Three ways that Singapore is building an elderly-friendly society

By 2030, one in four persons in Singapore would be aged 65 and above. This brings both challenges and opportunities to make the city more accessible, friendlier, and better equipped for citizens to age well in place.  

In the recent years, Singapore has launched an updated version of the Action Plan for Successful Ageing, including a S$3.5 billion budget to support initiatives under Age Well SG. 

Age Well SG is the national programme led by the Ministries of Health, National Development and Transport, to help seniors age actively and receive care within their communities.  

The holistic approach of Age Well SG shows the broad implications of an ageing population. While healthcare remains a core area of consideration, physical infrastructure is as equally important to fostering a caring environment for seniors.  

These are some of the strategies that Singapore has launched recently to address the needs of seniors and their caregivers, for today and tomorrow.

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1. Giving people agency in their care 

In the event you lose the capacity to make decisions for yourself, what happens? 

Advance Care Planning (ACP) is a process that aims to cover this question—allowing people to prepare and plan for their personal care and health for the future.  

What this entails is documenting your beliefs, values, and care preferences, to guide healthcare teams and loved ones to act according to your wishes in the future. 

To facilitate access to a quality ACP, LifeSG rolled out myACP, a free digital tool for Singaporeans. This was developed by the Agency for Integrated Care (AIC) and GovTech Singapore. 

People above 21 years old who do not have any existing serious illness and have the capacity to make their own decisions can access this website and fill in their preferences for how they want to be treated. 

While planning for end-of-life is part of the process, ACP is broader. It asks individuals to think about what care practices best align with their values, including decisions to refuse treatment at end-of-life or in other care situations. 

The process can ultimately help reduce decisional conflict in healthcare procedures.

Australia and Canada have also rolled out digital initiatives for ACP. These tools, like myACP, open the door for conversations about future-care planning, inviting to destigmatise the topic, and making the process more accessible to the public. 

In Singapore, individuals with serious illnesses (such as cancer, dementia, or heart failure) may complete myACP with the assistance of their healthcare teams or an ACP facilitator. 

2. Exploring alternatives for inpatient hospitalisation 

The demand for care and bed spaces in hospitals are expected to increase with a rapidly ageing population. 

Since building more hospitals is not a sustainable solution, Singapore has been exploring alternatives regarding inpatient hospitalisation. 

Mobile Inpatient Care@Home (MIC@Home) is one such strategy. This involves hospital-care delivery in a patient’s home, including visits by doctors and nurses and regular procedures like therapy or investigations. 

This frees up space for more serious cases that require inpatient hospitalisation and serves as an alternative for patients who are more sensitive to hospital-acquired complications. 

The initiative is supported by the Ministry of Health Office for Healthcare Transformation (MOHT).  

Since MIC@Home is a regular public hospital service, it is entitled to the same financial support as a physical hospital inpatient stay. 

What makes MIC@Home different from other homecare services is that it stands as a substitute for hospital inpatient care. It is not limited to transitional or post-discharge care provided by Hospital-to-Home programmes, or palliative care that home hospices provide. 

To be eligible for MIC@Home, patients must be clinically stable and not require intensive hospital care. They must be able to communicate with their care team virtually through mobile or video-calling platforms, and be able to manage their medications independently or with their caregiver’s support. 

According to the MOHT website, some suitable cases for MIC@Home include (among others) pneumonia, dengue, cellulitis, urinary tract infection, and uncontrolled hypertension. 

3. Building more inclusive infrastructure 

Eldercare is not limited to healthcare, as creating a more inclusive environment to encourage people to age gracefully has been one of the priorities of the Singapore government. 

One such programme to support mobility and safety at home is the Enhancement for Active Seniors (EASE) developed by the Housing and Development Board (HDB).  

This programme subsidises items in a flat to improve mobility, accessibility, and safety, from grab bars and handrails to wall-mounted foldable shower seats and widening of entrances.  

Eligible households for EASE include those with a family member aged 65 years or older, or between 60 and 64 years old that requires assistance with activities of daily living. For the latter case, a Functional Assessment Report is required. 

EASE is one of the programmes that align with the “ageing in place” initiatives that the government continues to roll out to support seniors’ ability to live in their own homes and communities comfortably and independently. 

Last year, AIC and SMRT Corporation signed a memorandum of understanding to expand initiatives toward making Singapore’s public transportation more dementia friendly. This included dementia go-to points (GTPs) in train stations where the public can take any person appearing lost to get assistance. 

Infrastructure designs such as ramp access, wide entrances, and GTPs are just a few examples that help to enhance inclusion and show care not just for seniors, but for the public.