1. Lessons Learnt for Ageing in Singapore
Thelma Kay
ACHA , Kuching , October 2017

2. Demography/Ageing Landscape of Singapore
Total Population : 5.78 million
Total fertility rate: 1.2
Life expectancy: Males Females 85.1
Smaller household size
Increasing number of older old – frail, vulnerable
Feminization of ageing
>90% in high-rise housing, 82% in public housing
<0.3% of 65+ in institutional care

3. Singapore’s Ageing Landscape
Old Age Support Ratio*
Elderly Persons : Persons of Working Age
2010
2020
2030
One in five residents will be over 65 in 2030
*Definition of old age support ratio should be re-examined

4. Principles and policies
Whole of government approach (multisectoral, multiagency)
Older persons as resource/asset not burden/problem
Culture and tradition – filial, social piety (Pioneer Generation Package)
Building blocks at different levels (many helping hands)- self, family, community, government
Inclusive society – greater collective responsibility and social solidarity, co-create society

5. Institutional Framework
Ministerial Committee on Ageing (multisectoral)
Age Planning Office - under Ministry of Health
Agency of Integrated Care (AIC) – coordinates and integrates long-term care ,under Ministry of Health
Action Plan for Successful Ageing (2016)
Healthcare 2020 Masterplan
Smart Nation ( digitally enabled population)
Laws: Maintenance of Parents Act
Mental Capacity Act
Elder/family friendly provisions in other laws
eg. income tax

6. Economic policies Social security policies:
- Central Provident Fund : Mandatory comprehensive savings schemes used essentially for retirement, healthcare , housing
Employment and labour market policies:
- Extend retirement age ( Reemployment Act 2012)
Tax policies
Immigration policies esp. for foreign domestic workers, care staff

7. Infrastructure polices (housing)
Universal design for all government housing
Falls prevention programme (screening, workshops)
Home modification - Enhancements for Active Seniors (EASE), now nationwide
-Subsidized elder-friendly home modifications to improve home safety e.g. anti-slip floor treatment, grab bars for falls prevention.

8. Health and care policies
Promoting a healthy body and mind
- Health screening with follow-up
Health counselling
Community nurses
Link to neighbourhood doctors
- Mental First Aid Kit – to reduce risk of mental illness
- Involving young generation
School health promotion programme
Health promoting schools (youth ambassadors)
Healthier food options in food outlets (Healthier Hawker Centre initiative)
Health Promotion (exercise stations,walking trails, interest groups )
National Seniors’ Health Programme
Workplace health programme

9. Social Policies Community based support Family friendly policies
Community facilities ( community club, senior centres, etc)
Activities (e.g. sports - activeSG , courses - course Xpress etc
Neighbour help neighbour, befriending and monitoring network.
Family friendly policies
Tax relief for parental support, more for living together
Priority given to multigenerational housing
Family life education
Maintenance of Parent Act
Social assistance programmes
Comcare schemes (benefits and transfers) etc…

10. Coordination and cooperation
Coordinated at high level - Ministerial Committee on Ageing
Holistic, multisectoral and integrated - economic, health, housing/infrastructure, and social services
Plan, process, implement
Design actual and specific services
Establish quantitative outcome indicators
Assign interministerial responsibilities
“Many helping hands” - web of support from family, community, VWOs, private and public sector
Learning from other countries e.g. intergenerational contact zones (playgrounds, childcare/eldercare centres, Project Spring-Winter)

11. Implementation and monitoring
Ministries and agencies in their respective sectors
NGOs as service providers
Community-based delivery by location/shared affiliation (e.g. faith-based)
Task forces to supplement or course-correct eg. task force on transport
Monitoring in accordance with KPI
Periodic review by Ministerial Committee on Ageing
Reporting to parliament ( especially Committee on Supplies), ASEAN , United Nations and other bodies

12. Issues for further action
Co-ordination between Health and Social Ministry (even intraministry)
Insufficient involvement of Finance Ministry and Social security office
Over-reliance on NGOs for delivery of services
Life course approach not reflected in ageing plan (education, savings, health)
New old , better educated, still healthy – higher expectations but more ready for self-care, ageing in place, technology, new economy
Avoidance of hard truths – need for nursing homes, inadequate retirement income, future of work, LTC, dementia