Future Care Planning

Future care planning involves the following aspects:

• Legal (e.g., Deputyship, Lasting Power of Attorney, estate planning, will)
• Financial (e.g., Special Needs Trust, financial literacy in building up assets for your loved one’s future care needs)
• Healthcare (e.g., Advance Care Plan, Healthcare Passport)
• Living and care arrangements

You can refer to the FutureReady website by MINDS as a resource to help you draft and implement a future plan for your loved one. This resource is helpful for persons with all disability types. 

The care plan may need to be reviewed as new needs emerge for your loved one or family circumstances, caregiving roles and responsibilities change.

Here are some actions to consider:

1. Assess your current caregiving abilities, health status and your own care needs, and think about how these might change in the future.
2. Re-examine the distribution of caregiving roles across your loved one’s network of support.
3. Expand your loved one’s current care circle by roping in your extended family members and social support network.
4. Start preparing and planning early for the transfer of your caregiving role because it will take time and require acceptance from all parties involved.

In care planning, it is important to consider your loved one’s opinions and preferences (e.g., who they have a good rapport with). The care plan should ultimately cater to their needs and be structured based on their goals.

There are laws that protect the interests of persons with disabilities, including the Children & Young Person Act, Vulnerable Adults Act and Mental Capacity Act. Understanding these laws can help you safeguard your loved one’s rights and make informed decisions on their future care plans.

You can consider the following to ensure continuity of care for your loved one:

1. Appoint a Testamentary Guardian (For persons with disabilities below 21 years old)

   In the event where both parents have passed on, a testamentary guardian can be appointed. The guardian will have custody of the child and the power to make decisions regarding their welfare until they reach 21 years old².

2. Apply for Deputyship

   A deputy is a court-appointed individual who has the power to make decisions on behalf of their loved one who lacks mental capacity in matters relating to personal welfare, property or finance³.

3. Write a handover letter to future guardians and caregivers

   A handover letter can guide future caregivers, guardians, deputies and trustees to plan for and provide the best possible care for your loved one when you are no longer able to⁴. Also known as a letter of wishes, it should include important and relevant information, such as your loved one’s health information, daily living habits and recreational preferences. The letter may also include your loved one’s hopes and aspirations⁵.

4. Writing a Will

   Within your will, you can specify how your assets will be distributed, including to your loved one. A will can also include the appointment of testamentary guardian and trustee for children below 21 years old. If your loved one lacks mental capacity and is 21 years or above, it would be beneficial to appoint a deputy separately to make specific decisions on your loved one’s behalf (e.g., usage of assets willed to them).

For more information on the legal aspect of future care planning, check out Singapore Legal Advice.

Long-term financial planning involves having sufficient funds to carry out the care plan for your loved one. You can set up trust funds, such as through the Special Needs Trust Company (SNTC), to help your loved one receive the assets under your will, insurance and/or CPF nomination. In setting up a trust, you can also include instructions for executors of the will to sell off any property and place the proceeds into your loved one’s trust account.

Through SNTC you can also nominate your loved one to receive a monthly payout from your CPF funds under the Special Needs Savings Scheme (SNSS) upon your demise. This would help to ensure that your loved one continues to have a regular flow of money.

Advance Care Planning is the process of planning for future health and personal care for your loved one’s with mental capacity. In helping your loved one through this process, you can:

• Get your loved one to share their personal values and beliefs
• Understand their goals for care
• Explore what they may or may not want in different medical situations
• Choose someone to be their Nominated Healthcare Spokesperson to voice their wishes when they can no longer do so
• Write down their wishes and share the plan with their future caregivers and Nominated Healthcare Spokesperson

The AMD is a legal document that individuals sign in advance to inform doctors if they do not want any extraordinary life-sustaining treatment to be used to prolong their life⁶. If your loved one is 21 years old and above, and has mental capacity for decision-making, you can encourage them to make an Advance Medical Directive (AMD).

It is important to prepare your loved one for the eventual change in care arrangements. This includes helping your loved one understand the future changes to their routine, the environment, and the caregiving roles of the people around them.

In the process, you may have to address difficult topics like mortality with your loved one. While doing so, you should use simple but specific language, anticipate their concerns and speak in a reassuring manner⁷. It may be helpful to work with social workers to facilitate these conversations.

Apart from discussing future care arrangements with your loved one, it is also important to prepare the newly designated caregivers and family members for the upcoming changes. Purposeful actions, such as building rapport and familiarity between your loved one and the new caregiver will help smoothen this transition. You can do the following:

• Put together a personal profile of your loved one to help the new caregiver understand your experience with and knowledge of your loved one
• Create a checklist of what he/she can do
• Document your loved one’s needs and desires i.e. what’s important to and for him
• How can the successor caregiver help for now

As you hand over these caregiving responsibilities, you may need to give yourself time to get used to these changes, although it may be difficult at first.