Taking eldercare to new heights
Published on
21 May 2024
Published by
The Straits Times
Not just technology but an improved ecosystem, incorporating best practices from around the world, is what will make the biggest difference.
Earlier in May I visited the Ageing Asia Innovation Exhibition, which was part of the World Ageing Festival that is held every year. As a senior myself, I wanted to see what innovations are out there that can help people like me when we need them.
Many people are already in need, and their numbers will grow as ageing proceeds. Singapore Citizens aged 65 and above make up almost one-fifth of Singapore’s population, up from almost 12 per cent from a decade ago, according to the Government’s 2023 population report. By 2030, the proportion is expected to rise to one-fourth.
Ageing is accelerating across most of East Asia, as well as parts of Europe. In response, all manner of innovations have emerged to cater to the swelling ranks of elders.
Impressive technological advances
I was blown away by the technologies on offer at the exhibition, some of which I had never heard of. There was, for example, an “exoskeleton” – a wearable robotic suit that enables wheelchair-bound people to walk at multiple speeds and even climb steps.
A Japanese company called Viami showcased a shower bath system resembling an MRI machine, which makes it easy for people in wheelchairs or even stretchers to have showers, complete with soaping and rinsing mechanisms, with minimal help from caregivers, who otherwise have to lift and carry people to bathe them.
Centropix, a Liechtenstein-based company, displayed one of its inventions – a thin mat embedded with copper coils that emit electromagnetic impulses that are claimed to stimulate cell metabolism, improve blood circulation, relieve pain, promote healing and improve sleep.
There was an array of texture-modified foods for people with swallowing difficulties. Items of dim sum displayed looked exactly like those you would order in a restaurant except that the ingredients have been specially rendered to make it easier and safer to swallow. The foods are said to maintain the nutrition as well as the taste, but have special enzymes to soften the texture.
I tried out something called a “bike labyrinth” – a stationary bike with a video screen in front that enables users to cycle through a choice of 700 routes from around the world, both in cities and the countryside – a virtual cycling experience with realistic views.
There were elder-friendly furniture, virtual reality games to help prevent dementia, shoes with special air cushion soles for pain-free walking, image-based patient monitoring solutions by remote control, aided by cameras installed on the ceiling, as well as sensors under mattresses to alert caregivers, and more.
Not displayed but available for those interested were telepresence robots, which can be controlled remotely and allow family members and health professionals to communicate with the elderly from distant locations, and even therapeutic robots, which can provide emotional support.
With new innovations emerging from everywhere, it’s clear that eldercare will be well served by technology, which will get better every year. That said, the main obstacles to improving eldercare are non-technological. They have to do with such things as broader health policies, infrastructure, mechanisms for social connection and integration, labour policies, managerial and caregiving skills and innovative approaches to dealing with elders.
Big strides in recent years
In some of these areas, Singapore has made great strides in recent years. Among health policies, the recently launched Healthier SG scheme, which takes preventive care a step further, will delay the onset of age-related disabilities and enable them to be treated early.
The number of active ageing centres (AACs, formerly known as eldercare centres), which offer various recreational facilities, opportunities for companionship and information on care services, is to be increased from just over 150 at present to around 220 by the end of 2025. They will cover about 80 per cent of Singapore’s senior population and provide a wider range of services.
More financial support for long-term care is now available under CareShield Life and ElderFund schemes.
More elder-friendly housing is coming on stream with “vertical kampungs” and other assisted-living facilities such as Harmony Village @ Bukit Batok, which will offer flats designed to be elder-friendly, with easy access to medical attention. They will come with short and flexible leases of between 15 and 35 years, which will make them affordable to many senior citizens.
The HDB offers subsidies and grants to retrofit homes with elder-friendly features such as modifications of bathrooms and features that ease accessibility. Home-based services are available for elders who find it difficult to access services in the community, including doctor and nurse visits, palliative care and meal deliveries.
While some experts favour an “ageing-in-place” approach whereby people can age at home within their communities, this may not be practical for all. Some will need professional care round the clock that is not available in homes. What’s needed is a diverse range of residential facilities, including nursing homes available at different price points. The Ministry of Health plans to double the number of nursing home beds to more than 31,000 by 2030.
There have also been labour policy reforms in recent years that are pro-elder, including the increase in the proposed retirement age, a call for more flexible working hours with part-time work options, financial support for older workers under the SkillsFuture scheme and subsidies to employers to hire such workers.
While all these initiatives are welcome, there is more to do to further improve the eldercare ecosystem.
Easing manpower constraints
The planned expansion of facilities will call for significant increases in healthcare staff. There are plans to expand training for them, but the Ministry of Health acknowledges that Singapore will still have to rely heavily on foreign workers in this area.
To attract more qualified staff – both domestic and foreign – salaries will need to be raised. While pay scales have been going up, they will need to remain competitive – not just with those in other parts of the health system, but also internationally, given that the demand for eldercare workers is soaring in parts of East Asia and Western Europe. Some of these countries are offering not only more attractive salaries than Singapore for eldercare workers, but also pathways to permanent residency and citizenship.
Around the world there are innovative approaches to eldercare which Singapore can adopt or adapt.
Pet therapy, music therapy and art therapy, which have been proven to be effective in improving the mental and emotional well-being of elders, are now widely used. Such services can be expanded.
Japan, which has one of the most advanced eldercare systems in the world, has several unique innovations, including elder-friendly malls and supermarkets, which are laid out differently and offer goods and services, including restaurants that cater to elders. It also has an arrangement called “fureai kippu” or “caring relationship tickets”, which allows individuals to earn credits by caring for the elderly in their community, which can be saved for the individual’s own future care.
Many countries encourage interactions between elders and young people through collaborations with schools. For example, in Japan, school children, as well as young volunteers, visit eldercare facilities. Under a programme in the US called Experience Corps, seniors volunteer in local schools. In the city of Cleveland, there is even an intergenerational school, which allows for daily interactions between students and older adults.
Intergenerational interactions have been proven to improve mental health and slow cognitive decline among the elderly, while the young benefit from improvements in social skills, a reduction of ageist attitudes and greater exposure to life lessons.
With so much to learn from the world, there is a case to encourage foreign direct investment (FDI) in eldercare services, through incentives comparable with those in areas such as technology and manufacturing provided by the Economic Development Board, so that not only the latest technologies but also the best practices can be transferred to Singapore.
Given the prevailing demographic trends, FDI in eldercare, too, should be given as much priority as sectors that have been traditionally promoted.
Correction note: In an earlier version of the story, we said that “People aged 65 and above make up almost one-fifth of Singapore’s population.” The Department of Statistics has clarified that this proportion applies only to Singapore citizens. We had also indicated that “this was up almost 12 per cent from a decade ago.” It should be “this was up from almost 12 per cent from a decade ago.” We apologise for the errors.
Source: The Straits Times © SPH Media Limited. Reproduced with permission.
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