Future Care Planning

Future care planning involves the following blocks:

• Financial – plan and manage costs to ensure financial security
  • e.g., trust and savings schemes to build up assets for your loved one’s future care needs, CPF nomination, financial aid and literacy

• Medical and Healthcare – identify relevant healthcare support and plan for healthcare needs
  • e.g., Advance Care Plan, health passport

• Living Options – assess the long-term living options well-suited for your loved one
  • e.g. care options and arrangements, developing independent living skills

• Legal – protect and support your loved one’s rights throughout their life
  • e.g., Deputyship, Lasting Power of Attorney (LPA), will and estate planning

• Daily Living – identify support networks and community resources to address your loved one’s life goals and needs
  • e.g. Lifelong learning and employment, social and community engagement, support network

Beyond preparing for the five building blocks, building a care plan involves:

• Assessing your ability to care for your care recipient now and in the future caregiving, your health status and care needs.
• Including your loved one in making decisions, based on their preferences and goals.
• Sharing caregiving responsibilities within your loved one's support network.

To assist you in building the care plan, the FutureReady website by MINDS is a digital toolkit that allows you to explore the care options available for all five domains, by bringing you through a series of modules that guide you in making informed decisions. You can also upload, store and share your care plan documents with family members. These resources are suitable for persons of all disability types.  

As you build up the care plan, it is equally important to prepare your loved one and their future caregivers for transition of care. This means helping your loved one to understand and adapt to future care arrangements. This involves developing independent living skills where possible and familiarising them with changes in care environments and future caregivers. By gradually handing over care responsibilities to future caregivers during the transition, you can also reduce potential disruptions to your loved one’s daily routine. A well-thought-out care plan should be flexible and regularly updated as needs or circumstances change. Such a plan will lay the foundation for a smoother and effective transition of care.

1. Secure your finances by setting up trusts and savings schemes

Long-term financial planning involves having sufficient funds to carry out the care plan for your loved one in the future. Here is how you can prepare:

• Estimate your loved one’s financial needs in the future, to cover his daily living needs, housing, medical, transport, food and so forth.
• Consider what you have already put in place, or need to put in place, to meet these needs e.g. savings plan, insurance, assets/investments etc. where your loved one is a beneficiary.
• Consider if setting up a trust fund, such as through the Special Needs Trust Company (SNTC), is a viable option. The trust would help your loved one receive the assets under your will, insurance and/or CPF nomination. You can also include instructions for executors of your will to sell off any property and place the proceeds into your loved one’s trust account.
• Nominate your loved one to receive monthly payouts from your CPF funds after your passing through the Special Needs Savings Scheme (SNSS). This ensures that your loved one continues to have a regular flow of money.

You may wish to approach SNTC to evaluate your financial needs and determine if trusts are suitable for your family.

2. Support your finances with financial schemes and subsidies

Check if you qualify for schemes such as CareShield Life and Home Caregiving Grant. Grants and subsidies can reduce the long-term costs of disability support while ensuring that your loved one has access to the necessary resources to improve their quality of life.

3. Consider additional financial protection

Financial security is important for your loved one’s future. You may wish to consider the following options:

• Purchase financial plans where your loved one is the beneficiary.
• Explore health insurance plans that suit your loved one’s unique needs, although some plans may not always cover every person with disability (PWD).

These plans provide additional financial protection to handle unexpected situations and address the long-term financial needs of your loved one. You can speak to your financial advisor or attend talks conducted by the Institute of Financial Literacy to learn more about your options in creating a strong financial plan. 

1. Identify relevant healthcare support in your community

Building a strong network of healthcare providers and services is essential to your loved one’s well-being. You can do the following:

• Identify trusted doctors, therapists or clinics that your loved one feels comfortable with.
• Schedule regular check-ups to monitor their health and address any new medical conditions early.
• Build and maintain good relationships with healthcare providers to ensure continuity of care over the years.

Having a primary healthcare professional, such as a family doctor, who understands your loved one’s history and needs can be especially valuable. This ensures consistent monitoring of their health over time and provides a trusted point of contact for addressing medical concerns or changes as they arise.

For disability-friendly clinics, consider:

• Mount Alvernia Outreach Medical & Dental Clinic @ Enabling Village
• MINDS Developmental Disabilities Medical Clinic
• IDHealth

2. Health Passport

For caregivers who find it helpful and manageable, a health passport can be a useful tool. This is a document that consolidates your loved one’s key medical information in one place, such as:

1. Medical history, allergies, medication and specific care needs.
2. Medical action plan that includes emergency contacts and steps to take during emergencies.

While maintaining and updating a health passport requires effort, it serves as a quick reference for healthcare providers, especially those unfamiliar with your loved one, to understand their medical needs. It can also reduce the stress of repeatedly explaining your loved one’s medical details to healthcare professionals during consultations or emergencies.

3. Advance Care Planning 

Advance Care Planning (ACP) allows individuals with mental capacity to make plans for their future health and document their healthcare wishes. It is a process that caregivers and families can consider when it is meaningful and necessary.

If you explore ACP with your loved one, you can:

• Help them share their personal values and beliefs.
• Understand their goals for care.
• Explore what they may or may not want in different medical situations.
• Choose a Nominated Healthcare Spokesperson who can help to voice their wishes when they can no longer do so.
• Write down their wishes and share the plan with future caregivers and the Nominated Healthcare Spokesperson.

An Advance Medical Directive (AMD) is a legal document that informs doctors in advance if an individual does not want extraordinary life-sustaining treatment to prolong their life. This is an option for individuals who are 21 years or older and have the mental capacity to make such decisions.

As a caregiver, it is also worth considering making your own ACP and AMD to ensure your healthcare preferences are known and respected.

By focusing on the most practical and meaningful steps for your family’s circumstances, you can better plan for your loved one’s future healthcare. If you are unsure of where to begin or need guidance, reach out to healthcare professionals for support.

1. Care options and arrangements

Choosing the right care arrangement depends on your loved one’s needs and preferences. Arrangements may include home care, assisted living, or residential facilities.

It is important to prepare your loved one for transition into a new living arrangement. This involves:

• Introducing your loved one to future caregivers.
• Helping them learn relevant skills to adapt to the change.
• Familiarising them with the new environment to ease the transition.

2. Foster independent living skills

Developing essential skills can help your loved one become more self-reliant. Here are some examples of independent living skills that may be helpful for them:

• Personal care: hygiene, dressing, and grooming
• Time management: planning and following daily routines
• Basic money management skills: budgeting and managing small expenses
• Household tasks: cleaning, laundry and cooking

If your loved one is attending a service (e.g. special education school, day activities centre etc.), speak to their service provider and explore how you can create a step-by-step plan tailored to your loved one’s strengths and needs to help them acquire the skills gradually. The Enabling Academy provides a list of training courses across various domains like communication, financial management and numeracy literacy that can help your loved one develop essential skills. This builds confidence and control, allowing them to better adapt to future living arrangements.

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.

Start by thinking about the kinds of support your loved one might need in the future and consider the legal tools only if they are necessary for your loved one’s care. 

1. Understand decisions your loved one may need help with in the future. These can include: 

• Managing money (e.g. manage bank accounts, pay bills)
• Consenting to medical or dental treatments
• Signing work contracts
• Deciding where and with whom to live
• Handling inheritance matters

If your loved one cannot make these decisions independently, you may need legal powers to make decisions in their best interest.

If your loved one is assessed to lack mental capacity to make decisions independently, you may consider applying to be a deputy.  A deputy is appointed by the court and has legal powers to make decisions on behalf of a person who cannot.

• For your loved one below 21 years old: Appointing a Testamentary Guardian ensures they have a legal guardian until they turn 21 if both parents have passed on.
• For your loved one who are 21 years old and above: You can apply for deputyship to make decisions about personal welfare, property and affairs on their behalf.

There are two routes to apply for deputyship: the Simplified process (supported by Ministry of Social and Family Development (MSF)’s Assisted Deputyship Application Programme (ADAP) for caregivers of persons with disabilities) and the Standard process, which allows more personalised legal powers to cater to the unique needs of your loved one.

If there is no suitable person to be appointed, the Professional Deputies and Donees (PDD) Scheme enables registered and trained professionals such as lawyers or social workers to be appointed to act in your loved one’s best interest.

For more information on deputyship, you may refer to the resources below.

3. Apply for Lasting Power of Attorney (LPA)

If your loved one has mental capacity, an LPA allows them to choose someone to make decisions in areas of personal welfare and/or property and affairs for them should they lose mental capacity in the future.

As a caregiver, having an LPA yourself is also important to ensure a trusted person can make decisions for you and understands your wishes and arrangement for your loved one. This helps to safeguard you and your loved one’s interests when you are not able to.

4. Write a Will

A will lets you specify how your assets should be distributed. It can also appoint a trustee to manage funds for your loved one, or a Testamentary Guardian for a care recipient under the age of 21.

Think of this as part of a larger plan, working hand in hand with an LPA to ensure continuity of care for your loved one when you are no longer able to support them.

Take your time to think through and decide on the legal instruments you need for your loved one and yourself. It is not mandatory to have all the instruments; they are also not a one-size-fits-all solution for every family. Begin by considering your loved one’s needs and your family’s unique situation. If legal arrangements become necessary, approach them step-by-step, knowing you can revisit and adjust them over time. There is no need to rush into making long-term decisions immediately.

For more guidance, you may refer to the resources below.

There are various educational programmes, vocational training and recreational clubs that can equip your loved one with practical skills and provide opportunities to participate in leisure activities within the community. This includes the Enabling Services Hubs (ESHs) which offer a wide range of learning courses and social activities for you and your loved one. There are also support services and networks in the community that can alleviate stress from your caregiving duties. A resource guide has been developed for you to find out more about the range of post-18 options available after your loved one graduates.

1. Lifelong learning and employment

Help your loved one build skills and independence through education and work. Depending on their interests and strengths, they can:

• Pursue further education at an Institute of Higher Learning.
• Explore work opportunities through training and job placements.

2. Social and community engagement

Encourage your loved one to participate in activities they enjoy, like sports, arts, or music. These activities help to:

• Build friendships and create a sense of belonging.
• Improve overall well-being and create an enriching life.

Explore community clubs and events that match your loved one’s interests to support their social interaction and engagement. You may refer to the resource guide for more information.

3. Support services and networks for persons with disabilities

Create a strong network of formal and informal support as a safety net to ensure safety and independence for your loved one:

• Identify alternative caregivers who can step in when needed.
• Connect with neighbours or even familiar faces like the local coffee shop aunty who can look out for your loved one and provide informal help in emergencies.

4. Support services and networks for caregivers

Caring for yourself is just as important as caring for your loved one as you navigate the demands of caregiving. To ensure your well-being, here are some self-care tips you can follow:

• Join a caregiver support group or online forum to connect with other caregivers and exchange tips and experiences.
• Practise self-care to manage stress and maintain your health.

Building a strong support system benefits both you and your loved one, ensuring a sustainable caregiving journey.

1. Prepare your loved one

It is important to prepare your loved one for the eventual changes in care arrangements. You can introduce them to the changes gradually. This includes:

• Explaining the future care arrangements (e.g., new routines, environment and caregiving roles) using simple, clear language or visuals.
• Engaging them in activities, through shared hobbies or casual meetups, to familiarise them with the new setting and build rapport with the future caregiver.
• Discussing sensitive topics in a calm and empathetic manner. Acknowledge and validate their feelings while offering reassurance and support.
• Involve social workers to facilitate these conversations if necessary.

2. Prepare future caregivers

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 also write a handover letter to future caregivers in the care plan.

• Put together a personal profile of your loved one to help the new caregiver understand your experience with and knowledge of your loved one. This includes important and relevant information, such as your loved one’s health information, daily living habits and recreational preferences.
• Create a checklist of what your loved one can do (i.e. abilities in independent living skills)
• Document your loved one’s needs, desires, hopes and aspirations (i.e. what is important to and for them).
• Suggest aspects of care that the future caregiver can assist in prior to the transition.

For a better idea, you may refer to the Dani Plan (listed under Resources), which was developed by a caregiver couple to comprehensively consolidate various categories of information about their loved one.

Handing over caregiving responsibilities can be emotionally challenging. As you hand over these responsibilities, be patient and give yourself time to get used to these changes. By preparing early and involving all stakeholders, you can facilitate a smooth transition for your loved one and future caregivers.