AUG 16 — While it is romantic to envision a global city with all the qualities attractive to both young and old, it can be a nightmare for the urban planner who has to think of managing with scarce resources such as land, finance and manpower, for a small island like Singapore.
It is well known that Singapore is one of the most liveable cities in the world, but is it age-friendly?
Significantly, the World Health Organisation’s Age-Friendly Cities framework highlights the social aspect of communities, and not just barrier-free or accessibility features.
On the same note, the International Longevity Centre lists the main characteristics of sustainable “lifetime neighbourhoods” as: social cohesion and sense of place, housing, innovation and cross-sectoral planning, built environment, social inclusion, and services and amenities.
In any discussion of age-friendly communities, the physical, social and recreational aspects have to be given equal importance.
Defective kerbs and loose flagstones are high risk factors for falls among both young and old. I have noted while travelling abroad that small but thoughtful modifications to the environment go a long way to enabling seniors to be independent and mobile. The availability of benches along street pavements is a major factor, and public toilets and accessible shops with friendly sales operators also can make a great difference.
In our heartlands, risks to the lives of young and old are prevalent, due to the lack of consideration among car and bus drivers for pedestrians. The overhead bridges are marathon uphill challenges for pregnant women and elders. I know of one elderly gentleman who suffered a heart attack when he arrived at the top of an overhead bridge!
And, with an ageing population, we need more traffic junctions with pedestrian crossings and disabled-friendly technology.
SHIFTING MINDSETS: THE VALUE OF SENIORS
Together with the “brick and mortar” infrastructure, there needs to be an inculcation of a “caring and considerate” (C&C) societal infrastructure. A mindset change has to occur with our demographic shift from youthful to ageing population; this is critical to the nation’s balance and integration.
The C&C attitudinal shift has to be in all segments of society — family, community, workplace, playground, recreational and tourist spots, ticket booths and hospitals. It is hypocritical to state that we respect our elders but, in reality, we may be ignoring their input on decisions and issues that impact them.
The various media channels tend to depict older citizens as “needing” care, but it is surprising that we tend to forget that they “give” lots of care too. Social research has shown that, at the young-old stage, seniors are giving financial, social and physical support and care to their family members at both ends of the spectrum — that is, their ageing parents as well as their near-adult children.
When they have grandchildren, they chip in to supervise foreign maids or provide care directly. According to the National Survey of Senior Citizens 2011, 29 per cent of seniors with grandchildren care for them. And 41 per cent of spouses provided care to an ill spouse. These are not factored as “economic contributions”, hence they tend to be overlooked by policymakers and economists.
There are mixed messages juxtaposed in government press statements sometimes, when Singapore is promoted as a nation of opportunities for ambitious and highly-driven young adults — yet, at the same, time its population is ageing.
The public and stakeholders should note that an ageing population is not necessarily a burden to society. The older population is very diverse in almost every aspect — financial, health, social, physical, education, religion and personality. To generalise about a group of people amounts to stereotyping.
SMALLER HOMES, BETTER CARE
As an affluent nation, Singapore is well-positioned to improve social and healthcare provisions for its people. It is good that a public consultation is under way for enhancing nursing home standards. This is an arena that, in my opinion, requires urgent attention.
As the demand for nursing homes increases, the quality of holistic care and response to patients’ needs must improve, particularly with the changing characteristics of our ageing cohorts — the seniors of the future will expect better professional care, and so would their families.
There has been a lag in the professionalisation of the gerontology or eldercare service sector in terms of the training requirements of staff. It is imperative to ramp up locally available courses in gerontology, nursing, occupational therapy, physiotherapy, social work and counselling.
As services and institutional facilities expand, the government has to also step in to ensure standardisation of care and programmes. Lack of minimum competency standards — for example, a Certificate in Ageing/Gerontology for staff of Senior Activity Centres — puts Singapore in poor light when compared with other developed countries.
Compared with other nations, it is also noticeable that our nursing homes are still designed in a “hospital-like” fashion. In Japan, there has been a trend towards group homes and small-scale care houses, and such housing adaptations are being made in European countries such as Denmark and Holland, where research shows that residents place much value on the cosy and comfortable atmosphere of smaller physical facilities — compared to a large nursing home that accommodates 100 to 200 residents.
Large institutions cater more to the need for efficiency and custodial function of the administration, but less to the social and physical needs of the residents. The trend in institutional facilities in developed nations is to provide client-centric care — and this is the direction Singapore should also take, to be an age-friendly city. — Today
* Associate Professor Kalyani K. Mehta is head of the Gerontology Master’s Programme at SIM University.
* This is the personal opinion of the writer or publication and does not necessarily represent the views of The Malay Mail Online.
