Ageing in Singapore: It takes a village to support our seniors
Published on
31 Jan 2025
Published by
The Straits Times
A community of care and connection is essential to ensure they live with dignity and purpose.
With Chinese New Year celebrations in full swing, chinks in the festive atmosphere are brought into sharper relief – particularly for the vulnerable.
Take the recent story of Ms Ng Tang Puay, 71, who lives alone in a rental flat. Diagnosed with cancer during the Covid-19 pandemic, she experienced first-hand the difficulties of navigating a harsh world under lockdown as a single senior.
Having received help from social service agency Lions Befrienders who broke through her isolation, she now makes it a point to spread festive cheer to other elderly, who may feel left out as others around them celebrate.
Ms Ng’s story is not unique. In 2022, government data revealed that 79,000 residents aged 65 and above were living alone in Singapore – a number set to rise as one in four citizens is projected to be 65 or older by 2030.
With such rising numbers, support for our seniors – such as the befrienders who helped Ms Ng – needs to be embedded in our community, rather than be one-off lifelines.
What more is needed to ensure seniors in Singapore not only age in place but also thrive in doing so?
Part of the answer lies in building a supportive environment – a kind of ecosystem that enables older adults to flourish.
Like plants in a garden, seniors are deeply influenced by their surroundings, where the interplay of elements like social networks, physical accessibility and community care can determine whether they thrive or wither in isolation.
However, there are a multitude of pressing issues that are vying for attention on the ageing agenda. So why should building supportive environments become a central priority?
To answer this, it is important to recognise that many factors that influence health are often not solely medical, but also social.
Environments are physical and social
As a retired educator, 70-year-old Molly (not her real name), keeps busy doing exercises in the park while chatting with friends. She exudes a sociable and seemingly worry-free demeanour. One would not have guessed that she recently underwent assessment for mild memory difficulties, given how her days continue to unfold as serenely as before.
The secret? A little help from friends and family, age-friendly neighbourhood spaces and accessible health services – in other words, a supportive environment.
Molly envisages many more golden years ahead, despite her health issues. Factors that have spurred her on include loved ones offering encouragement, while neighbourhood amenities – such as signs to help her with directions and a refurbished park – motivated her to continue enjoying the outdoors and exercising with friends in the community.
This is a testament to how “place” in the ageing-in-place equation can move the needle for older adults’ health and well-being in a significant way, with implications for their levels of motivation in taking charge of their health, independence, social connectedness and more.
Environments are the foundation for shaping the ageing trajectories of older adults.
Beyond just natural or built surroundings, the World Health Organisation (WHO) points out that environments also consist of interpersonal connections; caregiving support; enabling technology; societal attitudes towards ageing; health and social services; and systems and public policies.
At the launch of the Healthy Ageing and Prevention Index in Geneva in 2023, Minister for Health Ong Ye Kung pointed out that social factors can account for about 60 per cent of health outcomes. Known as social determinants of health, these factors include housing, access to health and social care, literacy, food security and more.
The crux is that many of these social factors are embedded in our environments. Far from being insurmountable, they can be addressed and modified, offering valuable opportunities for positive change.
By converging our efforts around building supportive environments, we can target and strengthen many of these elements that affect older adults’ well-being. Given Singapore’s finite resources and a ticking clock as our population rapidly ages, this could be a strategic move.
Bringing together, research, policy and practice
We are making progress in developing enabling environments for our older adults. For example, under Age Well SG, active ageing centres are being expanded and enhanced islandwide, to serve as drop-in hubs for older adults to stay socially engaged and physically active. More community care apartments – a housing option that includes on-site social activities and care services – are also being built.
But we can do better to rally policy, practice and research around this priority.
Research can play an important role by putting evidence into action and implementing solutions: by studying how policies, programmes and practices could take off in the real world, and what might work for whom and where, and bringing stakeholders together to share findings along the way for real-time adjustments.
To this end, the Geriatric Education and Research Institute, as a national entity, works with other research centres to co-develop and evaluate intervention programmes to support and extend the healthy years of older adults. Across our projects, we identify barriers and facilitators that can influence the success of these programmes.
Health services are one such vital component in the care ecosystem. In our study of a community-based national frailty programme, one perennial yet fundamental barrier was identified: older adults’ attitudes towards their health condition and their motivation to address it. In this case, we found that most participants had little awareness of frailty in the first place, and how this condition could affect their independence. Many felt little need to take steps to prevent or manage it.
The good news is that this intrinsic barrier can be chipped away through the encouragement of friends and shared peer activities, or a healthcare worker who sheds light on what frailty is and urges the older adult to join a recommended health programme.
A unique advantage and a collective will
It will be challenging to bring policymakers, healthcare practitioners, researchers and community partners together, as seen in other countries where systemic and geographical barriers persist. However, in Singapore, it might just be possible. Our unique context, including our policies, infrastructure and small size, makes it an excellent place to test, implement and refine strategies for better health and well-being.
This “Singapore advantage” also aids in aligning diverse actors in the public, private and non-profit sectors with differing agendas.
For inspiration, we can look at the sustainability agenda, to which the public and non-profit sectors have contributed significantly amidst the turbulence of climate change, the pandemic and other headwinds. Even within the private sector, as analysts have noted, many companies recognised that sustainability was no longer just a moral choice or a regulatory obligation – it was a strategic imperative, as it could boost their bottom line in the long run.
In the ageing space, there can be mutual benefits for all involved – such as new opportunities and markets – if they mobilise around the cause of enhancing environments for older adults. In this regard, the “Singapore advantage” makes it more viable to bring various people to the table for dialogue, to forge alignment and buy-in that leads to action.
The year 2025 marks the mid-point of the United Nations Decade of Healthy Ageing, while in parallel, Singapore’s own such “decade” is under way: over the next 10 years, $3.5 billion will go to Age Well SG to support older adults in the community.
The WHO defines healthy ageing as the process of developing and maintaining functional ability – the capability to meet basic needs, learn, grow, make decisions, be mobile, build relationships, and contribute to society – that in turn enables well-being in older age.
From a strategic angle, building supportive environments for older adults can also amplify the outcomes of policy efforts, such as Healthier SG, which seek to improve and maintain older adults’ physical and mental capabilities through lifestyle changes and preventive care intervention.
By placing this endeavour at the heart of our efforts, we can unlock greater progress in our race against time to uplift the overall health of our older population.
Crucially, there is now a renewed collective will from across levels of government and society to forge kinder, more conducive environments for all generations. Let us, as members of our evolving ecosystem, seize this momentum.
Associate Professor Ding Yew Yoong is the executive director of the Geriatric Education and Research Institute and a senior consultant in geriatric medicine at Tan Tock Seng Hospital.
Source: The Straits Times © SPH Media Limited. Reproduced with permission.
Photo: The Straits Times
Written By: Ding Yew Yoong
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