Nursing Homes vs Domestic Helpers vs Home Caregivers – Which Is Better for My Loved One?

There comes a time when our loved ones may require extra help to carry out their daily routines, or for medical support. In Singapore, we have a few options to pick from, which leaves us with the question—which is the most well-suited option for our loved one? We explore three commonly considered options—nursing homes, domestic helpers, and home caregivers—below. 

What Are the Different Care Options in Singapore? 

Nursing Homes

Nursing homes are long-term residential care facilities. They provide help to individuals who may require help in carrying out most of their daily life activities, or require additional medical elder care. Some elder care services which can be found in a nursing home are nursing care, physiotherapy, dietary services, and dental care. There are some nursing homes which specialise in dealing with elderly who have specific conditions such as dementia, or psychiatric conditions. At nursing homes, trained nurses are available around-the-clock for the residents to seek assistance from, and residents in nursing homes have to adhere to a daily schedule and routine.

Nursing homes can be a temporary short-term care option for several days for elderly who may require care while their caregivers take some time off. Also, night respite care is available for those who have Sundowning behaviour, which refers to confusion happening during late afternoon, and extending into the night. Sundowning causes a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions. 

Domestic Helper

A domestic helper is someone who is hired to help out with chores at home, or to care for individuals such as young children or elderly in the home. Domestic helpers in Singapore are  hired through employment agencies or by the individual, and are under the purview of the Ministry of Manpower (MOM). In hiring a domestic helper, there are several one-time-off fees incurred in hiring a domestic helper. This includes the employment agency fee, permit application, medical examination, to list a few, and they can add up to $1,500 on average. Depending on the nationality of the domestic helper, a domestic helper’s minimum salary could range from $450 to $570. 

Domestic helpers may require specific training to learn to provide specialised care for elderly with certain conditions; you may need to send them for further caregiver training such as the course conducted by Agency for Integrated Care. 

Home Caregivers

A home caregiver is any individual who takes on the commitment and responsibility of looking after someone who requires assistance in helping themselves due to illness, disabilities, or mental health issues. Home caregivers go to someone’s home and provide help with activities such as meal preparation, dressing, grooming, medication monitoring, transportation and light housekeeping. Besides assistance with daily activities, some of the duties of a home caregiver may involve caring for medical and emotional needs as well.

There are agencies which offer caregiving services. It is important to note that home caregiving services are not the same as home health services, where licensed doctors, therapists and nurses provide medical services. While in-home caregivers may have received training to help them to do their job, they focus mostly on activities of daily living and are not required to perform complex healthcare-related tasks. 

What Factors Should Be Considered in Choosing From the Three Different Care Options? 

There are several factors to consider in choosing the right care option for our loved ones. 

Health Status and Needs of the Elderly

Knowing the condition of our loved ones will help in making a decision on caregiving options.

Nursing Homes

Nursing homes are suitable for elderly who have high care needs, such as:

• Being physically or mentally disabled due to illness
• Having mobility needs and/or are bedbound
• Requiring help with their daily activities like toileting and walking 
• Being unable to be cared for at home by family or paid domestic worker or other care options like day care, home medical services and nursing services etc.

Home Caregivers 

Home caregivers are usually professionally trained to help out with activities of daily living, such as walking to the toilet, showering and so forth. Seniors who may have some light care needs, such as help with daily activities of living, could employ the help of a home caregiver. 

Domestic Helpers

They are usually not professionally trained in caring for elderly with care needs and are not expected to be able to care for such elderly without training.  Households who have elderly who do not require any special care may choose to hire a domestic helper to help out with the daily chores. 

Caregiver Type and Frequency of Care

The attitudes and expertise of the caregiver, as well as the frequency at which they can provide care, matters in considering which service to choose for your loved one. 

Nursing Homes

They have trained staff who are well-equipped to care for elderly people with medical needs. As there are many residents in a nursing home, staff are spread out in their ability to provide additional support or to build rapport with the residents. Care is available round the clock for residents who stay in nursing homes. 

Home Caregivers

They primarily focus on the care recipient’s well-being and hence can focus their energy and attention to provide care to the person in need. This could provide additional companionship and support for the care recipient. Home caregivers can be trained to provide help in areas like Activities of Daily Living, or even care for bedridden individuals. Some caregivers are even able to handle and manage individuals with more rigorous care routines, such as injections, oxygen therapy, or helping with rehabilitation exercises.

This will need to be specified before employing a home caregiver, as these require specific training. If the caregiver is able to manage the care recipient’s needs, they can sometimes help with some light housework relating to the personal hygiene and well-being of the care recipient.

However, this will need to be discussed between the family and the caregiver with regard to work expectations. The number of times a week and duration of care the caregiver provides is flexible and up to discussion between the family and the caregiver. 

Domestic Helpers

They are mainly employed to help with the household chores, such as cleaning, washing, laundry, ironing and cooking. Most of them are not equipped with the necessary skill sets for caregiving, so additional training will be required for them to be able to care for elderly with greater care needs. They stay together with the family and are hence able to build relationships with the elderly better. Domestic helpers are available to provide daily care, as they live together with the family. The Ministry of Manpower recommends up to eight hours of work a day for helpers working more than five days a week, and a weekly rest day to ensure they get to rest and recuperate as well. Off days in the month are required to be given to the helper. 

Accommodation

Nursing Homes

Nursing homes have in-built facilities and equipment for the elderly with greater care needs, such as handrails in the environment or adjustable beds to shift the position of the elderly. However, being a resident of a nursing home would mean adherence to a fixed schedule, and may be restrictive on the resident’s independence. Nursing homes may be necessary if your loved one cannot remain safe independently by themselves. Often, residents in nursing homes require some time to adapt to their new ‘home’, which can be a challenge for some seniors. The new environment, which can be noisy and unfamiliar from home, could cause some additional stress at the start of their stay. 

Domestic Helpers and Home Caregivers

They typically stay or go to the family home to carry out their duties, hence there is no physical transition needed for the elderly, besides getting used to having a new somebody around the house. Some homes may benefit from some re-adaptations to the home environment to ensure safety for the elderly. There are some government subsidies, such as Enhancements for Active Seniors Programme (EASE) or Seniors’ Mobility and Enabling Fund can help to subsidise part of.

Wait Time 

The average wait time for a subsidised bed in a nursing home is about a month, while home-based caregivers have a wait time of about seven days, based on press releases from the Ministry of Health. For domestic helpers, if the helper was hired through an agency, the wait time could be one to four weeks after the helper’s application process has been finalised.

Training and Certifications 

Nursing Homes

Have staff who are certified and trained to carry out medical and rehabilitative procedures required for their live-in residents. 

Home Caregivers

Homage Care Professionals are caregivers or nurses who are trained to provide quality care for the elderly. If your loved one requires more advanced nursing procedures, Homage nurses are equipped to handle simple procedures like urine bag drainage to complex nursing procedures such as PEG feeding or Nasogastric Re-insertion. 

Domestic Helpers

Domestic helpers are typically not certified or trained to handle greater care needs. There are some training grants the domestic helper is eligible to, such as the Eldercare Foreign Domestic Worker scheme, to develop skills to care better for your loved one.

Cost Comparison 

The costs you are able to afford for the care of your loved one is important to consider as well. Nursing homes can range from $2,000 and above a month as they provide comprehensive and specialised care. Domestic helpers’ minimum salary range from $570/month, excluding the cost of maid levy, paid rest days, insurance, and food and transportation allowances. at Homage, you can get a qualified caregiver Home caregivers for just $21 an hour. Fortunately, there are various subsidies to offset the costs of hiring a domestic helper, caregiver, or the cost of staying in a nursing home. 

Welfare Benefits to Elderly 

Nursing Home

Typically plans out some activities for its residents, such as rehabilitation exercises or group activities. This keeps their mind engaged, and keeps them active as well. 

Domestic Helpers 

Domestic Helpers can be instructed to bring your loved ones for walks,  as well as provide personally cooked meals catered to your loved one’s preference.

Home Caregivers

Home Caregivers are equipped to cook and prepare meals that are suited to your loved one’s taste, and engage in meaningful companionship with your loved ones.

Beyond that, Care Professionals from Homage also provides a personalised care plan for each care recipient, where exercises, meals, and activities are customised to your loved one’s needs.

Language is taken into consideration when we match your loved one with the right Care Professional. This is to ensure that your loved one will be able to communicate and engage with the assigned Care Professional meaningfully. 

What Care Option is Best for My Loved One? 

Considering which care option would be most suitable for your loved one would require careful consideration of the above factors.

For example, if your loved one has high support needs and requires personalised care, a home caregiver or nursing home may be suitable.

If your loved one is active and fairly independent and may require minor help around the house, a domestic helper may be well suited to provide this help. If only temporary care is needed in the short term, respite care or a short-term stay at a nursing home could be considered. 

Choosing the Best Care Option in Singapore

Homage provides caregiving services at every stage. Our trained care professionals are able to provide companionship, nursing care, night caregiving, home therapy and more, to keep your loved ones active and engaged. 

Provide the best care to your loved one today!  Fill up the form below for a free consultation with our Care Advisory team.