Paying Homage to the elderly in Singapore

IN HER first 10 years, Gillian Tee was cared for by elderly people. As a child, she lived with her grandmother, and her direct caretaker until she was 10 was a woman in her sixties.

The indelible mark they left on her led Ms Tee to set up two decades later a business that would help to take care of the elderly.

With her co-founder Lily Phang, she set up Homage, a start-up that primarily offers in-home care services that help seniors with their Activities of Daily Living (ADL), which include everyday activities such as medication care and personal care.

Miss Tee says: "Homage is a tribute to the people who have raised me, cared for me and given me what I have. I thought a lot about what this means as my mother is over 70 years old this year and I would like her to be able to age gracefully and continue to be in control, living life with choice and dignity in the comfort of her home."

Before starting Homage, Miss Tee was in the United States as a co-founder of another start-up, Rocketrip, that helped people save on business travel expenses.

"That business is now thriving. I am very driven by businesses that improve livelihoods and help people gain a better quality of life. It's the same motivating force that is now driving Homage," she says.

To understand thoroughly her target group, the elderly, she had to start from the ground up. She worked with a local senior care organisation to identify a few seniors who were wheelchair-bound and required daily assistance, and offered to provide the seniors with free caregiving in order to learn what they really needed.

Miss Tee says: "The limitations with medicine and the institutions created for the care of the sick and the old are that they do not include the view of what makes life significant, yet those institutions are the ones largely defining how we live in our final days.

"We have learnt that seniors care about avoiding suffering, strengthening relationships with family and friends, being mentally aware, staying physically active and achieving a sense that their life is still purposeful.

"More people are gradually realising that by remaining in a strong community or at home helps optimise for that type of well-being."

Since the business started in 2016, it has grown to a force of more than 300 carefully-screened professionals on the platform and they have provided more than 30,000 hours of caregiving in Singapore.

Upon signing up, the care manager - typically the loved one of the elderly - can specify his or her preferences for a caregiver and provide details - such as medical conditions - of the care recipient. The Homage platform uses this information to build the care profile and find the best-suited care professional. The care owners will automatically get notified of the assigned caregiver.

"The caregiving market is actually dominated not by newer players but by traditional homecare agencies that have been around for a long time. To this end, we believe the current experience of engaging caregiving services needs significant improvement, and a big enabler of that improvement is technology."

She hopes that technology can help to differentiate Homage from traditional home care agencies.

By the click of a button, care managers can get a suitable caregiver from their homes, which is important as some elderly may find it hard to move around.

Users pay S$20 to S$25 an hour for basic nursing and everyday care services and between S$60 and S$90 for nursing procedures, including stoma care and injections.

Homage also provides home rehabilitation services, including home physiotherapy, speech therapy as well as occupational therapy for between S$160 and S$220 a session.

While Homage has received about 4,000 applications to be caregivers, only 300 has been accepted. They go through a rigorous selection process including a background check, CPR certification, tuberculosis screening, reference checks, certified caregiver training (for the non-nursing trained), among others.

Most of these applicants are nurse-trained, with an average of three years nursing experience. There is also a contingency system in place.

Citing a case where the feeding tube was blocked, she says: " We try to make it easy for our care owners (family members and loved ones) to reach us any way they prefer and offer a care line over phone as well as a WhatsApp line for emergencies. Emergencies come through phone although we also offer an option through the app for booking services with higher urgency within one to two hours."

She believes that her business will continue to grow due to the burgeoning ageing population.

There are some 487,000 people above the age of 65. One of the challenges she faces now is creating awareness of home-based and community-based care throughout Singapore.

She says: "We want people to know that such an option exists to give them the control they want to age in the comfort of their own homes. While acute care remains a fundamental pillar in helping seniors deal with various medical conditions, we're experiencing a shift in healthcare and wellness back to the community and home."

While Homage is focused on providing holistic care for the elderly, it has also started providing daily assisted care for a few adults with disabilities.

Miss Tee says: "Besides helping them (the elderly) independently at home, we also want to help meet their needs more holistically, including helping them stay physically active through simple exercises. Down the line, we might apply some of our insights and lessons learnt from providing senior care to caring for a different target group, including children."