# data[].attributes.attachment_link.readable_text
SINGAPORE: They get taken for beggars sometimes as they poke through the trash, by people who exclaim "eiyuh!" in disgust. Impatient drivers honk as the duo push their laden trolleys along the road.

"My brother cannot hear the cars horn," said the man who asked to be known as 'Eddie'. "When I tell them he cannot speak or hear, most say sorry. Others curse and say, '****, lah, I don't care'."

The 63-year-old has long since learned to swallow his pride and let such comments slide, over 20 years of doing what he must to look after his deaf-mute brother, who is 68 and diabetic.

This includes scrounging for odd jobs, in between forays to pick and sell cardboard around their Serangoon one-room rental flat, in any weather.

"We've collected in the rain. I got sick. It's okay when (my brother) falls sick; I cannot fall sick, because I am basically his ears and head, so he's in trouble," said Eddie, who pushes a trolley stacked with cardboard higher than his 1.5-metre frame.

A good day is when the brothers collectively make about S$20. That's with a haul of nearly 200kg, depending on price fluctuations. Said Eddie: "After a long time, our bones start to ache. It really hurts."
SAVINGS WIPED OUT
Life had looked a lot different, once.

Back then, Singapore, like Eddie, was young and the economy booming ("if you wanted jobs, there was one for you," as he put it). Earning steady money as a factory worker, construction labourer, driver and printer, he built up a family and a comfortable nest egg over the years.

Then cancer struck, twice - taking from him both his wife and his mother within the space of a year, and wiping out his life savings and most of his Medisave, he said.

Eddie was left to care full-time for his deaf-mute brother, which meant he could no longer hold a steady job. His brother's life as a cardboard-picker became his own. "No choice. Back then there weren't all these concessions for the elderly, or Pioneer Generation card; we had only ourselves to rely on."

As Singapore ages, the number of seniors who work into their silver years is growing too - especially among the lower-income group, for whom retirement is an alien concept.

In recent years they have become more visible as food court cleaners, servers, security guards, tissue-sellers and scrap collectors. Given Singapore's plethora of help schemes for the needy - such as the Pioneer Generation Package (PGP) and Silver Support Scheme for the old - why do the elderly poor feel the need to work for long hours and often low pay?

Do the jobs that the elderly poor do, as well as society's safety nets, offer them adequate sense of security and quality of life in their old age?
RELATIVE POVERTY RISING AMONG THE WORKING ELDERLY
In a 2015 paper on elderly poverty in Singapore written for the Tsao Foundation, Assistant Professor Ng Kok Hoe of the Lee Kuan Yew School of Public Policy made one surprising observation - while the poverty rate among elderly persons not working had fallen over the years, that for elderly persons in the workforce appeared to have actually increased dramatically.

The poverty rate among the working elderly jumped from 13 per cent in 1995, to 28 per cent in 2005 - to 41 per cent in 2011.

"This should be a strong reminder that work cannot be relied upon as the only, or even the primary, response to income insecurity in old age," Dr Ng wrote.

"In labour markets where older workers are likely to end up in low-paying and undesirable jobs, work may decrease their quality of life without raising their standard of living."

According to Manpower Ministry figures, in 2016 about 23 per cent of persons over 65 in the formal workforce were earning less than S$1,000 a month. That's less than the 36 per cent in 2013, and 57 per cent in 2003, indicating that earnings for elderly workers have been rising.

But inflation and wages in the rest of society have also risen. And Dr Ng's calculation draws the comparison between the elderly and the general population. It uses 40 per cent of the median population work income as a "convenient poverty line", and compares that to elderly individuals' incomes (which, besides work, could include sources such as children and state assistance).

Overall, Dr Ng has estimated that 6 in 10 elderly people in Singapore in 2011 were poor by that measurement.

He acknowledges that what is considered poor "is debatable", and notes that a project commissioned by the Tsao Foundation is looking into how much elderly households actually need for a decent standard of living in Singapore. (Singapore has no official statistics when it comes to elderly poverty, or poverty for that matter.)
WHY WORK?
"In Singapore, no money how to live?", is what Mr Ong Hock Soon says if asked why he is working long hours as a hawker's assistant at the age of 69.

But in the same breath, he'll tell you that he has turned down offers of social assistance, and would rather be self-reliant and "work until cannot move". That mentality of independence is something that crops up repeatedly among the working elderly.

Ms Nurasyikin Amir once thought like most people - that seniors should stop going around collecting heavy loads of cardboard. "Like, rest at home, you're old, retired already," said the volunteer with the Happy People Helping People Foundation, which assists cardboard collectors like Eddie.

"But what we came to realise is that when they collect boxes, they feel more empowered; they are earning their own money, even though it's not much, maybe S$2, up to S$10 a day. Who are we to stop them, right?" she said.

Some don't want to be a burden on their children. Like food-court cleaner Wong Yeow Kee, 85, who works a 3pm to 11pm shift,

I have children, but I like to smoke and drink, so I work to support my habit and enjoy life. I don't want to ask for their money.

Even when he'd chalked up hefty arrears, Mr Ng Teak Boon, 85, never thought about asking agencies for help. Estranged from his five children, he has been selling ice cream for 20 years from a pushcart, living on roughly S$950 a month from earnings and Silver Support payments.

"I will sell ice cream until I die," he said. "It's better to go outside. If you stay at home and watch TV, you will fall sick."
WATCH: When the lights went out for Mr Ng (5:55)
Indeed, there are those receiving financial assistance who still do the occasional odd job to "find meaning in life", said Mr Ng Koon Sing, head of COMNET Senior Services under AMKFSC Community Services.

But yet others do it out of "insecurity" and fear that "the money will run out", he also noted.

Many would have worked at low-paying jobs most of their lives, with modest or hardly any savings which illness and vices like gambling can quickly wipe out.
FALLEN THROUGH THE CRACKS
And there are those like Eddie, who seem to fall through the cracks.

These days his brother gets Public Assistance of S$500 a month and the PGP, so they need not worry about the cost of treatment for his high blood pressure and diabetes.

But Eddie himself has no such benefits. He is working, but not consistently enough to qualify for the Workfare wage supplement. He can't access his CPF funds until he hits 65. And the fact that he has a son makes qualifying for certain social assistance tough.

His son, who works as a salesman, is able to give him "S$100 here and there" but his income is inconstant, Eddie said.

Dr Ng calls this "a classic case of how there are various gaps (in the system) that I think we can do better at patching".

The range of job opportunities that are available to people in this economy; how the schemes step in, where the cracks open up... If we don't identify those gaps accurately and in a timely way, then you will have cases like Eddie's.

(Note: Since being alerted to Mr Ng's and Eddie's cases, the Ministry of Social and Family Development says its Social Service Offices have reached out to them.)

THE CATCH-22 OF LOW-WAGE WORK
Those kinds of limited job opportunities for an elderly person with little education is what concerns observers.

The older they get, those who previously held blue-collar jobs would find themselves even lower down the workforce rung, noted Dr John Donaldson, who has written on poverty in Singapore.

"One could have been a welder in their younger years, but today, they have to downgrade and become a cleaner," said the Associate Professor of Political Science at the Singapore Management University.

Mr Ong, the hawker's assistant, had a good gig going in construction for 35 years - a job he had held since leaving school after Secondary 2. Though tough work, the skills he honed paid off. "It was good money," he said.

But in the 1990s, he said, the influx of foreign workers who were willing to work longer hours for less pay made the industry untenable. So he quit.

"There was less work to be had. We could not compete," said Mr Ong, admitting that he'd also gambled away whatever money he had made, and was estranged from his family.

Starting over as a food stall assistant, he soon found that getting a position that paid adequately was tough. Jobless at one stage, he resorted to free food handouts.

Eventually, the Community Development Council helped place him in a job that now pays S$1,000 a month - enough, he says, to live on.
WATCH: Why Mr Ong wants to say 'sorry' to his children (6:00)
But wheels have been in motion to bolster the earnings of older workers. The Government's roll-out of the Progressive Wage Model has scaled up incomes in the cleaning, landscape and security sectors -where low-wage older folks tend to gravitate.

Mr Liew Sue Weng, 67, had been working since the age of 13 in jobs like construction and shipyards. He picked up landscaping at the Employment and Employability Institute and now draws S$1,300 a month, working a five-day week as a gardener.

The irony? He says he's been asking his boss to lower his pay - because he's afraid he might get a reduced subsidy on his S$50-a-month rental flat.

Then there is the Workfare supplement, paid by the State to top up the wages of eligible low-income older workers.

The hitch? Those doing informal work like Eddie, who don't work for a full month, don't benefit. And manual jobs carry the element of uncertainty, often depending on health, noted Dr Ng: "I may have enough for tomorrow, but I have no way to plan for next year and the next."

Take Madam Lee Yuit Mei, 67, who has osteoporosis. She used to earn S$800-S$1,000 as a full-time cleaner, but after breaking her wrist in a fall in 2010, she switched to working part-time.

TOO MANY SETS OF HOOPS?
She now makes just S$350 a month working three-hour days, four times a week. But with savings squirreled away over the years, she can meet her living expenses, she says.

For those less lucky and in need of temporary financial aid, there is the ComCare Short to Medium Term Assistance scheme. Those aged 55 and over made up about 35 per cent of applicants in 2015 - up from 29 per cent in 2012.

Indeed, the problem in Singapore is not the lack of schemes to help the elderly poor - as, say, compared to other countries in the region featured earlier in this series ( read the full series here.)

Said Mr Simon-Peter Lum, assistant manager of COMNET Senior Services under AMKFSC Community Services: " We'd be hard-pressed to find seniors who are the abject poor, compared to other countries."

For instance, those on Public Assistance may not get a lot of cash upfront, which has often been noted by critics - but, Mr Lum pointed out, they get many other subsidies (such as for medical treatment) and fee waivers (such as rental).

The problem, rather, is that there are too many targetted help schemes - with varying criteria and limiting conditions attached, observers say. This creates two types of problems.

One: Confusion and lack of understanding, which might explain why some elderly poor would rather just carry on working than attempt to seek support. Said Dr Ng:

Researchers don't understand the schemes fully, civil servants don't often understand all the schemes available, so how would those people know where to get the help?

He continued: "If I am collecting cardboard, am I going to spend time figuring out how the schemes work, and then test out each one to see if I qualify; or am I going to work so that I can secure tomorrow's expenses? I am going to work!"

Two: Having to jump through hoops to meet criteria, means that some will fall through the cracks.

Take the requirement that applicants don't have children who can support them. Said Ms Nurasyikin: "Just because they have kids, it doesn't mean that they are taken care of... But (applicants) don't get the assistance just because the database shows that they have kids."

The further danger, said Dr Ng, is that such rigorous means-testing would "discourage others who might actually qualify if they tried".
THE FUTURE ELDERLY POOR: NOT WHO WE THINK
Ms Wong Yock Leng, a senior social worker with Tsao Foundation, said: "When you ask for ComCare assistance, they will check for everything... That's why a lot of people don't apply anymore after that. It's so daunting, the whole process."

But the future face of Singapore's elderly poor may not be today's low-wage worker that social safety nets typically serve.

Said Ms Wong: "The one-room flat, low-income group, they have a lot of support.

"But it's the three- or four-room flat, the middle-income people, who will bring their problems into their old age. And we have a lot of clients like this - asset rich and cash poor."

She said the "real urban poverty" is this group which are "neither here nor there". They may earn S$4,000 or S$5,000, but taking care of two elderly parents can drain their cash fast. "At the end of the day you won't have much left for yourself."

Then there is the growing number of childless Singaporeans. It is estimated that by 2030, there will be only 2.1 working-age citizens for each one aged 65 and above, compared to around 5.4 currently.

On top of that, the growing gig economy means that incomes will be less stable, while the decline of industries based on manual skills disadvantages the low-skilled worker, said Dr Ng. He added: "Technology has thrown a huge spanner into the works. Now whole industries, like taxi drivers, can disappear just like that, and no government has a solution for it."

What does this double-whammy of population and job trends mean?

Traditionally, you have three sources of income for retirement. You have the state that can provide for you; your family; or your younger self - your savings and so on.

But if work is going to be unstable and uncertain, if families are becoming smaller, then what else?

"Even in a country that's so conscious about social spending, the Government has no choice but to look into public support schemes - so your Silver Support and your Workfare," said Dr Ng, who also threw in the possibility of exploring a universal basic income.

SMU's Dr Donaldson remains positive about Singapore's ability to adapt, noting the great improvement over a short time in a country on the frontline of an ageing challenge.

He arrived in Singapore in 2005, and has co-authored several research papers and findings on poverty and the elderly.
NEXT: In Singapore, social isolation may be the greater danger for the elderly poor. This is part of a CNA Insider series exploring the issues of elderly poverty in Vietnam, South Korea, Singapore and Myanmar. Watch and read the entire series here.
"It's now 2017, so if you think about change over time in terms of plugging these gaps, it is a completely different game. They - not just the Government, but society and families - are much more aware, much more focused on plugging those gaps and innovating," he said.

# data[].attributes.attachment_link.title
Ploughing on: The faces and insecurities of Singapore's elderly working poor

# data[].attributes.attachment_link.description
SINGAPORE: They get taken for beggars sometimes as they poke through the trash, by people who exclaim "eiyuh!" in disgust. Impatient drivers honk as the duo push their laden trolleys along the road. "My brother cannot hear the cars horn," said the man who asked to be known as 'Eddie'.

# data[].attributes.body
The elderly who are living alone as their family would have passed away because of various reasons, like cancer or old age, result in being lonely forever as they might have forgotten their friends' phone numbers. According to the article, some elderly people are even found dead in their homes as the are lonely and no one would know the present state of those who are living in a house.

# data[].attributes.attachment_link.readable_text
Longevity is bittersweet for Madam Ng Poh Choo.

At 83, Madam Ng, who used to serve drinks at a coffee shop, has outlived three older brothers who died of cancer or old age.

The single woman has been living alone in a one-room rental flat in Bukit Merah for the last 13 years.

"I do get lonely and I can't remember my friends' numbers to call, so I don't have a choice," she said.

Social workers found her lonely and depressed three years ago and referred her to an eldercare centre nearby for activities.

Madam Ng is among a rapidly growing group of elderly folk here who live alone. The number of old people aged 65 and above who live by themselves has nearly tripled over the last 15 years to 42,100 last year, up from 14,500 in 2000.

The elderly make up about a third of all one-person households here.

Sociologists interviewed said such solo elderly households are more prevalent now due to factors such as an ageing population and changing family structures resulting from a low birth rate, rising divorce rate and estranged familial relations. Others simply desire more personal space and independence.

"Singapore is ageing rapidly and while our 12 per cent rate of one-person households is quite a bit lower than in Japan, Korea or Taiwan where they are between 20 and 35 per cent, the rate will rise very rapidly in the next few decades," said Professor Jean Yeung, director of the Centre for Family and Population Research at the National University of Singapore.

"Current infrastructure and resources are clearly not adequate to meet the demand."

Whether some senior citizens live alone as a result of forced circumstances or choice, some studies suggest that they are more likely to fall ill or die before their time.

A local study published in June this year explored the relationship between loneliness, social isolation and mortality risk and found that loneliness is associated with a higher mortality risk among the elderly in Singapore.

Between 2007 and 2011, at least 50 elderly people have been found dead in their homes.

Yet, the study's authors were also quick to point out that in a densely populated city-state like Singapore, where the healthcare system is good and children often live close by, living alone does not imply social disconnection or lack of support from children.

The issue of the rising number of isolated seniors was flagged back in 2012 by Speaker of Parliament Halimah Yacob, then Minister of State for Community Development, Youth and Sports.

She said then that the reach of Senior Activity Centres, which provide recreational and social activities for the elderly, needs to be widened as they are located at the void decks of selected one- and two-room rental blocks. They now also cater to those not living in rental flats.

Ms Peh Kim Choo, director of Hua Mei Centre for Successful Ageing at Tsao Foundation, said this trend of seniors living alone has implications for the national vision of the old being able to age comfortably at home in the community.

"Will they be able to access help and support easily when a crisis happens at home, or will they be shipped off to a nursing home the minute conditions arise?" she asked.

"The existing gaps are not so much a lack of services but how these services are coordinated and working in tandem with healthcare and psychological care services."

Last year, The Straits Times broke the news about a new eldercare system aimed at better supporting vulnerable old people.

Under this, Singapore would be divided into zones with each one overseen by a cluster operator. The idea is that having a single operator overseeing community services in each zone will entail better coordination and less wastage of manpower.

Touch Community Services was appointed by the Ministry of Social and Family Development to monitor seniors in the Kallang/Novena and Yishun/Sembawang regions.

"Social workers help to monitor, provide suppport services and work closely with hospitals to ensure smooth transition of care services when (elderly folk) are discharged," said Ms Julia Lee, director of Touch Senior Cluster Network.

When asked, the Ministry of Social and Family Development said the cluster operator model is relatively new but hopes it will "reap benefits through improving and streamlining referral processes across services, improving service coordination for seniors, and minimising duplication in services".

As for Madam Ng, she once had suicidal thoughts, but is more active and happier now. She said: "When I take part in activities like singing songs at the eldercare centre, my thoughts do not go wild."

# data[].attributes.attachment_link.description
Longevity is bittersweet for Madam Ng Poh Choo. At 83, Madam Ng, who used to serve drinks at a coffee shop, has outlived three older brothers who died of cancer or old age. The single woman has been living alone in a one-room rental flat in Bukit Merah for the last 13 years.

# data[].attributes.body
caring someone can save their life and mental state

# data[].attributes.body
One example is  Ms Nurhaida. she is a single mother who has six children and lives in a tiny 30 square metre flat. The family receives some financial help from charities, the government and her boyfriend. However, the help is not enough for them. Hence, no one in the family can get sick as they cannot afford to see the doctor or buy medication. Ms Nurhaida said that one of her children has asthma but she has not been able to afford to buy medication for her. They also do not have much furniture in her house due to financial struggles. These are just some of the struggles faced by Ms Nurhaida and her family.

# data[].attributes.attachment_link.readable_text
Nurhaida Binte Jantan is making dinner. She is roasting otah-otah, a Malay dish of fish paste wrapped in banana leaves, over a portable stove.

She is a 29-year-old unemployed single mother with six children from five to 13 years old. She lives in a tiny flat, just 30 square metres, with little furnishing.

There is no dining table, so the children eat their otah-otah with rice and chillies crouched on the floor.

The children share the single bedroom - their only bedding is mattresses and thick blankets. Nurhaida sleeps on the sofa in the living room.

She receives weekly groceries from charities, as well as about S$600 ($474, £262) a month in government aid and money from a boyfriend. But she admits that it is difficult to make ends meet. She has not been able to afford asthma medicine for her second daughter for months.

"No one can afford to get sick in this house because our finances are too tight. It's quite tough and a struggle for me to be raising them up," she said.

"I have to look after this house 24/7... so for me if I were to find a job, it would have to be a night job, so that once they are in bed, I can go out and the older kids can watch the young ones."

What is surprising about Nurhaida's story is that she lives in Singapore, one of the wealthiest countries in the world. But it is also one of the most costly.

Singapore recently ranked as the world's sixth most expensive city according to the Economist Intelligence Unit, and its property market is among the top 10, according to PricewaterhouseCoopers.

The city-state's efficient infrastructure, relative safety and low taxes have attracted many of the world's wealthy. It now boasts more millionaires per capita than any other country.

Its gross domestic output per individual is among the highest too, at over $51,000 (£30,600), outranking that of developed economies like Germany and even the US in some measures. But the wealth gap is the second-widest among advanced economies in Asia, next to Hong Kong.

So it comes as no surprise that the less well-off would struggle to pay for daily necessities. There is no minimum wage or poverty line set and no welfare provision along the lines of many developed Western economies.

It has become such a problem that anti-poverty campaigners are now posing a challenge - can you make ends meet on S$5 dollars a day?

'Change the narrative'

According to the campaigners, S$5 a day is what nearly 400,000 Singaporeans are left with after paying for utilities, school, rent, loan instalments and healthcare.

The people behind the challenge are Caritas Singapore, the social and community arm of the Catholic Church. They wanted to change the opinions of Singaporeans about the poor, said Tang Lay Lee, an advocate and social worker from the group.

"Mindsets will not change just with facts and figures about poverty. We want people to feel what it is like to be in the shoes of a person getting by on S$5 a day for food and transport," she said.

The issue has been raised in parliament by Nominated MP Laurence Lien.

"Social researchers have estimated that 10 to 15% of households are low income. We do not see poverty in your face; it's not abject poverty around here," he said.

"And that's why it's hard to understand, if you look at the infrastructure, it's beautiful but what happens behind closed doors is a different matter for most families."

Mr Lien said that despite government efforts, the problem had got worse in the past decade because of globalisation and the influx of lower-cost foreign workers who have suppressed the wages of many blue-collar Singaporeans. It is meant that the income of the poorest 20% of Singaporeans had stagnated, he said.

But Mr Lien said that national identity was also a contributory factor.

"This society has been founded on the basis of meritocracy... if you have been successful, it's because of your own efforts, if you're not, it's your fault," he said.

"But we need to change that narrative because people have got different opportunities and different conditions that could impede their ability to move out of that poverty trap."

Welfare 'crutch'

The budget announced by Singapore's Finance Minister Tharman Shanmugaratnam last week aims to address some of these problems.

The stated aim of the budget, which will push the government into deficit this year and next, is to achieve a "fair and equitable society".

To do this, the government is offering kindergarten fee assistance to more households to help families like Nurhaida's, as well as transport subsidies to those with disabilities. But the lion's share of spending will go to the older generation.

Singapore is spending the equivalent of $7bn on lifelong healthcare subsidies for elderly citizens. Some 450,000 aged 65 and above will get medical benefits ranging from specialist care to medical insurance.

The city-state has one of the fastest ageing populations due to the low birth rate, and many of the elderly, dubbed the "pioneer generation", are credited with the work that built today's modern, wealthy Singapore.

But despite the wealth, there is increasing discontent. The ruling People's Action Party, which has held power for more than half a century, suffered its worst election result in 2011. It has since lost two more by-elections, and some analysts say that they are now seeking to placate a more demanding electorate.

Financially, Singapore can afford a welfare state for those in need, said Eugene Tan, an associate professor of law at Singapore Management University who comments widely about local politics. But politically, welfare is unpopular, he said.

"It is seen as a path to economic irrelevance because it undermines the dignity of work in a society that abhors and just doesn't do welfare," he said.

"It's an abiding fear of becoming enervated by a poor work ethos where welfare becomes a crutch."

But he admits that Singapore has become more welfare-oriented than ever before, even if that welfare is strictly controlled.

"It's a social welfare state in-the-making, where the tight-fisted approach is now recognised to take away from nation building."

But whether Singapore ever goes the way of many other developed economies by providing more welfare for families like Nurhaida's would be "a tightrope walk", he said.

# data[].attributes.attachment_link.title
How do Singapore's poor families get by?

# data[].attributes.attachment_link.description
Nurhaida Binte Jantan is making dinner. She is roasting otah-otah, a Malay dish of fish paste wrapped in banana leaves, over a portable stove. She is a 29-year-old unemployed single mother with six children from five to 13 years old. She lives in a tiny flat, just 30 square metres, with little furnishing.

# data[].attributes.body
"Experts in the social service sector said the rise is likely due to an ageing population, compounded by retirees not having enough savings to cope with rising living costs."

# data[].attributes.body
some of the elderly might be sick, and in serious need of medical help. however, they might not b able to get the medication they need due to the financial difficulties that they have. they might also request for financial aid so that they can pay off some of their debts and get the necessities that they need

# data[].attributes.body
Money donated by charities and money given by the government is still not enough for some families and households.
This may result in

certain families in Singapore not having enough for daily needs like groceries and food, or other necessities like furniture, a house big enough for them and medication.

# data[].attributes.body
some of the elderly have families. However, their families may be too busy with their own lives and do not have time to visit the elderly

# data[].attributes.body
They are lonely as they do  not have anyone, like friends and family, to communicate with. Loneliness affects them mentally and it may even affect their lives.
The article, 'Lonely and 'waiting to die',  Singapore's elderly poor find hope in many helping hands', tells me that "Since her husband died 17 years ago, Mdm Fernandez had been living alone with no friends or family – and slowly falling prey to loneliness and dementia."

# data[].attributes.attachment_link.readable_text
SINGAPORE: Her one-room flat was a cluttered mess, and Madam Helen Fernandez herself never seemed to bathe, said her neighbours who always saw her in the same set of clothes.

When case workers first visited the unkempt and confused elderly widow, they had to rush her to hospital for very high blood pressure - which resulted because she hadn't been taking her medication and had been missing doctors' appointments.

Since her husband died 17 years ago, Mdm Fernandez had been living alone with no friends or family - and slowly falling prey to loneliness and dementia.

There were times when she'd even call up the police just to talk. It was how her case got referred to the Social Service Office, and then to case worker Ahmala Rajoo in 2015.

"She was receiving financial assistance, about S$500 a month," said Ms Ahmala, a care executive with NTUC Health Cluster Support in Bukit Merah. "But she wasn't managing it. She was always left with nothing, and she could never tell what happened to her money."

But the neatly-groomed Mdm Fernandez you meet today almost doesn't seem the same person. At 78, she is chatty, cheery and cheeky, and greets every visitor with a delighted "come in!"

"They want to put me in home, you know, old age home... I said, don't want! Put me there for what? I won't see anybody," she said.

The walls of her newly-repainted, now-clean flat are plastered with photos and cards from friends. She has blossomed under the care of Ms Ahmala, meal delivery services, befrienders from volunteer group Helping Joy, NTUC Health Care@home services, and the Senior Activity Centre in her block.

"Her memory has worsened. But thankfully with the community support, she's more active than before," said Ms Ahmala.

"I don't think she grasps that I am a social worker. To her, I'm probably like a friend that is helping her out."
WATCH: The transformation of a lonely widow's life (5:10) THE DANGERS OF ISOLATION
Singapore's elderly poor are not short of assistance schemes by the State to meet their material needs: From heavy medical subsidies and food vouchers, to long-term financial assistance, and even rental waivers for those on Public Assistance.

But the greater problem for many of them - especially those like Helen who are unable to work and homebound due to disability, failing health or mental illness - is social isolation.

Because of the stigma against mental illness especially, many of such elderly folks in Singapore are "forgotten by society" with people going out of the way to avoid them, said Mr Ng Koon Sing, head of COMNET Senior Services under AMKFSC Community Services.

This isolation from the outside world feeds depression and suicidal tendencies, aggravates mental conditions, and worsens their physical health.

In Singapore, elderly suicides have been creeping up, from 95 cases in 2010 to 126 cases in 2014. Said Ms Ahmala of her elderly clients:

Most of them will tell you that they're just waiting to die. And they will tell you that there's nothing else to look forward to.

And they can pass under the radar, until a neighbour, or a visit to hospital, or door-to-door outreach by social workers brings their plight to light.

Volunteers and community workers report finding some living in squalor, with cockroaches and bed-bugs, sleeping on the floor, and in poor physical or mental health because they have been neglecting their medication.
WATCH: The shocking condition of one elderly man's flat, before volunteers gave it a makeover
But thankfully for these whom the rest of society has forgotten, there is a growing community network striving to ensure they find some measure of well-being and companionship in their final years.

It's an extensive web made up of welfare groups, charities, hospitals, and operators (like NTUC Health) of Senior Cluster Networks initiated by the Ministry of Social and Family Development.
THE ONLY ONES AT HIS FUNERAL
Take Mr Jesmond Oh, a nurse who doesn't spend his days in the hospital, but visiting the homes of his elderly wards.

One of them was an underweight, 60-year-old former security guard who was frequently falling down because his toes had been amputated due to his poorly-managed diabetes.

When Mr Oh's care team at Tan Tock Seng Hospital's (TTSH) Department of Continuing and Community Care took up his case and began visiting him at home to monitor his condition, Mr Oh said: "Initially, he didn't listen to us. He kept taking his medicine his own way."

His house was a mess. When we cleared his mattress, we found three cockroaches, scissors, medication all over the place, insulin injections on the bed as well. He'd just lie down on these.

The man was also depressed. At one stage, he told them: "If I jump down, all of you don't need to come already." Alarmed, the doctors had him brought in for psychiatric evaluation. Mr Oh recalled: "He was traumatised and decided, 'I will not play this type of joke anymore.' After that, he was very good and compliant with us."

That rocky start evolved into a close friendship over six months.

One of the first things the team did was to arrange for meal deliveries, so that he would get the proper nutrition. His neighbours had been packing meals for him - but it was "all this unhealthy food that made his (diabetic) condition even worse," said Mr Oh. "And he'd had to pay them 'tips'. It was quite upsetting that they were making use of him."

The team also called in a housekeeping service, arranged for escorts to his medical appointments, got someone to help him daily with his wound dressings, and a community social worker who visited him daily.

One evening after work, Mr Oh's phone rang. It was the police. They told him that the man had been found dead at home; he'd fallen and hit his head. "They called me because my number was one of the last few that he'd dialed on his mobile phone," said the nurse.

The man had never spoken of any next of kin, so his body stayed in the mortuary for 21 days while notices were posted in the newspapers.

Apparently, no one responded. So the few of us - the medical team, social worker and myself - were the only ones at his funeral wake.

BRINGING THEM A REASON TO CARE ABOUT LIFE
Sadness and loss is a part of the job, but what keeps Mr Oh going is the hope that "towards the end, I've actually touched them and helped them to achieve a better quality of life at home".

Like Madam Ong Ah Hiong, 89, a widow who has survived the deaths of her husband, all three children and her siblings.

She had gone to TTSH's A&E department with very high blood pressure in January this year. The doctors there assessed that she was at high risk of falling, and since she was living alone and had a history of depression, referred her to Mr Oh's community care team.

Every visit, he banters with her while going through the basic health checks, where necessary calling up the doctor for a consultation.

Said Mdm Ong: "My heart tells me he cares for me. You can't imagine how happy I am with all of you visiting me."
WATCH: A special friendship (4:31)
If not for such services and home visits, many of the elderly poor would tend to neglect their health, to the point where they keep being hospitalised.

Ms Jess Ho, principal social worker for NTUC Health Cluster Support at Bukit Merah, said: "Some seniors refuse to take their medication, especially when there are more than five types. They find it so disheartening, sometimes they give up altogether. They feel that life is short, 'I don't want to go through this in my final years, taking all this medicine'."

And then there's the cost of transport just to keep a doctors' appointment, or of getting the proper nutrition. Said Mr Oh:

The elderly poor are prioritising their basic needs over their health. They will say that they can't even afford three meals a day.

"The worst case I met, he's surviving on S$2 chicken rice a day and S$1 mineral water. The rest of the day he will just eat biscuits."

This is why the TTSH team works with the Social Service Offices to get their patients any assistance they might need, including something as basic as a running water and electricity supply.

NTUC Health's cluster networks too work closely with hospitals, the various agencies and community groups, to "co-manage" their senior patients' well-being holistically. From 2013 to 2016, they have reached out to more than 4,800 seniors in the Taman Jurong and Bukit Merah regions alone.

Ms Ho said: "Some need to be motivated, they need meaning because they're all alone. We need to get them to know it's worthwhile taking care of themselves."
POVERTY ISN'T JUST THE LACK OF MONEY
Indeed, it is common to think of poverty as referring to material or financial resources. But researchers say that the lack of social contact can be just as impoverishing.

Assistant Professor Ng Kok Hoe of the Lee Kuan Yew School of Public Policy referred to a study done across four continents, where focus groups of the elderly were asked what they needed in life. Social participation was cited every time.

"It means not feeling like you are left out as a member of society," said Dr Ng. "A decent standard of living means that I want to be a part of society, having access to friends. It doesn't mean I stay home all day and eat to meet my bare nutritional needs."

Just ask hawker's assistant Mr Ong Hock Soon, who has lost touch with his children for years. His fault, he says, as he had a bad temper and he gambled.

The 69-year-old admits that in the emptiness of his flat sometimes, it all becomes too much.

When I go home at night, yes, I will feel lonely. I will cry.

"Then in the morning I wake up, go to work, and I'll be happier. I'm most happy going downstairs (to the Senior Activity Centre) because I've got many friends," he said.

"My greatest regret is my children. I want to say sorry to them. Dad was wrong last time. I hope you will forgive me."
WATCH: Mr Ong's biggest regret (6:08)
Elderly isolation happens for various reasons - apart from family estrangement, it happens when spouses die and the children are no longer around.

But there's also the stress of caring for a sick spouse. "I'm cooped up with my spouse for over 20 years, I don't have any life to myself, no resources and nowhere to turn," is one common scenario that Tsao Foundation senior social worker Wong Yock Leng describes. Such spouses often end up prone to depression.
EVERYONE CAN LEND A HAND
Alleviating the loneliness and stress is what volunteer group Happy People Helping People Foundation is all about. Apart from organising food vouchers and ration packs for their clients, who are elderly cardboard collectors, the group also holds get-togethers and outings to places like the zoo.

It might sound tacky, said volunteer Ms Nurasyikin Amir, but the outings are "what they look forward to the most. When we are distributing rations, they will ask us when is the next outing?".

When we first met them, they were very quiet and reserved. Now, they make friends more, and they look out for each other, which I think is very important.

Perhaps more importantly, what the vulnerable elderly need are for others - and not just the community groups - to keep an eye out for them.

NTUC Health's Ms Ahmala, for instance, is kept busy handling 28 active cases concurrently, which can run the gamut from hoarders to the suicidal to the terminally ill. So it helps when neighbours step up to report someone they think might need help - and some actually help to shoulder the burden of caring for their fellow residents.

Said Ms Jess Ho: "They do visits and they are like our eyes and ears. Today (this neighbour) is not doing well, he is not eating, then they would call my case worker to drop by."

As Ms Nurasykin put it, the hope is that more will replicate the Happy People model in their own neighbourhoods. "If everyone just helps their neighbour ... like what our tagline says, not everyone can do everything, but everyone can do something."
Read part 1: The faces and insecurities of Singapore's elderly working poor This is part of a CNA Insider series exploring the issues of elderly poverty in Vietnam, South Korea, Singapore and Myanmar. Watch and read the entire series here.

# data[].attributes.attachment_link.title
Lonely and 'waiting to die', Singapore's elderly poor find hope in many helping hands

# data[].attributes.attachment_link.description
SINGAPORE: Her one-room flat was a cluttered mess, and Madam Helen Fernandez herself never seemed to bathe, said her neighbours who always saw her in the same set of clothes. When case workers first visited the unkempt and confused elderly widow, they had to rush her to hospital for very high blood pressure - which resulted because she hadn't been taking her medication and had been missing doctors' appointments.

# data[].attributes.body
most of the elderly are lonely and don't have anybody to spend time with