Decentralisation of Care for Older Adults in Singapore

Introduction

As Singapore’s population continues to age rapidly, the need for innovative solutions to provide comprehensive and accessible care for older adults has never been more pressing. One promising approach gaining traction is the decentralisation of care, particularly through the concept of Naturally Occurring Retirement Communities (NOACs). This strategy leverages existing community infrastructure to create a network of localised care facilities and services, thereby enhancing the quality of life for seniors while easing the burden on centralised healthcare systems.

Concept of Naturally Occurring Retirement Communities (NOACs)

NOACs are not a new concept; they involve transforming existing residential clusters into supportive environments for older adults. In Singapore, each Housing and Development Board (HDB) estate can be viewed as a potential NOAC. By leveraging the already familiar community layout, we can enhance these estates with additional facilities and services tailored to the needs of seniors. This approach builds on the idea that older adults benefit from remaining in familiar surroundings where they are surrounded by a supportive network.

Decentralised Care Model

The decentralised care model proposes the conversion of several levels of HDB blocks into care homes within each estate. These care homes would be complemented by various essential services such as food outlets, grocery stores, medical clinics, and laundromats. This setup would allow seniors to access a broad range of services within their immediate community, reducing the need for travel and increasing convenience.

The integration of these services within HDB estates could include:

- Care Homes: Dedicated levels within HDB blocks transformed into residential care facilities to provide support for seniors with various levels of needs.

- Active Ageing Hubs: Centers offering recreational and social activities designed to keep seniors engaged and active.

- Day Care Centres: Facilities providing daytime care and support for seniors while their family members are at work.

- Medical Clinics: Accessible primary care services within the estate to handle routine health needs.

Government Role and Public Service

The decentralisation of care can be supported by government initiatives, providing a public service model that ensures equitable access to essential services across the population. The government could act as a central organiser, akin to a centralised kitchen supplying food products to numerous small supermarkets. This model allows for streamlined coordination and consistency in the quality of care and services provided.

Integration of Advanced Healthcare Services

To address higher-function healthcare needs, the decentralised care model can incorporate advanced solutions such as:

- Teleconsultations: Healthcare attendants can facilitate teleconsultations for more complex medical needs, enabling seniors to receive specialist advice without leaving their estate.

- Automated Dispensaries: These can be installed within the community to provide automated medication dispensing, ensuring that seniors have easy access to their prescriptions.

- Routine Monitoring and Screening: Regular health checks for conditions such as sarcopenia, osteoporosis, hearing, and vision impairments can be conducted within the community, allowing for early detection and intervention.

Conclusion

The decentralisation of care for older adults in Singapore represents a transformative approach to addressing the needs of an aging population. By utilising the NOAC concept and integrating various services within HDB estates, we can create a supportive, accessible, and efficient care environment. This model not only enhances the quality of life for seniors but also optimises resource utilisation and alleviates pressure on centralised healthcare systems. As Singapore continues to adapt to demographic changes, the decentralised care approach offers a promising path forward in fostering a healthier, more connected community for its older residents.

About the Author

Dr. Tan Jit Seng is a seasoned medical professional with over 22 years of experience in the field. Since 2009, he has dedicated his career to serving the community, managing and running transitional care services that bridge the gap between hospital care and home-based care. His extensive experience spans a variety of healthcare settings, including home care services, nursing homes, and community care clinics.

Dr. Tan's diverse medical background includes postings in Intensive Care Units (ICU), Emergency Departments, and various specialized fields such as Surgery, Orthopedics, Internal Medicine, Geriatrics, and Family Medicine. His wide-ranging expertise has enabled him to provide comprehensive care to patients across different stages of life and health conditions.

During the 2003 SARS epidemic, Dr. Tan played a crucial role in hospital services, contributing to the frontline efforts to manage and contain the outbreak. His commitment to public health was further demonstrated during the COVID-19 pandemic in 2019, where he spearheaded community vaccination services for nursing homes and special education schools, ensuring vulnerable populations received the protection they needed.

With his wealth of experience and deep commitment to community health, Dr. Tan Jit Seng continues to be a leading figure in providing high-quality, accessible healthcare to those in need.