Govt moves urgently to expand aged care services

By Claire Huang, Channel NewsAsia, 20 Jan 2012

The government is moving with urgency to significantly expand care services for the aged, to cope with the expected surge in demand by 2020, due to a fast ageing population.

It estimates that by 2030, there will be 117,000 seniors who are semi-ambulant or non-ambulant -- more than 2.5 times that of today.

Minister for Health Gan Kim Yong announced Friday morning a slew of initiatives at the Ministerial Committee on Ageing dialogue session with stakeholders, to seek their ideas on the way forward.

Mr Gan said: "More than 85 per cent of the 600,000 seniors in 2020 are expected to be functional and healthy. We will be aggressively pushing for preventive screening and promoting a more healthy lifestyle among seniors, so that they can remain active and healthy for as long as possible."



On its part, the Ministerial Committee on Ageing -- set up in 2007 to promote active ageing as Singapore's population rapidly ages -- will enhance care for the aged here.

It wants to at least double the outreach of home-based healthcare services, from the current 4,000.

The government will also increase the number of seniors who are eligible for home-based social care, from the existing 2,000 to 7,500.

Besides these, it wants to expand the number of day social and rehabilitative care places to about 6,200, from the existing 2,100.

Currently, there are 42 Seniors Activity Centres that serve 18,000.

The Ministry of Health (MOH) said it intends to build more Seniors Activity Centres, so that they can reach out to the growing number of vulnerable seniors.

Mr Gan also announced plans to ramp up the number of nursing-home beds by some 70 per cent, to 15,600.

"We need to act now. The first cohort of Baby Boomers turns 65 years old this year, Mr Gan said. 

"By 2020, some 600,000 people, 15 per cent of the cohort of the population, will be above 65 years old, and from there, the pace of ageing will start to accelerate. 

"2020 is less than 10 years away. We must be ready when rapid ageing sets in."

Other ideas the government is exploring is the development of more aged care facilities like day centres and nursing homes, under a Build-Own-Lease model.

Mr Gan said the ministry will develop manpower for the sector.

So, the ministry will also have to expand new care services, including stronger transition care after discharge from hospitals, as well as further develop transitional convalescence facilities, to rehabilitate seniors.

He added that the committee will review care financing schemes to make aged care more affordable.

To help raise productivity, Mr Gan is prepared to work with stakeholders to study how information technology can be maximised to help achieve better integrated care and greater efficiency.

Over the years, MOH has gradually shifted its focus to the aged care sector.

But with a rapidly ageing population, this has now become an immediate task of enormous proportion.

The ministry thus, has its hands full, as it tries to play catch-up on a massive scale.

Greying society? Yes, but with a silver lining
Elderly people today are healthier, more active and a resource to tap
By Salma Khalik, The Straits Times, 23 Jan 2012

SINGAPOREANS born today can expect to live almost two decades longer than those born in 1965, when the country became independent.

Life expectancy then was 64.5 years. In 2010, it was 81.8 - a good 17.3 years longer.

Not only are people living longer, more are staying healthy and active as they age. Slowing down, falling ill and feeling old have all moved to later and later in life.

People in their 70s and beyond do not act as 'old' today as people the same age did 20 or 40 years ago.

Highlighting this, Mr Heng Chee How, Senior Minister of State in the Prime Minister's Office, noted the brighter side of Singapore's greying society.

While Singapore will have more old people in future, more of them will be fit and active, and living fuller lives than elderly people in the past.

Their longer lifespans and improved quality of life are likely to be the result of a healthier environment and diet, and a greater availability of services.

Mr Heng, who is on the Ministerial Committee on Ageing and who heads a sub committee on active ageing and employability, said: 'At every age point, Singaporeans are healthier today than at the same age point in the past.

'This means that many can continue working beyond the official retirement age of 62.

'We should not neglect that, as numbers grow and characteristics change, what this segment is capable of contributing to one another, and to wider society, changes also. So they are an asset in the making as well.'

Employers seeking workers, for example, should look at this group of healthy older people with experience as a pool to tap.

A baby born in 1965 had a life expectancy of 64.5 years at the time of his birth. But those born that year - now 46 or 47 years old - can expect to live far longer.

In fact, projections by the Department of Statistics Singapore in 2010 gave people born in 1965 an average of 37.8 years more of life. This meant they would live to an average of 82.8 years - considerably more than the 64.5 years projected when they were born.

Mr Heng said what has not changed much is the typical number of years of sickness before death - it remains the last eight years of life.

That means people tend to be relatively fit until about eight years before they die. In 1965, that point arrived when people hit 57; today, it is at age 75.

Said Mr Heng: 'What is reality? In 1965, lifespan was about 65 years. Today, half the people who are 65 years old have a chance of living beyond the age of 85.'

There are already more than 10,000 people in Singapore aged 90 years and older.

'Generally, people do not feel 'old' as quickly,' said Mr Heng.

The more positive aspects of today's elderly have been noted by other experts too.

Dr Wong Sweet Fun, a senior consultant in geriatric medicine at the Khoo Teck Puat Hospital, said a better environment, improved education system and social progress have resulted in healthier and fitter older people.

They may have the same medical problems as those the same age decades ago, but today these issues are picked up earlier and managed better, she said.

Dr Wong also noted a key difference in older people today, compared to those she saw when she began practising medicine about 25 years ago: 'The 60-to-70-year-olds today are more active compared to those I encountered when I first started practising.'

Four in five people aged 60 or older consider themselves healthy, according to a study of 5,000 elderly patients published last year by Duke-NUS and the National University of Singapore. Even among those aged over 75, more than three in four said they were healthy and independent.

The researchers concluded: 'While some decline in overall health is a consequence of ageing, the vast majority of older Singaporeans report themselves as healthy overall and in a wide range of health dimensions.'

The study looked at 15 dimensions of health, including the ability to hear, to have strong social networks and to be free from pain.

Mr Heng said part of his job on the Ministerial Committee on Ageing is to try to bring society's perception of older people in line with the reality this group is living in today.

He said: 'At which point do companies consider them to be no longer young and up-to-date? A person reaching even 40 years old, 50, 60?'

STUDY ON AGEING

THE Ministerial Committee on Ageing was set up in 2007 to help Singapore deal with a rapidly greying population.

By 2020, about 600,000 people will be aged 65 and older. This is expected to rise to 900,000 by 2030.

When Health Minister Gan Kim Yong took over as chairman last year, he set up four sub-committees, heading one himself.

This is the last of a three-part series with the sub-committee chairmen. The Straits Times interviewed Senior Minister of State in the Prime Minister's Office Heng Chee How, who will tackle Active Ageing and Employability.

Flexible work arrangements can help elderly stay active
By Salma Khalik, The Straits Times, 23 Jan 2012

COMPANIES should offer more flexible arrangements so as to allow older people to keep working, said Mr Heng Chee How, Senior Minister of State in the Prime Minister's Office.

He said companies should model themselves on adaptor plugs that fit any type of socket. For example, they could offer multiple working platforms - part-time work, flexible hours or working from home.

Such arrangements would allow them to take advantage of a large pool of older people who have stopped working, but could be persuaded to re-enter the workforce given the right conditions. Offering greater flexibility would also help companies cope with a tight labour market, said Mr Heng.

The employment rate among men starts to decline from the age of 50, Ministry of Manpower figures show. By the time they hit 55 or 60, the rate is accelerating rapidly.

Among women, the slide starts much sooner, in their 30s - an age when many start having children.

Only slightly more than three in four men aged aged 55 to 64 are still employed, while less than half the women this age are still working.

Mr Heng said that part of his job on the Ministerial Committee on Ageing is to 'make sure that as people want to work longer, and need to work longer, the health part is better taken care of to enable them to do so'.

From this year, companies have to offer employees who turn 62 - which remains the official retirement age - a chance at continued employment.

The Government is not expecting companies 'to do national service' with this change in the rules, said Mr Heng.

He noted: 'Most people in their 60s today are still very fit and able to carry on working. Health has become less of a barrier to employment. Sixty-year-olds can contribute better than they were able to 40 years ago, so we should tap them.'

Keeping older people employed can help them remain healthy, he said.

'Keeping active is the point, whether in employment or off regular work, because of the longer runway ahead. They should not just stall and degenerate.'

To that end, Mr Heng is testing out several schemes in his Whampoa constituency aimed at keeping people active and socially involved. If successful, they could be rolled out nationally.

With the help of the Health Promotion Board, Mr Heng is asking general practitioners in Whampoa to urge their older patients to join community activities.

Instead of just telling them they need to exercise more, he wants the doctors to recommend taiji or brisk walking activities organised by the community centre.

He wants older people to be drawn from one activity to another, such as singing or dancing, or an outing. This way, they will have a group of friends of their own age.

They can share their health experiences, and someone who discovers a chronic ailment, such as diabetes, can turn to these friends as a resource.

'They would not feel insulted if one of these friends 'nagged' them to go for treatment,' said Mr Heng. 'This social glue is very important.'



OLDER BUT STILL FIT

Most people in their 60s today are still very fit and able to carry on working. Health has become less of a barrier to employment. Sixty-year-olds can contribute better than they were able to 40 years ago, so we should tap them.'

Mr Heng Chee How, Senior Minister of State in the Prime Minister's Office