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Understanding the Concerns of Singapore's Elderly Population

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Understanding the Concerns of Singapore's Elderly Population

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An accessible guide that introduces the key challenges and concerns faced by Singapore's elderly population. Perfect for students beginning to learn about ageing issues.

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Ministry of Social and Family Development

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Ministry of Social and Family Development

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Ms Ang Bee Lian, 31 July 2018

Dear Social Service Practitioners,

With improvements in science and health, people now live longer. This means that there will be more older persons in society and a greater number of older persons with disabilities. Longer life expectancies and reduced fertility rates can mean more generations alive, but it also results in a reduction in the availability of familial care and support for the oldest-old. As a result, various segments of society such as families, care agencies in the community and the private sector will increasingly have to play a part in caring for the elderly.

Trend of ageing in Singapore

The size of the elderly Singapore resident population has increased substantially over the last decade with the proportion of residents aged 65 years and over increasing from 9.0% in 2010 to 13.0% in 2017 (Department of Statistics, 2017). It is estimated that the elderly population will grow by about 450,000, to 900,000 between 2018 and 2030 (Budget 2018, 2018). In 2030, the senior support ratio is also likely to be halved from 5.7 to 2.1 adults supporting one elderly person.

Changing Context of Elder Care

Trends in the past decades have resulted in structural transformations in family composition, community support networks and labour force participation. This poses stress and strain on the availability of family members and other informal supports to provide the assistance needed by the growing numbers of elderly. Changes in household patterns have also resulted in caregivers and care recipients being less likely to live with or near one another. Assistance is therefore more likely to be focused on instrumental tasks such as meal delivery, transportation and household chores, with grassroots volunteers and neighbours playing an increasingly significant role. For some family members, they serve as intermediaries between disabled elderly family members and formal care providers. In a sense, they are increasingly assuming the role as care managers, providing care management tasks such as service coordination, linkage, brokerage and information transmission including health conditions.

As a principle, most countries aim to reduce the use of nursing homes and other expensive residential settings by promoting home and community-based care. As much as possible, an older person with a disabling accident or illness will be rehabilitated and enabled to return to live in the community with services from voluntary organisations and the community. Generally, older persons prefer to reside in their own homes and within the community rather than in a more restrictive institutional setting. As such, to some extent, the move towards home and community-based care upholds individual autonomy and personal control. This move must however be accompanied by ensuring that there are resources to develop concomitantly the range, availability and affordability of community-based support services. It is important for there to be sufficient community resources and support to ensure a seamless and uneventful transition back from the hospital to the community.

Tapping on technological innovation

In recent years, technological innovations have made it possible for various devices to be used at home to facilitate care giving. For example, telemedicine has made it possible for ongoing evaluation of patients in their homes. Such efforts lessen the stress from transportation and the crunch on time in care giving.

Technology today also has the tools to provide in-home and community monitoring and response systems to deliver both pre-emptive and responsive healthcare interventions. For example, multi-modal sensors and devices can track the whereabouts of older persons, creating alerts to trigger a medical response when needed. Wearable technology such as RFID ¹-tagged slippers can prevent falls or avert dementia patients from getting lost. Gloves fitted with gyroscope and sensors can even combat hand tremors in those with conditions such as Parkinson's disease. Robotics and sensing technology can help detect feelings such as joy, sadness and anger. They can be used to conduct exercises, to enable basic cognitive tasks, and as a form of therapy for depressed older persons.

Technology has expanded the care options available for older persons and we should start tapping on such technology where possible to facilitate their care.

Paradigm for responsibility for care

Our policy approach reflects the view that families should have the primary responsibility for caring for and coordinating the needs of dependent members. However, the challenge is in determining the reasonable level of support to expect from families and at what point of frailty and deterioration of health.

With our ageing population, the number of caregivers will be on the rise in the years to come. They are an important source of care and help for the elderly and should not be overlooked. Practitioners should not only help caregivers who reach out for help but be on the lookout for those who do not ask for help but are in need of help. Practitioners can intervene by providing information on services and programs that provide respite care for caregivers, organising family meetings to discuss caregiving responsibilities and stresses, connecting caregivers to support groups or other caregivers and providing resources for financial management and planning, as well as financial assistance (Nguyen, 2012). These interventions should be done in a timely and sensitive manner so that caregivers do not feel even more overwhelmed.

In addition, practitioners can introduce the use of technology, especially the readily available mobile technology, into the support system. The aim can be to tailor solutions for individuals and deliver services with the help of digital technology including digital alerts.

What matters for older persons

Here are a few useful considerations for practitioners or caregivers who work with older persons on matters concerning ageing:

Giving Choices

It is important to give older persons choices. Each individual is unique, with different tastes and backgrounds. Some may want to dance and dabble in adventurous activities such as trekking while others may want to sign up for courses to acquire new knowledge and skills. There are also more avenues made available in recent years for seniors to pursue their passions. For example, seniors can tap on their Skillsfuture credits to take up various courses such as those offered by the National Silver Academy. Ultimately, all of us should be empowered with the opportunity to live an active life. As the Englishman George Bernard Shaw once said: "We don't stop playing because we grow old; We grow old because we stop playing!"

A positive mind set

While many older persons look forward to their golden years, others face different challenges as they age. It is not uncommon to hear of older persons having depression or suicidal ideation. This is usually due to loneliness, poor health or financial anxiety. Besides facing mental stress, older persons are also often easy prey for criminals and victims of ageist attitudes.

Overcoming these mind sets and challenges will require everyone - the government, the community, families and individuals - to play their part. As the government continues to reach out to caregivers and seniors with information and services, society also needs to correct the common misperception that ageing is a physically and mentally deteriorative process and to continue to promote ageing as an active and progressive stage of life. We need to work together to create a community where the elderly are treated with dignity, embraced and included in the progression of society. This will take time and there is much that we, as individuals, can do to make a difference in the lives of the elderly.

The Importance of Social Networks

Besides exercise and health screenings, the less spoken yet important contribution to wellbeing is having a network of relationships with family and friends. The network is a good insurance for lifting older persons up when they are down or in need of support. The Council for Third Age was set up to promote the importance of growing old with purpose and meaning. Its activities provide avenues for people to meet and keep in touch.

It is all about balance

The local community plays a large role in enabling ageing in place by helping to ensure continuity of care. We need to strive towards finding the appropriate balance in providing services by sharing the responsibility of both delivering the services and the cost of care among the individual, the family, the community and the state. The partnership will evolve as we continue to calibrate the range and extent of services that will be provided. With various segments of society working together, we can create an inclusive environment for our seniors to thrive in their silver years.
Footnotes References

MS ANG BEE LIAN

Director of Social Welfare (1 Nov 2013 - 30 Jun 2020)
Director-General of Social Welfare (1 Jul 2020 - 31 Jul 2023)
Ministry of Social and Family Development

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Ms Ang Bee Lian, 31 July 2018 With improvements in science and health, people now live longer. This means that there will be more older persons in society and a greater number of older persons with disabilities.

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Growing Old in Singapore: Basic Guide to Ageing

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Growing Old in Singapore: Basic Guide to Ageing

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A comprehensive introduction to what it means to age in Singapore, covering social aspects, healthcare, and community support.

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The Council for Third Age, C3A, is the administrator of National Silver Academy (NSA) and the Silver Volunteer Fund (SVF), as part of the initiatives under the Action Plan for Successful Ageing.

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An informative resource that explains how Singapore supports its elderly population through various programs and initiatives.

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A Guide to Senior Activity Centres in Singapore

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A Guide to Senior Activity Centres in Singapore

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Learn about the various senior activity centres in Singapore and how they help elderly citizens stay socially connected.

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Read more on www.AIC.sg, The Heart of Care.

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Explores how different generations in Singapore can connect and support each other, promoting social cohesion.

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Makan & Mingle is a programme that promotes intergenerational bonding between seniors and youths through food and activities.

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A youth-friendly guide on how young people can understand and support the elderly in their community.

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22 February 2022

In a society with an ageing population, what can we as youths, do to contribute? Kennice Foo learns more at Youth Corps Singapore's first Senior-Savvy event.
Being in their shoes
It's not something we see every day - Young adults hunched over the cardboard pieces they grasp in their hands, slowly advancing towards the stairs. One by one trail behind each other in a line, gingerly making their way up. One hand holds onto the handrails firmly to prevent from falling, another clutching their rounded backs. The smooth planes of their faces contort, sweat gradually forming. It's not an easy feat.

This is not foreign sight for the organisers of Camp Hiro. The social enterprise conducts Ageing Simulations for the youths to better understand what it's like in a day in the life of the elderly. Someday, everybody grows old. In time to come, it'll be our turn.
Equipping ourselves with relevant skills
"We didn't only want to provide volunteering opportunities, but to further youth's abilities to engage with seniors meaningfully. That would come in the form of changing mindsets and providing them with the right tools and skills," shared Shereen Ng, one of the organisers of Senior-Savvy.

Together with Shereen is a group of 10 volunteers. They are equally passionate about all things seniors. They form the Youth Corps Eldercare Cluster and Senior Savvy is their first event to increase awareness about the eldercare sector. Activities included dialect lessons, wheelchair workshops and talks such as dementia, challenging ageism, communicating effectively with seniors and re-igniting the Kampong spirit.
Participants get a taste of how it's like to push and be pushed; "Hands on Wheels" workshop conducted by St Joseph Nursing Home.
Breaking stereotypes and changing perceptions

A memorable activity was the '5BX Challenge with '. Over 20 young adults tried to keep up with a trio of strong seniors in a battle of fitness - two sets of cardio-drilling, push-ups, spider planks, lunges, squats and burpees. At the end of the challenge, the youths in the room were exhausted, catching their breath. trying to catch their breath but Team Strong Silvers didn't even break a sweat! Wew!
"Through this challenge, we hope that it can break stereotypes and everyone can see each other as equals, no matter our age. [Seniors] have the ability to do the things young people can do too,"
- Robert Ho, 47, a coordinator at an eldercare centre.

This aligns with becoming more senior savvy - changing our perceptions and refraining from stereotyping.

Among the young adults, 70-year-old Sheila Ng stands tall and proud, doing the exercises with much vigour. She smiles bashfully as she explains why she likes to exercise. "Because I'm vain," she admits with a hearty chuckle. "I want to stay slim, keep fit and be healthy. I like to meet youngsters and interact with them as well." Clad in a black polo tee, jeans and a bright floral cap, she sure isn't your typical grandmother!

Starting a conversation, sharing companionship

There are many other interesting seniors like Sheila out there who have stories to share and joy to spread. After all, they've been young before. To get to know their experiences and life lessons, starting a conversation is all that is needed.

We may be deterred by barriers like language, but Eleanor Yap, the founder of and speaker for "Effective Communication with Seniors" at Senior-Savvy believes that shouldn't stop us from striking up a conversation.

"It doesn't even have to be a conversation you share, but companionship. Bring something that they like to eat, ask them about their past. Don't look at age with intimidation. Get to know the people around you, the people in your community. The more you know about your community, the more you feel like you belong,"
Shereen shares what she likes and dislikes about seniors during the "Effective Communication with Seniors" workshop. Eleanor believes being completely honest by writing out what youths feel about seniors and vice versa is the first step to good communication. Participants striking up a conversation with seniors at the "Effective Communication with Seniors" workshop.
Through Senior-Savvy, I learnt that ageism exists even in subtlest ways. For example, the phrase "help the elderly" is commonly used, but the thing is, seniors don't always need help.

It's important for us to partake in such events because we as youths can do so much more to contribute to this society and to build a more inclusive and compassionate environment. Who doesn't want to live in a place filled with love and care?

As Mark Twain said,
"Age is an issue of mind over matter. If you don't mind, it doesn't matter."

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In a society with an ageing population, what can we as youths, do to contribute? Kennice Foo learns more at Youth Corps Singapore's first Senior-Savvy event.

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Healthcare Services for Seniors in Singapore

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Healthcare Services for Seniors in Singapore

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An easy-to-understand overview of healthcare services and support available for seniors in Singapore.

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Ministry of Health (MOH) is an innovative, people-centred organisation, committed to medical excellence, the promotion of good health, the reduction of illness and access to good and affordable healthcare for all Singaporeans, appropriate to their needs.

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Introduces various physical activities and exercises suitable for seniors, promoting active and healthy ageing.

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Move to Age Better (Exercise for Seniors)

Learn the ABC's of exercise to improve your strength, balance, cardio, mobility and flexibility to age well and maintain your functional fitness and performance!

In this workshop, you will:

- Learn and perform exercises using your own bodyweight and/or simple gym equipment such as dumbbells.
- Adapt the exercises according to your recommended intensity and ability.
Note: First-time participants are required to complete the initial Pre Participation Screening (Click Here) for exercise participation advice.

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A basic guide to understanding mental health and wellness among elderly Singaporeans.

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Silver Ribbon (Singapore) - Community - Complimentary Counselling Service

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S.A.G.E. Mental Health Training Programme for Grandparents

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Singapore's Action Plan for Successful Ageing

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Singapore's Action Plan for Successful Ageing

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A simplified version of Singapore's national plan to address the needs of an ageing population.

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An introduction to how Singapore helps its citizens prepare financially for their retirement years.

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Use CPF’s Retirement Payout Planner to set your retirement goals, project payouts and explore ways to optimise your CPF.