The changing face of elder care in Malaysia — Sayed Mohammad Reza Yamani Sayed Umar

JULY 10 — An elderly society is becoming increasingly prevalent in Malaysia at present. It is projected that the percentage of residents aged 65 and above will continue to increase over the coming decades, reaching about 8 per cent in first quarter of 2026, according to the Department of Statistics Malaysia (DOSM).

This pattern results from two factors that are changing the way society cares for its elderly: increased life expectancy and declining birth rates. Older people in Malaysia have long relied on their families, especially their offspring, for financial and emotional assistance. Yet, due to enormous social and economic shifts, this reliance is progressively eroding.

Family values and the passing of duty from one generation to the next have long been foundational to Malaysian approaches to caring for older people. In rural places in particular, it is not uncommon for parents to live with or stay close to their adult children. The children traditionally help with housing, finances, and everyday care. When economic activity was less urbanised, families were larger, and migration rates were low; this arrangement worked well. There was dependable long-term assistance for older people, as it was not institutionalised but rather ingrained in the family system.

Nevertheless, due to modernity and socioeconomic structural changes, this paradigm is becoming unsustainable. The movement of people to cities is a major cause of this change. More and more young Malaysians are relocating from smaller towns and rural areas to larger cities like Kuala Lumpur, Johor Bahru, and Penang in search of better jobs and educational opportunities. The chance of parents and children living together decreases as a result of this migration, which physically separates generations. Consequently, many older people end up living alone or with only their spouse, making it hard for them to get the daily help they need.

While having children remains vital for emotional and social well-being, research on ageing in Malaysia suggests that physical closeness is a significant driver of genuine support.

Caregiving becomes less regular and frequently consists of cash transfers or infrequent visits when children reside far away. For older people, who often need help with basic tasks or their health, this means conventional family-based care systems aren't as effective.

The drop-in fertility rates are another major factor reducing family support. Over the last several decades, the average household size in Malaysia has been steadily declining. Fewer children are available to help with the financial burdens of caring for elderly parents in smaller households.

In bygone days, it was common practice for four or six children to help out financially and take turns caring for their ageing parents. But in today's one- or two-child households, the load is often carried by only one parent. It puts additional mental and financial strain on people of working age, which makes it harder to maintain support over the long run.

Meanwhile, the growing cost of living is putting a greater strain on the finances of younger Malaysians. Many costs have risen sharply in recent years, including those for housing, transportation, student loans, day-care, and medical treatment.

The elderly dependency ratio, as a percentage of the working-age population, is increasing in Malaysia, as shown by statistics from DOSM.

The younger generation is already struggling financially to sustain their own nuclear families while also taking care of their aged parents, and this generational gap is only going to become worse. Therefore, rather than being a consistent, long-term plan, financial aid for ageing parents is often inconsistent, inadequate, or given just in times of crisis.

Family dynamics have changed as a result of both economic and social shifts. In Malaysia, especially in the cities, the trend toward nuclear families is becoming more common, replacing extended families. Many nuclear families have both parents working outside the home and adult children living away from home. Because of this, fewer resources and less time are available to care for loved ones.

Additionally, traditional caregiving responsibilities within families are less clearly defined than they once were due to shifting gender roles and rising female labour force involvement. These developments reduce families' ability to provide constant care for their elderly loved ones.

The rise in life expectancy is another crucial component. The period of dependence in old age is also increasing as Malaysians live longer. Some retirees may need assistance with healthcare and finances for 10 to 20 years after they stop working. Support systems centred on family are already under significant pressure from this prolonged period of dependence. It is becoming increasingly difficult to provide long-term care for such extended periods, even when children are ready to help.

Family support continues to play a vital role in the well-being of Malaysia's elderly, despite these obstacles. Emotional health and social support improve for older people when they have children, particularly if those children live close by. Having said that, this system's dependability is deteriorating. Geographical distance, monetary stability, and the availability of siblings to share duties are now among the many variables that impact support. As a result, while financial assistance from family members is still available, it is insufficient to provide a steady income for older people.

Finally, demographic, economic, and social shifts in Malaysia are reducing older people's reliance on family assistance. Declining birth rates decrease the supply of carers, increasing living expenses put a strain on younger generations' financial capabilities, and urban migration lessens co-residence and daily caring. Concurrently, family-based support networks are already under a lot of pressure due to the length of time people remain dependent, given the increased life expectancy. Culturally important as it is in Malaysia, family assistance cannot be relied upon alone to ensure the safety of older people.

As a result, conventional family structures must be accompanied by more robust institutional support systems to guarantee the welfare of an ageing population. These systems must include enhanced pension coverage, increased social assistance, and community-based care services for older people.

* The author is a Research Fellow at the Ungku Aziz Centre for Development Studies (UAC), Universiti Malaya and a part-time lecturer at Azman Hashim International Business School (AHIBS) UTM, and can be reached at [email protected].

** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.