Navigating ElderShield Claims with Dementia
When a loved one is diagnosed with dementia, it can be a challenging and emotional time for the whole family. One of the many pressing concerns that arise is managing the financial burden of long-term care. For Singapore citizens and permanent residents, ElderShield is a key component of this conversation. Understanding how the scheme works and what is required to make a claim, especially for a cognitive condition like dementia, is crucial.
The Core Requirement: Severe Disability, Not Just Dementia
A common misconception is that a dementia diagnosis automatically triggers eligibility for ElderShield. This is not the case. The scheme is designed to provide financial support for severe disability, which is defined as the inability to perform at least three out of six Activities of Daily Living (ADLs). This is a critical distinction, as the claim is based on the functional impact of the illness, not the diagnosis itself.
The 6 Activities of Daily Living (ADLs)
To qualify for an ElderShield claim, an individual must be certified by an MOH-accredited assessor as unable to perform a minimum of three of these six activities:
- Washing: The ability to wash in the bath or shower, including the whole body.
- Dressing: The ability to put on, take off, and manage clothes.
- Feeding: The ability to consume food and drink that has been prepared and served.
- Toileting: The ability to get to and from the toilet and manage bowel and bladder control.
- Transferring: The ability to move from a bed to a chair, or from a wheelchair to a bed.
- Mobility: The ability to move around independently, even with the use of mobility aids.
For an individual with dementia, the cognitive and physical decline can cause significant difficulty in performing these ADLs, but the link must be established and certified through a formal assessment.
Making a Claim on Behalf of Someone with Dementia
The progression of dementia often means the policyholder loses the mental capacity to manage their own affairs. In such cases, a caregiver or family member will need to make the claim on their behalf. The process involves some additional steps to ensure the application is handled legally and correctly.
The Mental Capacity Assessment
If the ElderShield policyholder lacks mental capacity, a mental capacity certification, signed by a doctor, is required. This assessment can often be conducted at the same time as the severe disability assessment. The application can then be submitted by a legally appointed donee, deputy, or in some cases, the caregiver.
Applying for a Deputyship
For successful claims where the applicant lacks mental capacity and there is no appointed donee or deputy, and payouts are directed to a third party, the caregiver or family member may need to apply for a court order appointing them as a deputy. There is typically a 12-month period to complete this, or the payouts may be suspended. For comprehensive information on Singapore's legal framework for mental capacity, you can refer to the Central Provident Fund (CPF) Board.
The Claims Process Step-by-Step
The process for submitting an ElderShield claim has been streamlined and is now administered by the Agency for Integrated Care (AIC) since November 1, 2021.
- Check Coverage: Confirm your loved one is an ElderShield policyholder. This can be checked via the CPF Board website using their NRIC and Singpass.
- Arrange Assessment: Contact an MOH-accredited severe disability assessor to schedule an assessment. This can be done at a clinic or as a house call, with varying fees that are reimbursable if the claim is successful.
- Prepare Documentation: Collect all necessary medical records and, if applicable, the mental incapacity certification.
- Submit Application: Use the AIC's eService portal (eFASS) via Singpass for a faster online submission, or request a hardcopy form if unable to use the online service.
- Await Outcome: The AIC will process the application, which may take several weeks. If successful, monthly payouts will begin.
Comparison: ElderShield vs. CareShield Life
Understanding the differences between the two long-term care schemes is important, as the rules and benefits can vary based on when a person was enrolled. The newer CareShield Life program replaced ElderShield for those born in 1980 or later and provides higher, lifelong payouts.
| Feature | ElderShield | CareShield Life |
|---|---|---|
| Enrollment Period | Automatically enrolled for Singapore Citizens and PRs born between 1970 and 1979 at age 40 (or born 1932 to 1969). | Automatically enrolled for Singapore Citizens and PRs born in 1980 or later at age 30. |
| Payout Amount | $300 or $400 per month, depending on the scheme and entry age. | Starts at a minimum of $600 per month, increasing over time. |
| Payout Duration | Up to 5 or 6 years, depending on the scheme. | Lifelong payouts for as long as the policyholder remains severely disabled. |
| Severe Disability Criteria | Inability to perform 3 out of 6 ADLs. | Inability to perform 3 out of 6 ADLs. |
What to Do if You Need Help
Seeking support from financial and legal professionals, as well as accessing community resources, can be a great help. Organisations such as the Alzheimer's Disease Association of Singapore offer valuable guidance and support for both caregivers and those living with dementia. The Agency for Integrated Care (AIC) also serves as a central hub for information on various long-term care schemes and related services.
Final Takeaway
Ultimately, a dementia diagnosis is not a claim but a key step in a larger process. By focusing on the severe disability criteria, gathering the necessary documentation, and following the official claims process, families can successfully apply for the financial assistance their loved one needs to manage the challenges of long-term care.
