Govt working closely with nursing homes to improve care for seniors

MOH and AIC's Reply

Straits Times and Lianhe Zaobao, 24 October 2016

Govt working closely with nursing homes to improve care for seniors

Nursing home operators here are passionate about caring for our seniors ("Nursing homes have made efforts to raise standards" by the Sree Narayana Mission (Singapore) and other homes; Oct 13, and "Evaluate future need for dorm-style nursing homes" by the Lien Foundation; last Wednesday).

The Ministry of Health (MOH) and Agency for Integrated Care (AIC) thank them for working tirelessly with us to improve the physical and psycho-social care for seniors.

Quality nursing home care is multi-dimensional, and infrastructure provision is only one aspect. 

In the past few years, the MOH and AIC have worked to enhance care staff salaries and training, raise care standards, as well as improve the living environment within nursing homes. The MOH has and will continue to try out new nursing home designs that can be more home-like, including smaller four-bedded rooms, and common living and dining spaces.

We have also injected some single rooms in government-built nursing homes for residents who need to be isolated or require some quiet time. 

From our calculations, development costs could almost double, and operating costs will also increase significantly if nursing homes are constructed with only single and double-bedded rooms. This is primarily due to the need for additional space and manpower, both of which are scarce in Singapore.

More land may also be needed to build additional nursing homes.

If we convert all nursing homes to be single or double-bedded rooms, the escalation in cost will ultimately be borne by patients and their families, as well as taxpayers.

Nursing homes have also pointed out that not everyone prefers single rooms.

We welcome the Lien Foundation's clarification that, given the space and cost constraints, it had never been its view that Singapore should build only single rooms, but to allow more choice and diversity in our nursing homes.

The MOH will continue to provide a mix of options to meet the diverse needs of our seniors.

Our surveys consistently show that seniors prefer to age in place, in the familiar surroundings of their own homes. The recent survey by the Lien Foundation and NTUC Income confirmed this as well.

The MOH will continue to enhance our suite of home and community-based care services to better support what seniors want.

Lim Bee Khim (Ms)

Director

Corporate Communications

Ministry of Health

Andy Seet

Director

Corporate and Marketing Communications

Agency for Integrated Care

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Forum Letter

Straits Times and Lianhe Zaobao, 13 October 2016

Nursing homes have made efforts to raise standards

While there may be a need for more eldercare options, our experience has been that not everyone prefers single rooms ("Nursing needs"; last Thursday).

During the Lions Home Inaugural Nursing Home Conference 2015, residents from various nursing homes said that they preferred not to stay in a room on their own because they were brought up in an extended family and were used to having people around them.

They spoke of their fear of being alone, and many of us can share stories which affirm that loneliness is one of the biggest fears for the elderly. This can strike regardless of generation or accommodation type.  

At a glance, care models of other countries may seem attractive. However, these come at a cost.

As charity organisations dependent on public donations, we need to be prudent.  

More studies are needed to understand and to represent the preferences of seniors and the sustainability of various care options.

As service providers, we acknowledge some of the challenges highlighted.

However, many homes have made progress in improving care despite limited resources, through the support of donors, committed volunteers and dedicated staff.

Being branded in one sweep as "soulless" in the Safe But Soulless study on nursing homes, commissioned by the Lien Foundation and Khoo Chwee Neo Foundation - despite our collective efforts to improve the quality and standard of nursing homes - is difficult to accept.

In particular, we firmly believe that the social well-being of our residents is equally important, and we have made many improvements in this area.

Many homes have committed volunteers who interact regularly with residents - by befriending them, and through "kopitiam" sessions and karaoke.

Residents also have the choice to participate in various music and art therapy activities. Special arrangements are also made in some homes for bedridden residents to enjoy outdoor activities.

More resources could be given to support these efforts.

Indeed, we should focus our efforts on how we care for residents and treat them with dignity, respect and trust - as, at the end of the day, this is what will make the difference.

S. Devendran
Chief Executive
Sree Narayana Mission (Singapore)

This letter carries the signatures of representatives from Kwong Wai Shiu Hospital, Lions Home for the Elders, Man Fut Tong Nursing Home, Moral Home for the Aged Sick and Singapore Christian Home.

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Forum Letter

Straits Times and Lianhe Zaobao, 19 October 2016

Evaluate future need for dorm-style nursing homes

Representatives from a few nursing homes have responded in a letter ("Nursing homes have made efforts to raise standards"; last Thursday) to a study, entitled Safe But Soulless, commissioned by us, on the state of nursing-home care in Singapore.

We thank the writers for acknowledging the challenges highlighted by the study.

Many points made by the signatories have already been made in the study. For instance, the letter states that while there may be a need for more eldercare options, not everyone prefers single rooms. 

Our study, which interviewed more than 50 long-term care experts, including nursing-home operators, notes that opinion is divided on whether Singapore should have subsidised single or twin-bed rooms in nursing homes, and meticulously presents both points of view.

Given space and cost constraints, it has never been our position that Singapore build only single rooms. We would, however, like greater diversity and choice. 

The letter also states that more studies are required to understand and represent the preferences of seniors.

One such survey of nearly 1,000 respondents released yesterday by Lien Foundation and NTUC Income shows that 60 per cent agree that residents should stay in single or twin-bed rooms rather than in six-bed wards.

It is worth noting that Japan, including densely packed Tokyo, stopped building dorm-style nursing homes more than 40 years ago. Yet, nursing homes in Singapore continue to house between six and 30 residents in a room. Many live like that for years.

It's time to carefully evaluate whether we should continue building such taxpayer-funded, dorm-style homes, given that it will be very expensive to retrofit them to keep pace with changing preferences of future cohorts of the elderly.

Another 5,000 nursing-home beds are expected to come on-stream by 2020. We suggest that these be made future-proof with a majority of single and twin-bed rooms and some four-bed wards.

The study also details progress by nursing homes to shore up care and better balance health and safety needs with succour for the soul by engaging residents in meaningful activities.

Indeed, some homes are doing a remarkable job in these areas, despite manpower constraints, and the study shares their best practices across two chapters.

However, even the best homes here pale in comparison with the best available in other advanced nations. Collectively, we can do better - and we must.

Lee Poh Wah

Chief Executive

Lien Foundation and on behalf of Khoo Chwee Neo Foundation