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Going fourth to multiply: talking about an old issue

By 2030 there will be estimated 600,000 Singaporeans aged 75 years and older.

Terrence Chee on 20 Jan 2014

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Publisher: SALT


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By 2030 there will be estimated 600,000 Singaporeans aged 75 years and older. Many, if not most, of those in this demographic will be in their ‘fourth age’, which is characterised by a loss in cognitive function and ability to learn, the prevalence of dementia, dysfunction and frailty.



In short, the fourth age of a person’s life is defined by a loss of functionality – and therefore dependency.


This dependency will demand increasing health and social service support. It is a prospect that will invariably be lengthy and expensive for the families affected – and for society.


There is no doubt that personal responsibility is part of the equation. Those of us approaching the fourth age must prepare ourselves financially, emotionally and perhaps even spiritually, for the almost-inevitable loss of our independence. Then, even basic everyday tasks will require the reliance on others.


Redefining the discourse on ageing


Much of this preparation will have to be addressed in the preceding stage of life – the ‘third age’, where the so-called ‘young-old’ are still in possession of relatively good health, physical strength and are able to participate meaningfully in society.


While there is a plethora of initiatives concerning the third age, the discourse now needs to include the fourth age as part of the continuum of the aging cycle. We cannot honestly address the reality of aging if we do not also mention the inevitable deterioration of the human condition.


Looking ahead, seniors are more likely to be living on their own, which suggests the importance of ensuring the availability of care within their community. This might include building care networks comprising paid staff and volunteers (including able-bodied seniors), especially within precincts with a high concentration of seniors living alone or those who require social and/or health care support.


Increasingly complex social problems


Ms Ang Bee Lian, CEO of NCSS who spoke at the MSF-CSC Social Sector Conference in April 2013, mentioned one of the dilemmas was how to galvanise the various sectors to meet competing needs with limited resources.


In the same conference, Mr Laurence Lien, CEO of the National Volunteer & Philanthropy Centre (NVPC), also reiterated the social problems we face today are complex and increasingly difficult to solve and that old paradigms need to be revisited.


But he also mentioned that there are opportunities in mobilising the private and non-profit sectors in the problem solving.


As an example, Laurence said that not-for-profit organisations may be better placed to take on certain projects by injecting diversity and innovation in palliative and end of life care in Singapore. The government must encourage alternative delivery models and lessen involvement by allowing private funding and initiative.


Our future situation should be characterised by a multi-facetted collaboration between the government, non-for-profit, and private sectors. Each is empowered to do the work without replication from another tri-partite member. We must let each stakeholder do what it is best suited to their expertise and allow the not-for-profit and private sectors take on some ownership to solve social issues.


The government’s role must then be to create an environment encouraging new models of delivery conducive for positive change.


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