Supporting caregivers and persons without mental capacity

When someone loses his or her mental capacity, it is sometimes up to loved ones to make important decisions on his/her behalf.

As a geriatric nurse, Priscilla Tan, 38, has seen some family members of her patients caught in disagreements about their loved one who had lost mental capacity. They were missing an important legal document – a Lasting Power of Attorney (LPA).

An LPA allows a person (known as a donor) to appoint someone he or she trusts such as a family member or close friend (known as a donee) to make decisions for them if they lose mental capacity one day.

Knowing the importance of an LPA, Priscilla spoke to her parents about it when her father was diagnosed with dementia in 2016. She explained to her parents the purpose of an LPA and convinced them that it was necessary. This was followed by a six-week wait for the LPA to be registered. This process has now been shortened with the amendments to the Mental Capacity Regulations in August 2019, which halved the waiting period from six to three weeks.

The application fee waiver for Singaporean Citizens making an LPA Form 1, which grants general powers to the donee, has also been extended till 31 August 2020.  For all LPAs received by the Office of the Public Guardian (OPG) from 1 August 2019 onwards, donors and donees can access the registered LPA online through OPG’s e-services portal. They may also request to share a soft copy with third parties like banks.

Priscilla advises everyone to make an LPA early, before a serious condition like dementia occurs.

For cases where an LPA has not been made, and the person has lost mental capacity, family members will need to apply to the Court to be appointed as a “deputy” so that they can make decisions for their loved ones. Sometimes, this process can be long-drawn and complicated.  Hence, to avoid this situation and start the planning process early, Priscilla will also be making an LPA for herself.

To better support caregivers like Priscilla and safeguard persons without mental capacity, the Committee to Review and Enhance Reforms in the Family Justice System (RERF Committee) has made several recommendations which include:

  1. Making counselling available to those facing caregiver stress, and mediation in the event of disputes between family members;
  2. Training and support for appointed and prospective deputies.

Since her father’s diagnosis, Priscilla says their roles have reversed. “I have become more like his parent instead,” she shared. She observes that often, caregivers share similar concerns. For instance, they face stress caring for their loved ones and worry that they may run out of leave to accompany their loved ones to medical appointments. To help both herself and her father, Priscilla sought community support by enrolling her father in the Memories Café programme at the Alzheimer’s Disease Association. Here, her father keeps active and engages in activities like music and drama, while Priscilla gets to meet other caregivers for peer support.

Priscilla is passionate about raising awareness on dementia and caregiving. She created the Instagram hashtag #MyOrthodoxDementiaTherapy to share her experiences with her father and their journey together.

“I hope to use this platform to reach out to more caregivers,” she says. “The journey can be lonely sometimes and I don’t think anyone would truly understand until they have gone through it.”

To caregivers who are apprehensive about seeking support, Priscilla says, “Don’t suffer alone. Ask for help and don’t stress yourself out.”

Caregiving does not need to be a lonely journey.  You can join support groups which offer a safe and comfortable space to share experiences and learn.