stigma. Residents are largely clean, fed and physically safe. But in keeping with the philosophy that these homes should be places of dire need, rather than choice, residents’ wishes and preferences have seldom been spoken about.

Once he or she moves in, a resident’s individuality is often eroded by conformity and the dreary rigour of routine. This must change.

Here is a charter advocating a more evolved philosophy of care that Singaporeans can hope to attain – where debilitation and dependence need not rob a person of dignity and purpose, of the passions, privileges and autonomy that make him or her human.

Safeguard privacy

1. Nursing home residents should live in a home-like environment where they can personalise their living areas and have privacy when they need it.

2. Married residents should be given the choice to have their own room with adjacent beds, should both spouses live in the same facility.

Preserve independence

3. As far as their cognitive and physical abilities allow, residents – rather than those who pay for their care – should make decisions on their care and living preferences. With the help of regular therapy, residents should be enabled to regain the ability for self-care, where possible, instead of expecting to be attended to night and day.

4. Restraints, physical or otherwise, should be an absolute last resort. Residents should not be made to use wheelchairs and diapers or be tube fed for the convenience of care staff or to increase work efficiency. Should any of these be required for clinical reasons, every effort must be made to wean residents off wherever and whenever possible.

Respect dignity & individual preferences

5. Residents must be respected as people rather than merely patients and have their individual needs and preferences taken into account. This should extend to their cultural and religious practices, languages they speak and preferred daily schedule, including their meals, care plans and activities.

6. Instead of being clustered in large groups for generic activities, residents should be empowered to form interest groups with other residents and take part in activities that interest them personally, following the example of co-curricular activities in school.

7. Residents or their families should be given a choice to be involved in the day-to-day running of the homes, including planning meals and activities.

Encourage accountability

8. Residents or their families should be able to raise issues that bother them and have access to a clear dispute-resolution process. Whistle-blowers should be protected. There should also be legal safeguards to prevent residents from being involuntarily discharged during the investigation process.

Support transparency

9. All nursing home fees, including those of consumables, should be published online. Any hikes should be communicated clearly to residents in advance and updated on the website promptly.

Urge personal responsibility

10. Residents or their families must accept personal responsibility for their own actions and choices, especially if they value personal autonomy over safety and face an increased risk of mishaps and accidents. They should also be considerate of the needs of fellow residents and staff and should not harass or abuse them.