The Old World

In a worldwide trend, Malaysia’s population is aging. Malaysians are retiring out of the workforce and starting to require more expensive care. Right now, there is a shortage in services for this special kind of consumer, who may not have much money to pay for long-term care.

That shortage can have serious consequences for the health of the overall economy. Malaysians having to take watch over their aging relatives can put a drag on consumer spending and worker productivity, factors that could put a drag on the overall economy over the long term.

Responding to this challenge will demand an agile combination of private expertise and public-sector guidance, as both interests intersect. The chief challenge for Kuala Lumpur is to make sure that residences for retirees do not simply go to the highest bidder, who sometimes may not be Malaysian at all. Senior care is not just a matter of construction, but also the provision of healthcare for a segment of the population that may be suffering from long-term, chronic, or even terminal illnesses.

The vulnerability of retirement home residents makes government oversight and planning all the more necessary. Residents of senior living centers may not have many other options, giving senior living providers the upper hand in negotiating price. And while a captive market can sometimes have no serious side effects, when it comes to healthcare for seniors, market failures can have serious consequences for human health and wellbeing.

Indeed, finding out an elderly relative is paying too much for substandard care can cause younger family members not only stress but also undermine government efforts to improve trust in the overall status of elderly care in the country. Complaints about abusive or neglectful elder care are likely to make their way directly to the nearest elected official, causing further headaches for regulators and providers.

At the same time, it is almost impossible for a public-private partnership or regulatory framework to satisfy all the needs of senior living residents and their families. Senior living is a deeply personal product, combining housing with healthcare, and expenses in end-of-life care can only expect to increase as Malaysia’s demands grow.

The most potentially successful models for senior living care do not need to separate generations of families in order to be successful. Indeed, just as some new developments are “mixed use” facilities, where people can work, shop, and sleep in the same place, a potentially successful model for senior living can be “multi-generational.” Middle-aged children can live near or adjacent to their parents and in-laws.

Veena Loh, writing in 2013 as the general manager of Malaysia Property Incorporated, a now defunct public non-profit that promoted Malaysian real estate, foresaw the coming crunch for demand in senior living and emphasized that senior living models that work abroad may not work in Malaysia.

“A developer who wants to provide senior living facilities, or a retirement home, needs to consider the Malaysian culture and stigma associated with sending the elderly to an old folks’ home,” Loh wrote for The Edge, a Malaysian business news site.
“More importantly, the local developer must ask some basic questions, ‘Who do you want to cater to? Is it the upper-, middle-, or lower-income elderly?’ Very often, the ultra-rich will have the means to renovate their homes to cater to their needs and may not want to be restricted to standardized living spaces. The middle class may have a more compelling reason to move into cluster homes and save on nursing, ambulance services, and other costs.”

Loh described a successful model in Indonesia that provided separate but attached apartments for different generations of residents. This type of plan for elderly care can serve as a compromise between having a family member occupy indefinitely in their relatives’ own living space and putting them in a facility far away from their loved ones.

Overall, however, responding to the challenge of rising demand for senior living care in Malaysia will require coordination between multiple sectors, including government, healthcare, real estate, and construction.