MALAYSIA is facing a demographic shift that cannot be taken lightly. The number of senior citizens is increasing, while family sizes are shrinking and social lifestyles continue to change.
In this situation, the important question that needs to be addressed is not merely how people can live longer, but who will care for them as they grow older and their health begins to deteriorate.
According to the Department of Statistics Malaysia (DOSM), the number of Malaysians aged 60 and above is estimated to reach 4.2 million in 2026, representing 12.3 per cent of the country's total population.
This is an increase from 4.1 million people, or 12.0 per cent, in 2025.
Meanwhile, the proportion of people aged 65 and above rose from 8.0 per cent in 2025 to 8.4 per cent in 2026, involving approximately 2.9 million people.
These changes indicate that Malaysia is moving towards an increasingly ageing population structure.
An increase in life expectancy is a development achievement that deserves to be celebrated. However, longer lives also bring new needs, particularly when individuals experience health problems or lose the ability to manage their daily activities independently.
In this context, Budget 2027, which was tabled on Oct 9, placed emphasis on the country's preparations for an ageing society.
The question is, to what extent will the measures announced be able to address the increasingly complex challenges of elderly care?
Budget 2027 opens the door to improvements
Among the key announcements was an allocation of more than RM40 million through HRD Corp to train 8,000 individuals in the elderly care sector.
The Government also announced the development of two National Integrated Care Centres (NICE) in Penang and Sarawak for training, research and care services.
In addition, the allocation for elderly assistance was increased to RM1.3 billion to benefit nearly 200,000 recipients. The Government also announced plans to draft a Senior Citizens Bill to address neglect and strengthen the care ecosystem.
In terms of taxation, the service tax rate for elderly care services will be reduced from eight to six per cent starting Jan 1, 2027, alongside a full exemption on care fees of up to RM96,000 annually.
These measures show that elderly care is receiving increasing attention in national planning.
However, from a social welfare perspective, the more important question is how these various initiatives can be coordinated to ensure that senior citizens and their families genuinely receive the services they need.
Not all senior citizens require full-time care
When discussing the 4.2 million senior citizens, society may imagine a significant increase in demand for care centres or old people's homes.
In reality, not everyone aged 60 and above requires full-time care. Many remain healthy, work, run businesses, look after their grandchildren and actively participate in community activities.
However, some senior citizens may experience chronic illnesses, mobility problems, memory deterioration or difficulties performing daily activities such as bathing, dressing and preparing meals.
This distinction is important because care planning cannot be based solely on the number of senior citizens.
The country needs to determine how many senior citizens remain independent, require occasional assistance or depend entirely on others.
Information on their ability to perform daily activities, health conditions, living arrangements and family support must form the basis of planning.
Without sufficient data on care needs, an increase in allocations alone may not guarantee that assistance reaches those who need it most.
When children are at work, who cares for their parents?
In Malaysian society, caring for ageing parents is often regarded as part of one's family responsibilities.
This value is important and should continue to be preserved. However, the realities facing families today are increasingly different.
Smaller family sizes mean that caregiving responsibilities may have to be shared among fewer children.
At the same time, many adult children work full-time, live far away or have responsibilities of their own, including raising children.
This situation places pressure on the so-called sandwich generation, comprising individuals who have to care for both their children and ageing parents simultaneously.
Imagine a working woman who has to send her child to school, manage office assignments and at the same time, take her frail mother for medical treatment.
If her mother's health deteriorates further, she may have to take repeated leave, reduce her working hours or leave her job altogether.
Such circumstances can affect not only household income but also the emotional well-being of caregivers.
Therefore, elderly care cannot be regarded solely as a private family responsibility.
Families undoubtedly play a primary role, but they also need social support and easily accessible care services.
Family caregivers need care too
One weakness that deserves attention in the development of the care system is the lack of support for informal caregivers, particularly family members who provide care without receiving payment.
These individuals may care for senior citizens for years without specialised training or sufficient assistance. Caring for someone with dementia, for example, requires patience, knowledge and specific skills.
The same applies to caring for bedridden senior citizens who need assistance with mobility, eating or personal hygiene. Without appropriate support, caregivers risk experiencing physical exhaustion, emotional stress and financial difficulties.
Therefore, it is time for Malaysia to give more serious attention to developing support systems for family caregivers. Measures that could be considered include basic caregiving training, counselling, guidance on managing chronic illnesses and temporary care services, also known as respite care.
These services allow primary caregivers to receive assistance for a certain period, giving them time to rest or attend to personal needs.
Employers can also play a role by providing reasonable flexible working arrangements for employees with caregiving responsibilities.
The reality is that safeguarding the well-being of family caregivers is part of ensuring that senior citizens receive quality care.
Training 8,000 caregivers must be followed by quality assurance
The announcement of training for 8,000 individuals through HRD Corp is an important development in building the care workforce.
However, the number of people trained alone is insufficient to demonstrate the sector's readiness. Questions that need to be examined include the training content, competency levels, recognition of qualifications and employment opportunities after training.
Elderly care involves more than helping to prepare meals or clean living spaces. It also requires an understanding of the ageing process, fall prevention, nutrition, communication and the handling of senior citizens with specific needs.
Therefore, training must be supported by competency standards, skills assessments and continuous professional development opportunities. At the same time, the welfare of care workers must also receive attention.
If jobs in this sector offer inadequate income, weak employment protection or excessive workloads, attracting and retaining a qualified care workforce will become more challenging.
Malaysia needs caregivers who are not only sufficient in number, but also well-trained, valued and able to build sustainable careers.
Long-term care must become a priority
One area that requires greater emphasis is the development of a long-term care system.
According to the World Health Organisation (WHO), long-term care encompasses various forms of health and social assistance for individuals who experience a decline in their ability to perform daily activities.
Such services do not necessarily involve placement in residential care homes. They can also include home-based care, day-care centres, rehabilitation, mobility assistance and community support.
In Malaysia, the development of such a system must take into account families' financial capabilities and differences in access between urban and rural areas.
Not all families can afford private care services, particularly when care is required over many years.
Therefore, the reduction in service tax announced in Budget 2027 is a measure that could help lower some costs for services subject to the tax.
However, tax savings may not resolve the broader issue of affordability, particularly for low-income families.
The Government should examine more sustainable financing options for long-term care, including targeted assistance, subsidies for community services and shared responsibility between the public and private sectors.
Protecting senior citizens requires effective implementation
The proposed Senior Citizens Bill also presents an important opportunity to strengthen protection for this group.
Neglect, abuse, financial exploitation and unsafe care require clear prevention mechanisms and enforcement measures.
However, legislation alone is insufficient if members of the public do not know where to seek help or if the relevant agencies lack the capacity to respond.
Therefore, legislative development must be accompanied by easily accessible complaint mechanisms, case referral systems and coordination between healthcare, welfare and enforcement services.
At the same time, protective measures must respect senior citizens' dignity, autonomy and right to participate in decisions concerning their lives.
It is time for care to become a shared responsibility
The 13th Malaysia Plan (2026-2030) also emphasises the development of a sustainable long-term care ecosystem, in line with the National Ageing Action Plan 2025-2045.
This policy framework provides an important foundation, but its success depends on implementation that makes a tangible difference to society.
In this regard, Malaysia needs to move away from a care approach that relies too heavily on families' capabilities towards a more structured system in which responsibilities are shared.
The Government must provide policies and protection, the care sector must offer quality services, employers must support workers with family responsibilities, while communities must help reduce social isolation among senior citizens.
We must also ensure that healthy senior citizens continue to have opportunities to lead active and independent lives for as long as possible.
Budget 2027 has outlined several measures to strengthen elderly care.
However, the real question is not merely how many caregivers are trained or how much assistance is allocated. More importantly, it is whether senior citizens who need help can access safe, quality and affordable care without placing an unbearable burden on their families.
Ultimately, an ageing population is not merely a challenge for the Government or care institutions, but a responsibility shared by society as a whole.
Malaysia should not wait until more senior citizens lose their independence before strengthening its care system.
With 4.2 million Malaysians already aged 60 and above, preparations must begin now. The true measure of a developed country is not simply how long its people live, but how well it ensures they are cared for with respect, compassion and dignity.