Assisted living facilities – a trendy option for our seniors?
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Assisted living facilities – a trendy option for our seniors?

3 elderly in a garden

At 85, Madam Goh Kim Eng is full of life and energy. The sprightly lady takes frequent walks at the Botanic Gardens, enjoys occasional trips to Bukit Timah Shopping Centre, and has gone on a four-day tour to the Cameron Highlands with her friends this year.

These are some activities she is able to enjoy at the St Bernadette Lifestyle Village, an assisted-living-facility (ALF) nestled within the prime residential area of Bukit Timah. Home is a tranquil single-storey bungalow, which she shares with seven other residents. Each resident has their own private room and toilet, along with a common living and dining area where they can mingle, watch TV and play mahjong.

“Everything is catered for you. I also enjoy the freedom – I can go out, and I have friends to talk to here,” said Madam Goh, who has been staying at St Bernadette for over a year. Her four children encouraged her to move in, as she was previously staying alone at home with a domestic helper.

Compared to conventional nursing homes, ALFs are catered for elderly individuals who are more mobile and do not need a high level of medical care. Some may still require help with certain daily activities such as showering and cooking.

This alternative model is slowly gaining prominence in Singapore. In January 2018, Minister for Health Gan Kim Yong said the government is exploring more alternative living options for the elderly such as ALFs, to address the needs of an ageing population.

Catering to the active elderly

3 elderly in a recreation room

The benefits of ALFs are allowing seniors to maintain their independence while ensuring that help is at hand if needed, said Dr Belinda Wee, who runs St Bernadette with her husband, Dr Joseph Lee.

“We try to let them live life fairly independently, but with someone looking over their shoulders,” she added.

The couple also runs a nursing home, Good Shepherd Loft, in a building adjacent to St Bernadette.  They started the nursing home in 2010 and opened the ALF five years later in 2015 after noticing a demand for eldercare for more active seniors.

“When we started Good Shepherd, the more mobile and able seniors always said they wanted to go home. Along the way, we thought maybe there was an alternative care model we could explore which would fit this group of people,” explained Dr Wee.

This model has worked, and the couple is opening another ALF along Adam Road in May 2018.

Other organisations are also planning to build ALFs. In March 2018, Lien Foundation announced it will be developing such a facility with 50 rooms, in partnership with four philanthropists. The facility is expected to be completed by 2021.

“For the longest time in Singapore, nursing homes have been the only large-scale option for residential care for the elderly. And that needs to change,” said Ms Radha Basu, director for research and advocacy at Lien Foundation.

In advanced countries like Finland and Japan, she noted that ALFs are growing at a rate faster than nursing homes, becoming the go-to option for elderly residential care.

Singaporeans also appear to view ALFs as a viable option in their old age. In a 2016 survey by the Lien Foundation and insurance company NTUC Income, nearly 50 per cent of almost 1,000 respondents said they were willing to stay in ALFs.

Different generations, different expectations

It is estimated that a quarter of Singaporeans will be aged 65 and above by 2030, with a third requiring some form of eldercare service.

A majority of the elderly then will comprise the baby boomer generation. Along with a different generation comes a different set of expectations. This is where ALFs can play a major role in the eldercare facility landscape in Singapore, said Ms Basu.

“Singapore went from a third-world to first-world nation in just one generation. The baby boomers who might need care eventually will be more educated, more affluent and have higher expectations. We need to give them more choices. Not one size will fit all. We also need to find better financing models and build up a private sector market for care,” she observed.

Conventional nursing homes are also trying to reinvent themselves to meet the changing needs of the elderly.

Across ECON Healthcare Group’s nine nursing homes in Singapore, its single-room wards are now considered a model for assisted living, said its executive director Ms Ong Hui Ming. The company has operated in Singapore for over 30 years.

“We’ve recently been seeing an increasing number of semi-independent clients who are choosing to move in,” she said.

Bringing in the community

Apart from planning for exclusive residential options, there can also be a rethinking of community spaces for the elderly, shared Dr Chong Keng Hua from the Singapore University of Technology and Design.

He co-authored a publication, “Second Beginnings – Senior Living Redefined”, that seeks to reimagine how 10 types of spaces can be transformed for seniors. For instance, he proposed a “wholesome market” concept that aims to co-locate places that offer geriatric care and a marketplace such as hawker centres for the elderly to frequent.

As it can be tough to persuade some elderly to visit the doctor, Dr Chong suggested merging healthcare facilities with a place they can relate to, like markets. The geriatric centre is then redefined as an informal local market.

One of his concepts from the book is currently being developed at the void deck of a HDB flat in Ang Mo Kio. Called Community Pocket, it will be an area designated for seniors within the HDB estate to implement their own initiatives and carry out activities. There will also be a gym and community garden to better enable ageing-in-place.

“It’ll be great if we can diversify living arrangements for our elderly. A lot of the elderly don’t need to go into nursing homes yet. These spaces provide the area for them to socialise and contribute to the community in their own ways,” he said.

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