Seniors

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Overview

This overview provides a synopsis of the current knowledge base. Having considered all the information, we make sense of it by taking a stab at the following: 1) What are the priority issues that deserve attention, 2) What are opportunity areas that community or voluntary organisations can already take action on, and 3) What knowledge gaps deserve further investigation?

Priority Issues

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Actionable Opportunity Areas

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Knowledge Gaps

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Definitions

Definition of [insert your target group / issue]

  • Identify and define your target group or social issue, and state who is included or excluded to provide a sense of the scope of the issue. (For example, will the page on Animal Welfare include livestock? Or just focused on pets, community animals and wildlife?)
  • It is usually easier to start with national guidelines, laws or reports from apex organisations.
  • Include a comparison with how other countries define the issue if possible (e.g. Local definition of Disability does not include mental health conditions)

Key Statistics & Figures

  • Size of target population / prevalence rate: Ideally, it would be the total number of people in your target group, identified by national censuses, surveys or research. When data isn't available, try using the best available proxy, e.g., number of people receiving key services.
  • If the issue you are interested has many sub-segments and sub-pages, then only include the key figures that affect all or most stakeholders in the sector here and leave the other relevant figures at the specific segment or page. This reduces cognitive load for the reader & contributor.

Map of Key Needs & Issues

[This table and arrows acts as a kind of visual map that allows a sense of sequencing; of the broad preconditions necessary for longer term outcomes to be achieved. Hyperlink the categories below to the specific page or sub-header in the page for easy navigation, so that you can click on 'Employment' below for example, and get straight to that page / segment]

Click the links below to go directly to specific areas of interest:

Health & Well-being / Active Ageing ↘
Family & Caregiving ↘
Social Inclusion → A Good Death / End of Life
Community Integration ↗
Financial Security ↗
Lifelong Learning ↗

Sub-pages

  • Dementia (cross-linked with Mental health)

Areas of Needs / Desired Outcomes

Health and Well-Being

  • Desired Outcome: [To insert]
  • Synopsis: [To insert]
  • Statistics: [To insert]
Existing Programmes Gaps & Their Causes Possible Solutions
Category A
Category B
Category C
Category A Programmes
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Category B Programmes
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Category C Programmes
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Family & Caregiving

  • Desired Outcome: [To insert]
  • Synopsis: [To insert]
  • Statistics: [To insert]
Existing Programmes Gaps & Their Causes Possible Solutions
Category A
Category B
Category C
Category A Programmes
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Category B Programmes
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Category C Programmes
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Community Integration

Existing Programmes Gaps & Their Causes Possible Solutions
Category A
Category B
Category C
Category A Programmes
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Category B Programmes
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Category C Programmes
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Lifelong Learning

  • Desired Outcome: [To insert]
  • Synopsis: [To insert]
  • Statistics: [To insert]
Existing Programmes Gaps & Their Causes Possible Solutions
Category A
Category B
Category C
Category A Programmes
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Category B Programmes
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Category C Programmes
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Financial Security

End of Life

Resource Directory

Geriatric Education and Research Institute - GERI

http://geri.com.sg

A geriatric Institute based in Singapore to conduct research and education on age-related health issues to promote healthy ageing.

Tan Tock Seng Hospital's Institute of Geriatrics and Active Ageing - IGA

https://www.ttsh.com.sg/IGA/

Temasek Polytechnic’s Centre for Applied Gerontology - CAG

http://www.tp.edu.sg/centres/centre-for-applied-gerontology

Silver Horizon Travel

http://silverhorizontravel.com/

cooperative formed by seniors for travel

Lien Foundation's Eldercare Portfolio

http://www.lienfoundation.org/eldercare

Tsao Foundation

https://tsaofoundation.org

International Longevity Centre (Tsao Foundation)

https://tsaofoundation.org/what-we-do/research-and-collaboration/about-ilc-singapore

Research unit under Tsao Foundation

Society for Continence (Singapore)

http://www.sfcs.org.sg/medi_page/site_web_sfcs/common_page.asp

References



Client Segments

[Use this table to structure newspaper articles?]

Date Description
27 March 2012 Straits Times special feature on OCD, featuring the disorder and stories of persons in recovery
07 February 2017 Straits Times Op-ed by IMH psychiatrist Chong Siow Ann on OCD

- https://www.todayonline.com/commentary/creating-dementia-inclusive-society-singapore

- https://www.todayonline.com/singapore/domestic-worker-jailed-5-months-abusing-elderly-woman-dementia-because-she-refused-sleep

- https://www.straitstimes.com/singapore/health/guide-provides-alternatives-to-hurtful-words-used-to-describe-people-with-dementia

- https://www.asiaone.com/lifestyle/what-happens-if-my-parents-get-dementia-step-step-guide

- https://www.straitstimes.com/singapore/an-app-to-help-unlock-dementia-patients-memories

- https://www.todayonline.com/singapore/coming-2020-dementia-friendly-app-seniors-loaded-museum-provided-content-jolt-memories

- https://www.todayonline.com/singapore/down-not-out-people-living-with-dementia-rise-become-ambassadors-illness

- https://www.channelnewsasia.com/news/singapore/singapore-dementia-caregiver-missing-items-temper-tantrums-11942262

- https://www.straitstimes.com/singapore/dbs-posb-staff-being-trained-to-aid-clients-with-dementia

- https://www.straitstimes.com/singapore/engaging-youth-in-dementia-outreach-activities

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Size of the Problem

[Size of the universe (size of total potential need/demand for services)] [Size of expressed need (those receiving services and on waitlist)]

Desired impact for target group

[If we have no conception of what counts as a ‘good death’, ‘social inclusion’, ‘engaged youth’ , then it would not be possible to determine whether our policies and services are performing well]

Needs of [insert client type]

Need for [ insert description ]

[Needs should not be identified in term of its specific solutions—eg youths need mentoring, seniors need hospice care, people with disabilities need day care (these are specific solutions we can be in the next column)—Instead, they should be defined in more ‘perennial terms’ because the solutions can change but the needs remain; I don’t need a CD player, or even an mp3 player, I need ‘portable music’ and currently the best solution seems to be Spotify]

[Also indicate the size of this specific need & projected demand were data is available]

Existing Resources

[e.g. existing services or programmes both private or public; relevant policies and legislation]

Gaps and Their Causes

[Some gaps could be due to 1) capacity of solution to meet size & projected demand, 2) quality of solution (effectiveness, efficiency, sustainability, scalability etc.), 3) accessibility (geographical, cost to client)]

Possible Solutions

[Based on the specific gaps and reasons for those gaps, what might be solutions that can help? Insert existing but untapped resources, or new ideas that have not been considered yet]

Need for counter social and cultural myths about aging

Existing Resources

d

Gaps and Their Causes

Possible Solutions

AARP's Disrupt Aging initiative

Need for End-of-Life Planning

Existing Resources

  1. Lasting Power of Attorney (LPA) allows a person of minimum 21 years old to voluntarily appoint one or more persons to make decisions and act on his behalf in the event of loss of mental capacity. The appointed person(s) can make decisions within broad categories of either 'Personal Welfare' or 'Property & Affairs' or both.[1]
  2. Advanced Medical Directive (AMD) is a legal document signed in advance to inform the doctor that one does not desire any extraordinary life-sustaining treatment to extend one's life in the event of terminal illness and unconsciousness. Anyone who is aged 21 years and above and without a mental disorder can make an AMD. [2]

Gaps and Their Causes

Resources above are available for individuals to plan and record their end-of-life wishes. However, there are several barriers that impede end-of-life discussions which are required for using these resources.

  1. Cultural and social barriers to discuss death and dying. [3] For example, the Chinese tend to regard death as evil and inauspicious and hence do not discuss it out of fear of inducing bad luck. [4]
  2. Family's difficulty accepting the patient’s dismal prognosis and impending death. Hence, they avoid conversations on death and dying as a coping mechanism to maintain hope and optimism regarding the patient’s disease recovery; protect themselves from emotional vulnerability associated with losing a loved one; and prevent intensifying negative emotions within the family.[5]
  3. Physicians avoid initiating end-of-life conversations for fear of reducing patients’ hope in the success of curative treatment. [6][7][8] However, what is important for maintaining patient’s hope is not the statistical effectiveness of medical treatment to prolong their life [9]. Patients conceive of hope in terms of the preservation of one’s self-identity - sustaining everyday routines and roles, preserving personal relationships, and maintaining control over their life (ibid). They are concerned with how medical interventions would affect their concept of self; how they could still find meaning in social relationships; and how they could minimise distress (ibid)
  4. Physicians often wait until all available curative treatments have been exhausted or symptoms of impending death surfaces before discussing end-of-life options with terminally ill patients. [5] Physicians may perceive death as an enemy they need to help patients avoid and defeat, not prepare for its arrival (ibid). Hence, they find it hard to initiate end-of-life discussions with patients as it equates to an admission of failure in their duty. [6]
  5. No formal/routine procedure within healthcare system for physicians to engage in end-of-life discussions with patients.[7] Hence, clinicians often lack proper structure and dedicated time to discuss end-of-life issues with patients (ibid).

Possible Solutions

  1. "Live Well. Leave Well." 3-year public education campaign by MOH and Singapore Hospice Council.[10] The campaign seeks to change how people perceive death and dying; encourage open discussions on what matters to them, and make plans in advance. In turn, it seeks to reduce situations where people make emotionally-charged decisions during a crisis, or loved ones are stressed out by surrogate decision-making as they are unsure of the individual's wishes.[11]
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