Navigating the twilight of their lives

MIRI (Sept 22): Former sales agent Lai Chze Khiong, now in his mid-60s, never expected that he would end up destitute just several months after his retirement.

His appearance was one of dignified simplicity – an old-fashioned polo shirt, khaki shorts and a worn-out belt pouch to keep his mobile phone.

By his side rested a small hand-carry bag and an eco-bag containing his few remaining possessions. These modest items all remained of a life now fractured, after his children cast him out of their house months ago over unresolved conflicts and disputes that he declined to discuss in detail.

“If someone offered me a job, any job today, I would work without a second thought,” he told thesundaypost when met at Senior Citizens Street in Persiaran Kabor in Miri.

Lai admitted that he had once been approached by a Welfare Department team after being spotted, and returning him to his family was their primary policy.

However, his situation was more complicated than what the officers could understand.

“My family rejected me. So, I would be grateful if there’s a home or shelter where I could rest my head without worrying about the rain or theft, a place to shower and if possible, I would want to make a living for myself too.”

‘Brutal reality’

Malaysia grapples with the complexities of becoming an ageing society, with Lai’s story being a stark reminder of the brutal reality that many elderly people face, where they are left navigating the twilight of their lives in uncertainties, longing for dignity and a place to belong.

The 2023 report by the Department of Statistics Malaysia (DoSM) indicated a rise in the composition of individuals aged 65 and over, increasing from 7.2 per cent in 2022 to 7.4 percent last year, encompassing approximately 2.5 million people.

For Sarawak, it is projected to hit the ageing status by 2028, ahead of other Malaysian states that are tagged with the 2030 deadline.

Among the issues that many elderly folks face are housing and living conditions.

Those who had barely made ends meet during their younger days now find themselves trapped in a precarious situation.

With conflicts with their children or other family members, limited savings and insufficient access to affordable housing, senior citizens like Lai are often left vulnerable.

So, how ready is the society when it reaches the ageing status? One can only imagine, being in the shoes of Lai, that the hope would be for a safety net – a system where no elderly individual is left to fend for themselves, and where support, care and dignity are guaranteed, not merely subjects of a debate.

‘Living out the regret’

Ibrahim Tambi, another elderly man found sleeping on a five-foot way at Senior Citizen Street, said he had exhausted his Employee Provident Fund (EPF) savings on his late wife and children.

Now, after being cast out by relatives, he must accept and endure the ‘brutal reality’.

Ibrahim recalled his time as a ship crew member, when he was earning a fair wage enough to support not only his immediate family, but his siblings as well.

Before becoming homeless, he was living with one of the siblings.

However, conflicts and inadequate space ended up becoming the major cause of him leaving and ending up on the streets.

In its ‘Economic & Monetary Review 2022’ published in March last year, Bank Negara Malaysia warned that an average Malaysian could be at risk of having depleted his or her retirement savings 19 years before death.

For Ibrahim, sleeping rough on the streets in old age was never the future that he had envisioned for himself.

Unable to do heavy labour, he now helps out at a local coffeeshop, packing food for a few hours, which earns him just enough to fill up an empty stomach.

His only hope now is simple – a shelter that can provide a measure of safety.

‘Living alone’

Homelessness among the elderly group may not be widespread in Miri, with Lai and Ibrahim representing a minor segment of those who have ended up being destitute due to personal circumstances.

However, the number of senior citizens living alone is rising and in this regard, they are facing many challenges such as financial difficulties and physical safety concerns, which must be looked into.

A larger concern emerges: as the ageing population in Malaysia continues to rise, many wonder about their future – what will their lives look like as they get older?

Alice Daring, 79, from Long Semadoh, has been living alone in Miri since the passing of her husband four years ago. Despite the solitude, she has been managing quite well, thanks to financial support from her children.

Her children live far away – two in Kuala Lumpur, and one in the USA.

One of her eight grandchildren, who is working in the oil and gas industry, stays with her during his onshore leave.

“For me, living alone isn’t much of a problem for now. My physical being can still handle house chores, and I have enough energy to dress up for meet-ups with friends and attend church regularly,” the Lun Bawang woman told thesundaypost.

Alice attributed her manageable ‘golden years’ to having a good support network.

“I’m blessed with siblings who always check on me whenever they can, as well as nephews and nieces, grandchildren and church friends who would reach out to me whenever needed.”

However, the retired teacher also acknowledged that not everyone her age had been fortunate.

“I have friends who are considering selling their properties to move into retirement homes because it’s the life that they expect and look forward to, but as far as I know, Miri does not have a proper one yet.

“I hear that it is still in the works. They may have to wait a bit longer for that to become a reality.”

Like many her age, Alice requires regular medical check-ups.

In this aspect, she was grateful for the availability and access to the public healthcare system, covering free hospital consultations and medication, among other facilities.

“It makes me appreciate the healthcare services that we have. However, other services meant for the elderly people do need some serious upgrades,” she stressed.

Despite her positive circumstances, Alice was deeply concerned about her peers and even the generations to come who might not have the same support as she had been blessed with.

She pointed out that addressing the ageing population’s needs should be a priority for the local leaders.

“Instead of debating trivial matters, it’s time to put taxpayers’ money to good use – making retirement homes and nursing services more affordable and accessible,” she said, urging elected representatives to stop wasting time.

“Instead, they should focus on the real needs of the people.”

‘Of stigma, access and affordability’

Former president of Palliative Care Association of Miri and a family physician, Dr Loh Yunn Hua, had observed a significant gap in inter-generational expectations.

“Old Asian parents struggle with the reality of the young ones leaving home.

“The elderly folks require social interactions, ideally with their peers.

“There has somewhat been a reduced stigma surrounding nursing homes or daycare centres in recent years, with many elderly individuals now seeking out such services that offer a sense of safety, community and engagement within their physical limits.”

Having said that, Dr Loh also observed that the availability of these facilities was limited, with the existing ones not providing the comfort and dignity as they should have.

“In countries like Taiwan, China or those in the West, such centres exist; there are new ones in Peninsular Malaysia, but they come at a cost.

“Unfortunately, many Malaysian seniors have depleted their EPF and personal savings, leaving them unable to afford such services.

“Hence, the need for non-governmental organisations (NGOs) and collaborative efforts to establish affordable care centres, or retirement homes offering nursing services, here.”

Dr Loh, who recently formed ‘Miri Awesome Seniors Group’ (for people above the age of 55), said she had received feedback from many senior citizens whom she had been interacting closely with, regarding the areas that they hoped the government and the local authorities could develop and enhance.

“Among the key points is the enhancements on public facilities meant for them such as more benches and grab bars in the public areas, more senior-citizens-friendly parking, as well as more ramps for better accessibility.

“The federal and state budgets should allocate funds for aged care, because there is increasing needs for aged care facilities, including the provision of trained caretakers.

“When someone is in the old-age era, health is the utmost important thing that the person should focus on; hence, the urgent need for more geriatric doctors,” she added.

Dr Loh had been going on frequent trips visiting elder care services in Malaysia well as in overseas countries like China, Taiwan and Singapore and in relation to this, she cited Singapore’s ‘Kampung Admiralty’ – an integrated housing for elderly residents, equipped with a wide range of social, healthcare, communal, commercial and retail facilities – as an example that Malaysia should emulate.

She, however, stressed that the goal for running a centre for elderly care must not be solely about making money.

“The core focus should be on providing a caring environment for the senior citizens after they have done so much in raising the younger generation and building the nation.”

Dr Loh said on the back of her managing nursing homes and daycare centres in Miri, she had witnessed a growing demand for elder care services.

“Many of their children are occupied with work,” she pointed out.

“The elderly people need a space where they can engage in light physical activities and occupy their time more meaningfully, rather than dwelling on negative thoughts when being on their own.

“There’s a clear reason why those seniors who remain inactive after retirement would often experience rapid mental and physical decline, compared to those who stay engaged and continue working past the retirement age,” she added.

Elder care, she emphasised’, should not be segregating the poor from the wealthy.

“Both face the same challenges in their old age. Developing a proper nation for ageing society is a universal human responsibility towards ensuring their well-being.”

‘Not prepared’

Sarawak’s Health Department director Dr Veronica Lugah, in an article published in October last year by Code Blue via the Galen Centre for Health and Social Policy, said Malaysia was ‘unprepared’ to become an aged nation by 2035.

Dr Veronica, a key contributor to the 2023 Health White Paper (HWP) outlining the nation’s healthcare reforms set for the next 15 years, pointed out that the elderly group incurred medical costs two to three times higher than the general population, and she regarded this as the country ‘not being equipped to provide long-term care for its senior citizens’.

“Malaysia is not ready for an aged nation status. We lack the adequate long-term care facilities and have very few geriatricians.

“Moreover, the country is grappling with the growing burden of non-communicable diseases (NCDs) like diabetes and hypertension, as well as mental health issues.”

Dr Veronica said one of the challenges faced by the healthcare system in the country, particularly in Sarawak, was the uneven distribution of doctors.

“Thus, the HWP’s implementation is meant to address this issue, with the relocation of 1,070 doctors to Sabah and Sarawak.

Further improvement was needed for the public healthcare system, as she quoted HWP’s fourth pillar, ‘Strengthening the Health System’s Foundation and Governance’.

“The issues of staff shortage, maldistribution of health workers, skills gaps between regions and quality concerns – all these must be addressed, while adapting to the challenges presented by an ageing population, changing disease patterns, and advances in medicine and technology.”