A VISIT to the emergency department often begins with a fall, stroke, heart attack, serious infection or another condition requiring immediate medical attention.
The healthcare team’s priority is to stabilise the patient, provide treatment and, when appropriate, arrange a safe discharge. But an essential question remains: what happens after discharge?
For many patients, leaving hospital does not mean returning to independent living. They may need assistance with walking, bathing, eating or taking medication, as well as rehabilitation, nursing services, mobility equipment or support from family caregivers.
This gap between acute treatment and ongoing support highlights the need for long-term care (LTC).
LTC refers to assistance for people who struggle to live independently because of ageing, chronic illness, disability or other health conditions.
Unlike acute treatment, it may continue for months or years. As Malaysia’s population ages, preparing for these needs becomes increasingly urgent.
An ageing population, a growing challenge
According to the Department of Statistics Malaysia (DOSM), people aged 65 and above accounted for 8.4% of the population in 2026, up from 8.0% in 2025. This represented approximately 2.9 million people.
Those aged 60 and above numbered 4.2 million, or 12.3% of the population. Malaysia is projected to become an ageing nation in 2036, when people aged 60 and above are expected to exceed 15% of the population.
Malaysians are also living longer. DOSM estimates that a baby born in 2026 can expect to live an average of 75.5 years. Someone reaching age 60 in 2026 can expect to live another 20.2 years on average.
However, longevity does not necessarily mean good health throughout life. The World Health Organisation estimated Malaysia’s healthy life expectancy at birth at 63.9 years in 2021, compared with an overall life expectancy of 72.8 years.
This difference of 8.9 years represents time lived in less than full health, although it does not mean everyone will require long-term care for that duration.
The distinction matters. Retirement and healthcare planning must consider not only how long people may live, but also whether they will remain independent and what support they might need as they age.
The financial and family burden
Consider an older patient who is treated for injuries after a fall. Although the immediate injury may heal, recovery could require physiotherapy, home nursing, mobility aids, adapted transport or modifications to the home.
These needs can place considerable financial pressure on households. Spouses and adult children may reduce their working hours, take extended leave or leave employment altogether to provide care.
The costs therefore extend beyond medical bills to lost income, reduced savings and diminished career opportunities for family caregivers.
Traditional retirement planning often focuses on replacing income to cover everyday expenses, including food, housing and healthcare.
Yet long-term care costs can be difficult to predict and may place sustained pressure on retirement savings, particularly when extensive assistance is needed over several years.
LTC should therefore be treated as a distinct consideration in retirement planning, rather than a peripheral contingency.
Preparing before a crisis
Preparing for long-term care does not require predicting exactly when illness or disability will occur. It requires recognising the risks and putting appropriate support in place before a crisis strikes.
Preparation may include personal savings, suitable insurance or takaful protection, family resources, government assistance and community-based care services. These measures must work together to make care more accessible and financially sustainable.
When a medical emergency occurs, families must make difficult decisions quickly. But the question should extend beyond whether they can afford today’s hospital treatment: if a patient returns home needing assistance for the next three, five or ten years, who will provide that care, and how will it be funded?
As Malaysia ages, long-term care financing must become a central part of discussions on retirement policy, healthcare sustainability and social security.
Policymakers must also consider how to support family caregivers and expand access to affordable, appropriate care.
Living longer is a significant achievement. Ensuring that those additional years are supported by dignity, appropriate care and financial security must be the next priority.‒Oct 15, 2026
Associate ProfDr Mazlynda Md Yusuf is an Actuarial Science and Risk Management Lecturer at Universiti Sains Islam Malaysia (USIM), and Dr Mohd Hafyzuddin Md Yusuf, is a Consultant Emergency Physician and Medical Lecturer at Universiti Malaya.
The views expressed are solely of the author and do not necessarily reflect those of Focus Malaysia.
