SINGAPORE — Migrant domestic workers have long been a pillar of Singapore households, cooking meals, cleaning homes and caring for children.
But as Singapore grows older, their jobs are changing.
Increasingly, helpers are being asked to care for people with dementia, Parkinson’s disease, disabilities, stroke complications and other serious medical or mobility needs — responsibilities that can demand skills closer to professional caregiving than traditional domestic work.
And a growing debate is emerging over a difficult question:
Are Singapore families asking domestic workers to perform caregiving jobs they were never properly trained to do?
One particularly troubling case involved an Indonesian worker identified as Safira, who was tasked with caring for an immobile elderly woman weighing 104kg.
According to the Humanitarian Organization for Migration Economics (HOME), Safira had reportedly been told before taking the job that the woman weighed about 70kg.
Once she began work, however, she was expected to transfer the woman between her bed, wheelchair and bathroom — despite having no formal training for the heavy lifting involved. HOME said hospital personnel had advised that several caregivers were needed for such transfers.
Safira was also expected to perform household chores for a family of five and, according to HOME’s account, sometimes worked around 17 hours a day, with her sleep interrupted by nighttime caregiving.
Within months, HOME said she had lost weight and developed persistent physical pain.
Her experience may be an extreme example, but advocates say the underlying problem is much broader.
From Housekeeping to Dementia Care
Another worker interviewed by CNA TODAY, identified as Anna, arrived from Myanmar in 2023 with an interest in caring for seniors.
Her first assignment placed her as the main caregiver of a woman in her 80s with dementia.
Anna said she had neither experience nor training.
After the elderly woman suffered a fall and became wheelchair-bound, the work became increasingly demanding. Anna eventually transferred after about a year.
Her next assignment involved caring for a bedridden man with dementia who was considerably bigger than her, again putting significant physical strain on her.
She eventually sought another transfer.
The cases illustrate an increasingly important distinction in Singapore’s care economy:
Housekeeping and caregiving are not the same job.
Helping someone with dementia, administering medication, preventing falls, transferring a bedridden person, assisting with toileting or managing behavioural changes can require specialised knowledge.
MOM itself acknowledges this.
The ministry says migrant domestic workers providing eldercare may need training in transferring patients between beds and wheelchairs, changing adult diapers, assisting with medication and handling age-related behaviour or communication difficulties.
Singapore’s Ageing Population Makes the Issue Bigger
This is unlikely to remain a niche problem.
Singapore is ageing rapidly.
In 2015, about 13.1% of Singapore citizens were aged 65 or older.
By June 2025, that proportion had climbed to 20.7%.
By 2030, projections suggest roughly 23.9% — almost one in four citizens — could be aged 65 and above.
That demographic shift means demand for dementia care, mobility assistance, post-hospital care and help with daily living is likely to rise sharply.
At the same time, more than 308,000 migrant domestic workers are already working in Singapore, according to figures cited in Parliament earlier this year.
Labour MP Yeo Wan Ling described them as the “invisible workforce behind our workforce”, arguing that their role has expanded well beyond conventional housekeeping.
Her argument was straightforward: modern caregiving can include dementia management, disability support, post-hospital recovery and senior care — yet many helpers still enter households primarily trained for domestic duties.
Government Says Training Options Already Exist
Singapore does have a significant caregiver-training framework.
In January, the Ministry of Manpower said the Agency for Integrated Care offers more than 240 caregiver-training courses, covering areas such as dementia, disability, eldercare and post-hospitalisation support.
Home-based training is also available.
Families and their domestic workers may tap the Caregivers Training Grant, or CTG.
Under the current AIC structure, eligible care recipients begin with S$400 in training support, followed by annual S$200 top-ups, with unused balances carried forward subject to a S$400 cap.
The training can be used by family caregivers as well as migrant domestic workers.
But availability does not automatically mean every helper receives appropriate training before starting a complex assignment.
HOME says it continues to encounter workers who are sent into households with significant caregiving responsibilities before receiving structured preparation.
Training Is Starting to Expand
There are signs that the system is evolving.
The Centre for Domestic Employees has been piloting specialist programmes covering eldercare, dementia care, infant and child care, and first aid and emergency response.
By June 2026, more than 370 domestic workers had reportedly undergone training through the initiative, according to The Straits Times.
Participants described gaining confidence in situations such as dealing with dementia-related mood changes and caring for seniors recovering from strokes.
Language training is another part of the equation.
MOM has pointed to conversational Hokkien and Cantonese programmes, while organisations also offer English and Mandarin classes.
The reasoning is practical: an elderly person who cannot communicate pain, discomfort or confusion to a caregiver may face additional safety risks.
But Training Alone May Not Solve the Problem
Experts interviewed by CNA TODAY argued that another weak point may be job matching.
A helper may have general eldercare experience but still be ill-equipped to manage severe dementia, heavy lifting, feeding tubes, immobility or challenging behaviours.
Likewise, families may underestimate how difficult their relative’s condition actually is.
Employment agencies therefore play a critical role in determining whether a worker’s skills genuinely match a household’s requirements.
HOME has called for a more standardised system for assessing care needs and workers’ capabilities, including potentially using trained care assessors in employment agencies.
Under existing MOM guidance, employment agencies are expected to disclose the caregiving tasks involved to prospective domestic workers, who should have an opportunity to clarify job requirements before accepting a placement.
But difficult placements still occur.
The Employer Has Responsibilities Too
There is also another side to the debate.
Families caring for dementia patients or severely disabled relatives can face enormous physical, financial and emotional pressure.
Sometimes they hire a helper precisely because one family member cannot provide round-the-clock care alone.
That does not necessarily mean employers deliberately misrepresent a job.
But experts argue that employers must recognise that a domestic worker is not automatically a trained nurse simply because she lives in the household.
Adequate rest is also important.
HOME warns that exhaustion can increase the chances of mistakes involving medication, patient transfers or medical equipment — potentially harming both the caregiver and the person receiving care.
Singapore’s Care Economy Is Quietly Being Rewritten
The larger issue therefore goes beyond whether helpers should attend another training course.
Singapore is gradually confronting a structural question about what the job of a migrant domestic worker has become.
A worker hired primarily to clean, cook and manage household tasks may now also be expected to:
- manage dementia-related behaviour,
- transfer wheelchair users,
- care for bedridden seniors,
- assist people recovering from strokes,
- monitor medication,
- handle special-needs children,
- provide overnight supervision,
- and respond to medical emergencies.
Those responsibilities are increasingly central to Singapore’s ability to allow elderly people to remain at home.
Yet they also blur the boundary between domestic work and professional caregiving.
That distinction could become one of Singapore’s biggest caregiving policy questions over the next decade.
Because with nearly one in four citizens potentially aged 65 or older by 2030, the country will not only need more people willing to provide care.
It will need to make sure the people already doing it have the training, support and working conditions necessary to do it safely.
And that may ultimately matter just as much for Singapore families as it does for the helpers themselves.
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