The expeditiousness of Ezzati Nasir’s father often left his peers speechless with envy. The 67-year-old — who served as state director at the Immigration Department until 2014 and continued to work on an ad hoc basis for the state government even after his retirement — had led an active lifestyle and often took part in activities such as interdepartmental sports competitions.
In 2019, he finally decided to fully retire. But not long after that, the coronavirus pandemic struck, forcing the once highly energetic man into inactivity.
It was around this time that Ezzati, founder and CEO of Teman Malaysia, started noticing that her father showed signs of cognitive decline. Within months, he was diagnosed with dementia. The news rattled the family, but they learnt to cope, with family members taking turns to be caregivers.
Teman, which means companion in Malay, is a social enterprise that provides care companionship services for the elderly. Primary caregivers can book the services — via the website or Teman app — of freelance carers, known as Temanions, to perform daily tasks, run errands, attend health appointments or simply enjoy free time with the seniors through planned and customised activities.
“We ventured into the aged care sector because everyone can relate to it. There must be a person we know who is struggling to manage their responsibilities when we mention elderly care,” says Ezzati.
The idea of setting up a care companionship start-up came about when the 31-year-old took part in the first cohort of the Social Enterprise Education Lab (SEEd.Lab), established by Petroliam Nasional Bhd (Petronas) and Tata Consultancy Services, in January 2020. The team she was on during the sessions was assigned to create an enterprise that revolved around the care ecosystem. It was then that another member of the team shared that he used to take leave from work to return to his hometown in Kedah just to take his parents for their hospital appointments.
The country is rapidly becoming an aged society while a volatile economy and skyrocketing prices of goods make it almost impossible for middle- and low-income breadwinners to leave their jobs to become stay-at-home carers for their ageing parents, says Ezzati.
As there is a stigma attached to retirement homes and aged care facilities, not to mention the high cost of such services for the average Malaysian household, there are not many alternatives to meet this need at present, she notes.
Launched in September 2020, Teman Malaysia offers companionship service for the elderly, whether it is for health appointments or curated activities that they enjoy. The social enterprise also provides long-term services such as keeping their charges company at home for up to 10 hours a day.
Despite having identified a need for such a service, it was a struggle to register the company, says Ezzati. “We first approached the Ministry of Women, Family, and Community Development (KPWKM), but then we were referred to the Social Welfare Department (JKM). When we went to JKM, they said the scope of our company did not fall under its governance as we did not own a nursing home.”
It was then that Ezzati learnt of companies that provide aged care solutions, but operate with a Companies Commission of Malaysia (SSM) licence. Nevertheless, the lack of acknowledgement for modern aged care solutions and overall governance of the sector was baffling.
“We don’t know what is happening in aged care governance at the moment. The most important area that needs to be taken care of is negligence of care. There are actually a lot of things that can be solved using simple processes,” she says.
Currently, the only legislation governing the aged care industry is the Private Aged Healthcare Facilities and Services Act 2018, which replaced the Private Healthcare Facilities and Services Act 1998 that regulated private nursing homes, as well as the Department of Social Welfare – Care Centre Act, which looks at the governance of care centres.
Another challenge was convincing SEEd.Lab’s panel of judges that freelance care services would attract youth participation. But within two years, Teman managed to realise its goal when the social enterprise managed to enrol 150 Temanions, all between the ages of 25 and 35.
The Temanions are freelancers who get paid on a weekly basis. The rates for their services range from RM13 to RM17 per hour.
To qualify as a Temanion, a candidate will have to fill up a lengthy application via Google Forms. Ezzati explains that the form was intentionally crafted to test a candidate’s perseverance — a must-have virtue for those aspiring to be carers.
Those who pass the first round will undergo an interview where an assessment of the candidate’s overall character is done. Teman also takes precautionary measures by doing background checks on candidates with the Royal Malaysia Police to ensure a safe experience for clients.
One of the main benefits of using Teman is that the Temanions will update the guardians on their charges from time to time during their shift. Clients who have subscribed to its long-term service, [email protected], can have a trial session before deciding on a Temanion.
Family members can choose from six packages: Teman to Health Appointment; Teman to Dialysis Treatment; Teman to Covid-19 Vaccination; Teman Customised Activities; Teman At Home; and Teman At Home (Plus) Package. If guardians are looking for someone to accompany their elderly parents, they can look at Teman Customised Activities and Teman At Home. These packages are designed to delay mental deterioration.
That is why Temanions are encouraged to conduct engaging activities with clients under their care. “We will play simple memory games with clients who are already showing symptoms of dementia. We will usually ask them anything for them to remember, chat with them and then we will ask the same question,” explains Ezzati.
“These small things help the elderly. Usually, the guardians of the elderly [who are already showing signs of dementia] will have games at home to stimulate their brain. We will play games — finding hidden objects in books, sudoku, chess and checkers. We colour and paint too.”
To ensure service excellence, clients are asked to rate the performance of the Temanion before payment is made in full for their service.
Shortage of caregivers
According to the World Bank, Malaysia will be classified as an aged population by 2044, with 14% of the population above 65 years of age. By 2056, the country will be a “super aged society”, with more than 20% of the population above 65.
The population of persons living with dementia, which leaves them dependent on 24-hour care, is estimated to be 204,000 to 264,000 (8.5% to 11%), according to the Alzheimer’s Disease Foundation Malaysia in 2020. This number is projected to increase to between 637,500 and 825,000 by 2050 — a whopping increase of 312% — a prediction largely based on data that show Malaysia is fast becoming an ageing nation, reports the New Straits Times.
Meanwhile, the Association for Residential Aged Care Operators of Malaysia has already expressed its concerns about the acute shortage of caregivers and nurses to assist the community.
Ezzati acknowledges that Teman is equally affected as the business relies completely on youths who are keen to freelance. “It is hard to find people, but it is not because no one is willing to do the job. We are grateful that we are able to find this valuable bunch of people who are very passionate,” she says.
Some of Teman’s freelancers were the primary caregivers of family members who have passed away. So, they relate most to the service they are providing, says Ezzati. “I feel the need to do this because I see myself using this service in the future,” she adds.
Teman’s services are currently available in major cities in the country; the Klang Valley, Negeri Sembilan, Melaka, Johor, Perak and Penang. [email protected] services are only available in the Klang Valley and Penang at the moment.
Ezzati aspires to expand Teman’s services nationwide, especially to the East Coast states and Sabah and Sarawak, where many leave their hometowns (and their parents) to work in large cities such as Kuala Lumpur or overseas. She also hopes Teman will be able to contribute to reducing youth unemployment and growing the gig economy by providing more freelance job opportunities.
In the long term, she hopes to expand its services across Southeast Asia. “I’ve always said this to the team, that instead of being Teman Malaysia, we want to be Teman Everywhere.”
It is currently conducting a pilot to offer corporate packages for employees. Similar to existing benefits, companies are able to provide a certain amount of companionship hours for their employees to receive a Temanion’s assistance whenever they need it.
To ensure a safe experience for the elderly to age in place, Teman hopes to extend its services by providing a 24/7 hotline for clients to call whenever they need companionship in the future.
Clients may access Teman’s short-term services through its app, which was launched in May via Google Play Store and the App Store. All clients are required to complete the electronic know-your-customer (e-KYC) process and register service recipients before making any bookings for safety purposes.