This article first appeared on Homage, an award-winning personal care solution that provides on-demand holistic home and community-based care to seniors and adults, allowing them to age and recover with grace, control, and dignity.

When we think about the challenges of living or caring for someone with dementia, the first things we think about are the social and psychological challenges.

Persons with dementia may require a greater level of care and attention from their caregivers because the condition can lead to memory loss, personality changes, and difficulties with balance and coordination. These can pose a strain on the time and energy of those who are caring for them. 

At the same time, these challenges also lead to increased financial costs as persons with dementia often require specialised facilities and help to ensure that they are able to continue with their daily activities with more ease and comfort.

Read on to learn about the costs you need to consider when you are living with dementia or looking after someone who does.

Care considerations for someone with dementia

If you or someone else you know has dementia, there are a variety of care options that you can choose from. These options range from external care facilities to home care services.

We will provide a brief description of what each care consideration includes followed by a price range estimate. All the costs stated below are estimated costs and may vary based on the service providers you choose.

Respite care

Respite care seeks to give primary caregivers a break by taking over their family member’s care needs and duties for a short period of time. As such, it is a great option for caregivers who spend most of their time looking after their family member with dementia and need time off to attend to other matters, such as their chores, work, or taking time off for themselves. Night care is also available for persons with dementia who display sundowning behaviours, where they become disoriented and restless from dusk to dawn.

Homage provides respite care and night care services for persons with dementia. The estimated cost for such services is as follows:

Estimated cost of respite care services: From S$24/hour

Estimated cost of night care services: From S$24/hour

Senior daycare centres

Senior daycare centres provide care and activities for seniors during their opening hours. Activities that your senior can take part in at daycare centres include chair hockey, art and crafts, and playing musical instruments like the ukulele. Some centres offer specialised care for people with dementia, and their programmes include occupational and music therapy to help persons with dementia stay cognitively active and exercise their mental faculties.

The staff at senior daycare centres are also able to help seniors with their activities of daily living (ADLs), such as having their meals, moving around their living area, or transferring from a bed to a chair. Most senior daycare centres are open on weekdays and closed on weekends and public holidays. There are senior daycare centres found across multiple locations in Singapore. You can choose one that is most convenient for you and your loved one. 

Estimated cost: S$900 - S$1,700 per week before subsidies (assuming daily attendance)

Domestic helper

Hiring a domestic helper to take care of yourself or someone else with dementia is a possible option for round-the-clock home care. Having a helper at home can also be a good option for larger families as they can also perform other tasks, like cooking and caring for children, which may help to relieve some of your duties as a caregiver. However, you would need to keep in mind that many domestic helpers are not professionally trained to take care of older people with specialised medical needs.

Before you hire a domestic worker, it is key for you to factor in the hidden costs that come with the process, such as insurance premiums, airfare costs, and daily living expenses.

Estimated cost: S$600 - S$850 per month, excluding living costs

Home care

If your loved one lives alone, you may want to consider investing in in-home care options to get more support with daily tasks.

Homage offers subsidised home care services at affordable prices on-demand, without a need to commit upfront to high costs. Some home care services include:

• Daily Living Care from S$21/hour

• Nursing Care from S$24/hour

• Home Therapy from S$180/hour

Hospice daycare

Hospice daycares provide full-time compassionate care for residents with advanced physical and mental health conditions. Hospice care would be best for people with advanced dementia, those with comorbidities, or individuals who require round-the-clock supervision.

Hospice staff can also help to cater for specialised care needs, like changing feeding tubes or catheters.

Some hospice centres also provide home hospice care, where hospice staff care for patients in the patient’s own homes if they cannot afford the cost of a hospice stay.

Home hospice care is available through some voluntary welfare organisations like Assisi Hospice and Metta Welfare Association. These organisations would require you to submit a means test form and to confirm that there is a caregiver staying in the patient’s home as the medical team would not be living on-site.

Estimated cost: S$250 - S$350 per day

Other costs incurred when caring for a loved one with dementia

Meal delivery services

You can opt for specialised meal delivery services so that you do not have to worry about having to cook or purchase food for your loved one for each meal. Low-cost and affordable meal delivery services, run by non-profit organisations like Bethesda Care Services and Meals on Wheels by the Agency for Integrated Care (AIC), are available.

These services might require a referral from a hospital or polyclinic.

Estimated cost: S$4.80 - S$6.96 per meal before subsidies

Laundry services

Laundry services for seniors are provided by senior home care services, whose staff can assist seniors with managing household chores. Such laundry services include washing, ironing, folding and arranging clothes. 

Estimated cost: S$2 - S$7.50 per kg

Housekeeping

Housekeeping services would include sweeping, vacuuming, air-con servicing and sometimes specialised disinfecting services. With professional housekeeping services, you can choose to let them come over once a week or on a fortnightly basis. Fees can be calculated by the hour or per session, and many companies implement additional weekend surcharges for such sessions.

Estimated cost: S$20 - S$106 per hour

Medical escort services

For older people living alone who have difficulties with moving around, medical escort services are available to bring seniors to their appointments at hospitals and clinics and to bring them back home. Usually, a medical escort would help to transport seniors who need assistance with moving around via non-emergency ambulances or vehicles. Such services are especially important for seniors who live alone without caregivers or family members, which can prevent them from missing hospital trips or important medical appointments.

Estimated cost: S$62 - S$90 per round trip

Other cost considerations that come with dementia care

Home upgrades and specialised facilities

Oftentimes, persons with dementia face greater challenges with mobility and moving around as their condition progresses. In such cases, making alterations to the living environment and upgrading the facilities in your loved one’s home becomes critical for their own safety. Potential upgrades include installing anti-slip floors, grab bars in areas like the bathroom and next to their bed to prevent falls, pagers that your loved one can press whenever they require emergency assistance, or elevator chairs to help one go up and down the stairs.  

If you wish to make such upgrades and live in an HDB flat, you may apply for the Enhancement for Active Seniors (EASE) Programme, which falls under the Home Improvement Programme (HIP). Under this scheme, you will be able to have slip-resistant treatments applied to two bathrooms or toilets in your home, install grab bars in them, and install ramps and wheelchair lifts to help your loved one access their homes safely at highly subsidised prices.

Cost of obtaining a diagnosis

While you might come to the conclusion that your loved one has dementia before they receive an official diagnosis, it is still important to get a confirmation of your loved one’s medical condition from a certified practising doctor. An official diagnosis can be obtained through a referral to the geriatric department of any hospital in Singapore.

Some costs that come with seeking a diagnosis would include the consultation fees for a visit to a specialist as well as the diagnostic tests involved. These tests can include brain scans, a psychiatric evaluation, laboratory tests of blood or spinal fluid, and a neurological evaluation. Nevertheless, early diagnosis has been shown to be able to cut the costs of dementia care by nearly 30% as it can reduce spending on unnecessary tests and treatments.

Cost of brain scan: S$375

Cost of psychiatric evaluation: S$124 - S$188 per hour

Cost of neurological evaluation: S$180 - S$200 per session

Cost of laboratory tests: S$400 for positron emission tomography (PET)

Treatment cost considerations

Dementia treatment includes physical and psychiatric treatments that help people with dementia maintain their physical and mental faculties. Such treatment methods include occupational therapy, rehabilitation and medications. Reminiscence and life story work, which encourages people with dementia to remember and recount their life histories to help improve their memory, is also another form of non-medical treatment available. 

Cost of rehabilitation sessions: S$140 - S$180 per session at a private clinic

Cost of medication: ~S$200 per month

Cost of occupational therapy sessions: S$180 per session

Subsidies for dementia care

As we have seen above, the costs of dementia care can add up to a lot. Thankfully, there are subsidies and grants available to lessen the burden of dementia care and treatment.

Home Caregiving Grant

The Home Caregiving Grant allows families, like yours, to cover some of the costs that come with looking after a loved one who has high care needs. Under this scheme, your family will receive a monthly grant of S$250 or S$400 if your loved one has been assessed to have a permanent moderate disability, which means that they are unable to perform at least three daily living activities on their own.

Caregivers Training Grant

The Caregivers Training Grant is available to caregivers of people with dementia to attend courses that can let them learn relevant caregiving skills. The grant is disbursed by AIC and is available for caregivers of individuals who are Singapore citizens or Permanent Residents (PRs). The grant provides S$200 for caregivers to enrol in any course of their choice that has been approved by AIC. These courses include those on dementia awareness and would be very helpful for a caregiver of someone with dementia. Foreign domestic workers are also eligible to attend. 

Community Health Assistance Scheme (CHAS)

Under the Pioneer Generation Scheme, older Singaporeans can also enjoy subsidies for healthcare costs. Seniors can use their Community Health Assist Scheme (CHAS) cards to receive special subsidies at eligible clinics. The degree of subsidies you can receive varies with the colour of your card. Subsidies for the treatment of a chronic condition like dementia can range from S$28 to S$90 per visit for Pioneer Generation card holders. All Merdeka Generation and Pioneer Generation card holders can receive CHAS benefits regardless of income or the annual value of their home.

Coping with caring for a loved one with dementia

Do you have trouble finding a service provider with staff specialised in dementia care? Or do you find yourself struggling to take a breather while caring for someone with dementia? Homage has got you covered. Our trained Care Pros provide respite care and specialised dementia care, allowing you to catch a break while we help your loved one with their daily care needs, rehabilitative exercises, and more.